Therapy Practices
Voice Assistant answers your practice's number while you are in session, in a greeting you have written yourself, takes the caller's message, and sends you a summary by email or text to read before your next client. It is not a crisis line and gives no clinical advice, which is why the greeting you write is the place to tell every caller about 9-8-8 and 9-1-1.
Your sessions run fifty minutes, back to back, and your phone spends them face down on the bookshelf, because a buzz in the room is the one interruption you will not allow. Between clients you have ten minutes for notes, a glass of water and the phone, in that order. Some days there is a voicemail. Some days there is only a missed call from a withheld number, or a few seconds of silence and a click. You know how long some people take to make that first call to a therapist, and a recorded beep is a hard thing to explain yourself to. You cannot ring back a number you were never given, and there is no way to tell which of those silences was somebody deciding to try the next name on the list. A receptionist for a practice of one is not realistic, and you are not sure you want a stranger answering for you either.
Your greeting, exactly as you wrote it, and then an ordinary conversation in which they can interrupt, change their mind or talk over it, something a beep cannot offer. The assistant takes what they tell it and sends a summary of what they wanted, by email or text, to the addresses you list, whether the call comes in at twenty past ten, over your lunch or after you have closed. The caller lands in your client list with that summary on their record, so the ten minutes between sessions go on reading one message and deciding whom to ring, not on replaying the machine. We know of no Canadian measurement of how many first-time callers to a therapist give up after one unanswered ring, so we will not put a number on it.
No. It does not transfer calls, so no caller is put through to the room you are in. If you have summaries sent to you by text, though, that text arrives after the call, possibly while you are still in the session, so keep your phone where you keep it now. It does not book either: it will not open your schedule, offer a time, or move or cancel an appointment. A first consultation is arranged the way you arrange it today, by you, when you ring back from the caller's record. Where that first conversation is part of deciding whether you are the right therapist for this person, there is a case for keeping it with you.
The assistant is not a crisis line. It gives no clinical advice, and nobody should rely on it to keep a caller safe. What you do control is the first thing every caller hears, and that is where crisis resources belong. The 9-8-8 Suicide Crisis Helpline can be reached by call or text 24 hours a day, every day of the year, and its own site tells anyone whose safety is at risk to call 9-1-1 right away. Put both near the top of your greeting, before you ask for anything, and again in your out-of-hours message, which is what someone ringing at two in the morning will hear. CRPO's standards, in their guidance on boundary crossings, say Registered Psychotherapists should consider establishing policies and protocols around after-hours communications; whatever yours is, write it into the out-of-hours message, because that is what a caller ringing late will hear.
Recording is a switch, and where it sits is the practice's choice, so settle it on the setup call rather than find out later. A therapy practice has a specific reason to want it off. Ontario's Personal Health Information Protection Act defines personal health information as identifying information about an individual in oral or recorded form that relates to their physical or mental health, and section 12 requires a health information custodian, which a therapist in Ontario private practice will usually be, to take reasonable steps to protect what is in its custody or control. Somebody explaining why they want therapy is giving you exactly that kind of information. Our reading, not the statute's: every recording kept is one more record to protect, and a recording never made is not. Switching it off does not mean a call leaves nothing behind, since the summary stays on the caller's record, and our privacy page sets out what else is kept and for how long. If recording is on, say so in the greeting, before the caller starts talking.
The summary goes by email or text to the addresses you list, and it is also kept on the caller's record in your client list. So the list of addresses deserves the thought you give to who opens your mail: in a group practice, an inbox the whole office reads is a different decision from the clinician's own. Among the ways CRPO's standards say a registrant demonstrates the confidentiality standard are collecting only the information reasonably required, and avoiding non-secure methods such as email for confidential information unless the client consents to the risk and there is no practical alternative. How that applies to a message about somebody who is not yet your client is a call for you and your college to make. What you can influence is how much a summary is likely to hold. Your greeting can ask for nothing more than a first name, a number and a good time to call back, and can say that nobody needs to explain why they are calling. Some callers will tell the assistant anyway, and what they say can end up in the summary, but a greeting that asks for less gives people permission to say less.
A short text to the caller after the call is one of the switches, and in a therapy practice it deserves a moment's thought, because the text arrives on whatever phone the person rang from, and a phone may be shared with a partner, a parent or an employer. Ontario's statute counts identifying information that shows who provides a person's health care as personal health information, so, on our reading, a text from your practice on somebody's phone is not a neutral detail. CRPO's standards say registrants should outline appropriate uses of technologies with clients, and give emailing or texting only for booking appointments as an example. If you would rather nothing from your practice appeared on a caller's phone until you had spoken to them, switch it off.
Only what you have written down. Beyond your opening hours, it has one box of plain writing to draw on: whom you see and whom you do not, whether you are taking new clients, what to say when somebody asks what a session costs or whether you direct-bill their insurance. If you are registered with CRPO, Standard 6.1.1 already requires a standardised fee schedule made available to current and prospective clients, so the box is a natural home for it, or for where it can be found. Apart from the hours, that box is all the assistant knows about your practice, so anything you would not say to a stranger on the phone does not belong in it.
Treat it as a message somebody took for you, not as an assessment. It is written by software from what the caller said, and software can mishear and misunderstand. CRPO Standard 3.4.7 says registrants do not rely on information obtained from computer-generated assessments, reports or statements without exercising their own professional judgment. It sits in the standard on electronic practice, and our reading is that a computer-written account of a phone call is the kind of statement it describes. The summary tells you whom to ring and roughly why. The person, when you ring, tells you what they need.
An illustration, with an invented practice and invented callers; it describes no customer. Wrenfield Psychotherapy is one Registered Psychotherapist renting a room above a pharmacy, with clients at nine, ten, eleven, one, two and three on a Wednesday. On the setup call she settles her greeting: "You've reached Wrenfield Psychotherapy. I'm with a client, and this is an assistant that takes messages for me. If you are thinking about suicide or are in crisis, you can call or text 9-8-8 at any hour, and if you are in danger right now, call 9-1-1. Otherwise, leave your first name, a number and a good time to call, and I'll ring you back today. You don't need to tell me why you're calling." Her box of plain writing says she sees adults and couples but not children, that she is taking new adult clients, that she does not write custody or court assessments, and that her fees are on her website and she is glad to go through them by phone. Summaries go to one address, her own. At twenty past ten a caller gives the first name Alex, asks whether she sees couples, hears that she does, and leaves a mobile number and "after five". At ten to eleven, when her session ends, the summary is waiting: Alex, the number, couples, after five. She rings at ten past five and books the consultation herself, from Alex's record. Recording is switched off, and so is the text to callers, because she would rather nothing from her practice arrived on the phone of someone she has never spoken to. Late that night somebody else rings and hears her out-of-hours message, which names 9-8-8 and 9-1-1 before it says anything else.
The greeting is yours, so the choice is too, but in a therapy practice we would say it plainly. A person who has worked up to ringing a therapist may say more than they meant to, and they should know who they are saying it to. The greeting in the illustration does it in its second sentence. We go through the wording with you when we set the number up, so that is the moment to settle it.
They can leave the message, and you will get the summary, but the assistant does not book, move or cancel anything. Taking the session out of your calendar is yours to do, and so is any decision about a late-cancellation fee. If you have a notice period, write it in the box so the assistant can tell a caller what it is.
Yes, if you write it in the box: that you are not taking new clients, and until when, if you know. If you are registered with CRPO, its standard on referrals notes that a registrant unable to accept an appointment request because of availability is not obligated to suggest alternatives. If you would like callers to hear where else they might look, write that in as well.
Yes. Unless you choose otherwise, it replies in whichever of English or French the caller uses, and you can set a line so that it always answers in French, which suits a practice in Quebec or one that keeps a separate French-language number.
Calls are processed in the United States, so what a caller says does not stay in Ontario, or in Canada. Our privacy page names the providers that handle a call and sets out what is kept afterwards, where, and for how long. Read it before your number goes live.
What this page says about the assistant holds wherever you practise. The law and the professional standards it quotes are Ontario's: its health privacy statute, and the standards the College of Registered Psychotherapists of Ontario sets for its own registrants. If you belong to a different college, in Ontario or anywhere else, read its standards instead, and if you practise in another province, read the privacy law that applies there; do not assume either says what this page quotes. No college has approved this product, and nothing here should be read as saying one has. 9-8-8 is national; its own site says it is there for anyone in need, wherever they are in Canada.
Setting this up is our work, not a form you fill in. We go through your wording with you, and you can change any of it afterwards.
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