Q: Why “Home-based” counseling and psychotherapy?
A: When I first introduce myself as “a psychologist who makes house calls,” many people are surprised because they had never heard of such a service. (It’s true there are very few psychologists offering this service compared to those working in offices and clinics.) People are usually delighted to hear that it’s available.
We usually think about mental health services as one person or more people talking to a mental health professional such as a psychologist, psychotherapist, or psychiatrist. However, many people and communities don’t have access to these professionals, offices, or clinics. Therefore, a broader view of mental health care involves a “psycho-social” approach and integrated services such as community centers and other services assisting people with access to food, general health care, affordable housing, child care, jobs and job training, financial assistance, etc. Case management and care coordination address the fact that it is difficult for many people lacking those services and/or having their basic needs met to show up for psychological services and psychotherapy.
This is why home- and community-based psychotherapy are so important.
The main advantages of home- and community-based services are:
Flexibility & Convenience.
Flexibility with Time & Place:
A client might be limited in their ability to travel to a clinic or office.
Some people are unable or unwilling to go to a clinic or office during regular daytime business hours and would prefer afternoons and evenings. For example, parents often appreciate appointments that don’t interfere with a child’s school day or that can take place in more than one home.
Flexibility within Sessions: Any given session can be separated into sections; for example, I might meet with one person for part of a session, then others might join in for the remainder. Session length is not as rigid as in office or clinic settings.
It’s helpful to be able to observe and work with clients and their families in their natural environment. Compared to office or clinic visits, clients really appreciate how quickly and comprehensively I can gain understanding of their daily lives and their routines and patterns or those of their family members.
Sometimes one or more members of a family are reluctant to participate in counseling; coming to the home can help people hesitant about the process become more comfortable with the service. For example, they can get to know me first without actually joining the sessions and, later on, decide to join in for part or all of a session.
Also, home visits offer a casual, relaxed environment to discuss often difficult topics. One of our basic needs is for emotional safety and security. It fosters health, growth, and rejuvenation. What better place to feel safe and secure than your own home?
I also help my clients by offering these additional services:
Attending Meetings: I can attend meetings with clients and other professionals.
Phone consultation is more accessible and available which includes Crisis Intervention. Also, you will not have to speak with anyone but me during our work together (I have no office staff etc.).
E-mail communication: I make myself available via e-mail to answer questions or to send relevant articles or exercises.
Q: What are some disadvantages to home-based services?
A: My fees might be higher than those charged at some clinics or private offices because the cost of providing the service is higher (travel being the most obvious reason). Contact your insurance company to see if your health care policy covers home-based psychotherapy, or call me and we can discuss insurance options or the private pay option. (I am in-network with Medica/UBH and they cover home-based psychotherapy.)
Another disadvantage is if the client does not want others living in their home to know they are working with me, then it might be best for them to see someone in a clinic or office.