By Sally Fraser-Mackenzie

Post-COVID transitioning back to therapy

I’ve been back at work for 2 months and there have been the expected and necessary adjustments post-lockdown, and then other curve balls where I have had to make my own adaptive responses on the spur of the moment, which will be more interesting to read about!

Some of the expected changes that we have had to make include:

1) spending a small fortune on digital thermometers,

2) times between clients to spray and clean,

3) attendance and temperature registers set up,

4) writing up new COVID contracts pledging our commitment to a germ-free practice,

5) sanitizers,

6) cloths for each client to dry their hands,

7) clients being fearful and not coming,

8) clients being broke and unable to pay bills, and

9) a much more clutter-free practice with less surfaces to clean!

I put out a table with a basin of warm water for each client outside. We use all sorts of fun ways to wash when they arrive: kaleidofoam, glittery soap, squeezy foam soap that disappears after about 20 seconds, water toys, boats, and spraying activities.  I’ve been presenting “cleaning” activities that serve my goals but are also fun on arrival. Then I spend the session keeping tabs on what’s been touched, putting away toys for a week that have been played with, and encouraging my clients to keep their masks on, often to no avail. During some vigorous somersaulting, a little boy’s mask slid over his eyes, and we both had a good chuckle!

The unexpected curve balls are interesting.  A sibling of a client came to visit at the end of the session, then chaos reigned and everything got touched, played with, and I could no longer keep track. I needed to write the mom and dad a diplomatic email saying I understood that the sibling would so love to play, but during these times, I simply can’t allow it, and then listing the reasons. Of course, they were very understanding, but I still felt sad for that sibling.

Another little 4 year old girl arrived and took absolute fright at the thermometer gun. She even refused to let me take my own temperature. The new goal for her therapy suddenly became desensitizing this aspect of COVID, as she will be exposed to this when she goes back to school and at shops. We spent the next two sessions playing doctor-doctor with dolls, and in the end she loved taking their temperatures. We are still working on taking her own!

Previously angelic children are now more inclined to say “no” and show belligerence and refusal. They’ve been at home, watching screens and sometimes having either no or undivided attention from adults. So gently revisiting manners and boundaries is necessary.

Some of our clients (often with ASD or highly sensitive) are loving this new and gentle world. No insult to the senses, no other children rattling their cages, just quietly staying at home doing the odd zoom call. Academics can soar; individual time can be spent on aspects they struggle with; learning at their own pace suits them better. The prospect of returning to school has been hard and many parents are opting for home schooling in the future.

I will be looking for COVID-related stories for our SAISI Newsletter later in the year, so if you have any stories, or interesting case studies, please start documenting them and get in touch with me. We live and work in interesting times indeed!

Thank you Sally for sharing your experiences with us.  Anyone who would like to contribute their stories to the newsletter please email  We’d love to hear from you!