Between-Session Communication Policy: A Practice Checklist

A useful between-session communication policy tells clients and staff what each channel is for, when it is reviewed, what cannot be handled there, how privacy and documentation are managed, and what route to use for urgent or emergency needs. The policy should be readable before a client needs it and realistic for the practice to follow consistently.

Before reviewing the wording, name the people responsible for the system behind it:

Policy checklist

1. Purpose and scope

• Which uses are supported: scheduling, billing, forms, brief updates, clinical questions, or something else?
• Which uses are not supported in that channel?
• Does the policy distinguish administrative messages from clinical content?
• Does it explain whether communication becomes part of the clinical record?

2. Approved channels

• Which portal, phone line, email address, or other route should clients use?
• Who monitors each route?
• Are unapproved personal numbers, social accounts, or staff inboxes addressed clearly?
• Does the channel description match the practice’s actual technology and privacy configuration?

3. Response expectations

• What is the normal review window in business terms the practice can keep?
• Are weekends, holidays, leave, and coverage explained?
• Does an automatic acknowledgement avoid implying that a person has read or acted on the message?
• Who is the backup when the normal responder is unavailable?

4. Clinical limits

• Which topics are better addressed during a session or another clinically appropriate contact?
• How will staff respond when a message contains more clinical material than the channel can safely support?
• Does the policy avoid promising care that the practice is not structured, licensed, or paid to provide?

5. Privacy and documentation

• Has the practice’s privacy/security owner reviewed the channel and wording?
• Are clients told about relevant risks and alternatives in plain language?
• Is documentation responsibility clear when a message affects care?
• Do retention, access, and deletion claims match actual systems and applicable requirements?

6. Urgent and emergency routes

• Does the policy say the routine channel is not continuously monitored if that is true?
• Are urgent and emergency instructions current, location-aware, and reviewed by clinical leadership?
• Does the workflow distinguish a delayed message from a real-time crisis service?
• Is staff escalation training consistent with the public wording?

7. Accessibility and inclusion

• Is the policy available in accessible formats and languages appropriate to the practice?
• Does it account for disability-related communication needs through the practice’s reviewed process?
• Can a client understand the next step without clinical or legal jargon?

Test the policy with five scenarios

Ask a reviewer to locate the correct route for:

1. changing an appointment;
2. asking about a charge;
3. sending a nonurgent update before session;
4. raising a concern while the therapist is away;
5. seeking urgent help outside the practice’s response window.

If the reviewer hesitates or chooses a different route than staff would, revise the system—not only the sentence.

Evidence and limits

APA guidance emphasizes setting communication and boundary expectations early in clinical practice. Privacy, records, consent, crisis, licensure, and payer requirements vary and must be reviewed for the practice’s services and jurisdictions.

Source

• American Psychological Association: The benefits of better boundaries in clinical practice

Completion state

The checklist is complete when the public policy, staff workflow, technology configuration, consent materials, and urgent routes describe the same real system. Record each approval and the next review date; do not rely on a policy that is “done” but has no owner.