Home-Based Psychotherapy

Add variability, clients, and an additional source of income to your practice

Home-based psychotherapy or In-Home therapy refers to situations where psychotherapists, social workers or counselors travel to conduct therapy or assessment at the site where a client resides. This type of practice comes with many advantages for clients and clinicians – the clinician has the benefit of seeing how and where the client lives and conducts treatment or assessment in the client’s natural setting. It is a chance for clients to enjoy the convenience of therapy/assessment that comes to them. It also comes with added complexities in the areas of boundaries, logistical arrangements, safety, and confidentiality.

With growing numbers of 3rd party payers, including Medicare, reimbursing for home-based therapy, this is a ripe and timely area for many practitioners to explore. Because home-based psychotherapy comes with its own advantages, challenges, and treatment opportunities, we recommend becoming informed beforehand.

Our 3 CE Credit Hours Course can help you get started:

In-Home Therapy, Home Visits, or Home-Based Therapy. (3 CE Credit Hours), Course includes MP3 audio interviews with experts.

Here are some relevant issues to consider:

• Some clients are homebound and unable to visit an office for psychotherapy for reasons that can range from agoraphobia to being bed-ridden for medical or old age reasons. While telemental health may be an option for some home-bound clients, it also may not be for a variety of reasons. Furthermore, many people prefer face-to-face sessions, as many psychotherapists are likely to appreciate.
• Seeing clients in their homes instead of a regular office has a different rhythm to the work. Visits are usually longer than the standard 50-minute clinical hour, and therapists therefore do fewer sessions in a given day.
• Not every client is a good candidate for home-based psychotherapy. Some issues to consider are Is it safe? Is there minimally necessary privacy? Is there a comfortable place to talk? Does the client feel safe at home? Can the client and therapist concentrate on therapy at the home setting?
• Since home-based psychotherapy occurs on the “home turf” of the client, he or she may feel more empowered than in a traditional office setting. Therapists should be aware of the potential loss of control they may experience in situations where the client has more expertise regarding their neighborhood, pets, and home setup.
• Interesting boundary situations arise with home-based mental health services. A therapist may be asked to answer the door, hold a child, loan money, drive to a local market or pharmacy, etc. Most clients feel less inhibited at home than in the setting of a traditional practitioner.
• Adding home visits to one’s practice may be financially lucrative and can add variety to one’s practice, which can prevent professional burnout.

Home-based therapy has many benefits for clients and psychotherapists. The creative change of environment can make therapy more accessible for clients in terms of logistics and comfort. The psychotherapist can benefit from experiencing the client’s life in a more complete way than simply hearing the client’s reports. It’s possible for the therapist to suggest life changes in the home to support the client’s growth. For clinicians interested in exploring home-based psychotherapy or home-based visits to augment regular office therapy, we recommend the following:

• Get informed of the complexities of Home-Based or In-Home therapy
• Review our free overview of In-Home Therapy Checklist
• Take our 3 CE Credit Hours Home-Based Psychotherapy Course (3 CE Credit Hours)
• Find a colleague with experience in this area to serve as a mentor, consultant or supervisor
• Consult on difficult cases with experts
• See also this related online course on Out of Office Experiences

Notes of Interest:

• Exciting development regarding issues of crossing state lines
• Crossing state lines is discussed further in our comprehensive TeleMental Health online course

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