Build a Between-Session Communication Policy

A client sends a message between sessions. Do they know when someone will read it, what can be handled there, and where to turn if the need is urgent? Your policy should answer those questions in language people can understand before they need help. It also needs to describe what staff can consistently do, including how messages are documented and privacy is handled.

Before you work on the wording, name the people who will keep the process working:

Policy checklist

1. Purpose and scope

• What can clients use this channel for: scheduling, billing, forms, brief updates, clinical questions, or something else?
• What should clients use a different route for?
• 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?
• Does the policy explain what happens if a message arrives through an unapproved personal number, social account, or staff inbox?
• Does the description match how the communication tool and its privacy settings actually work?

3. Response expectations

• When will someone normally review messages? Can the practice consistently meet that window?
• Are weekends, holidays, leave, and coverage explained?
• Is it clear that an automatic reply does not mean a person has read the message or acted on it?
• 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?
• Can clients understand the relevant privacy risks and their other options?
• When a message affects care, is it clear who records it and where?
• 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?
• Is it clear that a message read later is different from a crisis service available in real time?
• 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

Give a reviewer these five situations and ask where they would go:

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 gives a different answer from staff, find out why. You may need to change the process as well as the wording.

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

Before calling the checklist complete, compare the public policy with what staff do, how the technology is set up, the consent materials, and the urgent routes. They all need to describe the same process. Record each approval, the person responsible for keeping the policy current, and the next review date.