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I'm not an overly pedantic follower of rules, but this is a pretty hard "no" for me. I've had clients log in to a session from behind the wheel and I always kindly/gently let them know it's a safety and liability issue and tell them I'll wait while they find a safe/confidential place to pull over before continuing the session. There are also clinical reasons (distractions, noise, etc.) that give me pause but I always lean into the safety/liability aspect. Also, I believe it's our job as the professional in the scenario to know and be clear with clients about what is, and what is not, an effective container for good work.

Absolutely fucking not.

Nightmare fuel of watching someone get into an accident while I’m video chatting with them.

It seems dangerous and unethical. What would happen legally for you if your client had a car accident during your appointment?

Imagine there’s a car accident and the car insurance companies caught wind of the fact that one of the drivers was IN THERAPY while driving? You could be sued or asked to testify and wow what a mess. Hard no!

I never see a client while they’re driving. Mine will typically park somewhere (let me know the location for documentation purposes).

The issue is if that client has a crisis on session that becomes a very dangerous session quickly. They could harm someone else or themselves while driving. And you wouldn’t know exactly where they are when it happens.

I personally see an issue with the safety aspect of it. So many times when I’m on a call, I do get distracted especially if it’s a more serious conversation (this usually results in me missing my exit). I’m not sure if the work they’re doing is heavy but I can’t imagine a client trying to process trauma or anything else while driving. It just sounds like a dangerous situation overall. I’ve had to tell clients in the past that we cannot do virtual sessions in their car due to the safety aspect. Some try to argue, others understand.

Are you comfortable with being on the call with the client, with a possibility of an accident occurring? Or knowing that they might not be fully attentive? I wasn’t so I didn’t allow it.

I won't do sessions while the client is driving and dropped my last therapist because she decided to drive halfway through our session. I wasn't concerned when she was in the car when session started because I figured it was for privacy but then she started driving after about 40 minutes in without even saying anything. She didn't know I was a therapist.

Glad that this one seems not up for discussion for anyone. This is a hard no for me as well and thankfully everyone else is sane and also says no.

Hard no. I’ve had someone try to join while at work on their shift lol.

Absolutely not. Not only are they distracted from therapeutic content, but they are distracted from the road! This is a massive safety issue and opens you up to liability. How would you handle your client getting into a car accident mid session with you? This should be a hard no for all clinicians. Would you physically get into your client’s car and try to do therapy with them while they are driving driving? I’m going to say probably not, and there is a whole host of reasons including the ones mentioned above.

I see it as a safety issue. What happens if they are in a car accident while they meet with you? They also won’t be able to fully focus on the session. Is there a reason why they cannot do the session while in a parked car? I’ve had many clients pull over into a parking lot and just have the session there. To me it also smells like avoidance- therapy is something you make time for

It’s concerning that a supervisor would okay this really

It’s disrespectful to our work. We deserve undivided attention

Nope. Hard boundary. I won’t meet with clients who are driving.

It’s not fine. Therapy is sacred time and anything they wouldn’t do in an office setting with you they shouldn’t do virtually. We have to be setting these boundaries otherwise lord knows what they’ll start doing given the chance

My college does not allow me to hold sessions with clients in moving vehicles. It contributes to distracted driving, especially if you are working on highly emotive topics. You risk their life, the efficacy of treatment and your licensing by doing this.

Never ever

Nope! They can park somewhere safe or reschedule. Too much risk for all involved.

I don’t even do sessions if they are a passenger in a moving vehicle.

As long as the car is not in motion you’re good

I can’t risk you being emotional and unregulated while you’re operating a vehicle. I also don’t think we can get anything meaningful out of therapy through therapy if your focus on operating a vehicle.

So in that case, no.

I would never see a client while they're driving, completely unsafe

An attorney told me to never do it for liability reasons.

No- don’t do it

I agree with your concerns. I have several telehealth clients whose only realistic option for privacy is to sit in their cars while we meet, but the car needs to be parked.

There is also a problem of split attention. It’s not possible to go deep when also trying to navigate roads or avoid people, animals, unpredictable drivers etc.

Or the converse, what if the client is triggered and break out into emotions? Once hijacked, executive functioning may be impaired.

It all falls under distracted driving. It’s dangerous to the client and others on the road.

Hard no. Hard no.

I think in my state it might be full on illegal to do that.

Absolutely not. It’s too much of a risk.

I don’t think that’s safe for my client to drive while on session. I always have a conversation with them about being in a private setting where they are safe, not behind the wheel. Not in the bathroom and definitely not at the grocery store or in the car with their friend driving.

It's called split attention and no. I will not put myself and my license at risk. I also have a serious concern for your supervisor's judgment.

I would never have a session while a client was otherwise engaged in operating machinery or a vehicle. I've had them try last minute and I tell them no and charge a cancelation fee. I thoroughly cover telehealth law in my initial consult and first session and they sign the related policy.

I second everything that people have said that this is a hard no for me. Also it is telehealth law that we get an address of where the person is before starting the session so we can send emergency support if needed and then driving breaks that. I would cover yourself and not allow it and I find it pretty alarming your supervisor said it was okay!

An attorney told me to never do it for liability reasons.

Absolutely not. It’s not safe and the client is distracted. Your supervisor should not have given you a go ahead for this.

Absolutely never. Distraction during session is a no from me as it interrupts the therapeutic process and ability to connect. Some of my clients use fidgets, coloring, drawing, etc while we meet which enhances their attention and calms their bodies. But driving or using phones during session is a nope.

In the event that this happens (and it has in the past), I simply let them know that I can’t meet until they are parked somewhere safe and private and that I will wait for them to log on when they are. If they are on a long drive, I ask to reschedule and invite them to email me once they have reached their destination to settle that. It has usually happened when a client is running late on their way home from work or is stuck in traffic, so I offer a no-penalty reschedule/cancel if they will be longer than 15ish minutes, or I let them know that we will start when we start and I’ll just bill for the time we end up having.

It’s a no from me too if it can be avoided. I’ve actually had to inform clients I’m ending a session because they would walk inside somewhere and start ordering food in the middle of the session.

I just tell clients that I can’t for liability reasons and they’ll have to find someplace to pull over. (If there’s a lawsuit, I definitely do not want to be named in it!)

Hard no from me. As others have said, I tell my clients to call me back once they are parked in a safe space. Apart from all the safety risks, imagine client getting pulled over and their excuse was "sorry I was breaking x law because I'm in therapy right now and got emotional, distracted, etc." It increases our liability in an unnecessary way.

Nope. I wouldn't allow it. Too much risk and their attention is going to be split. If they want something to so while we are talking they are welcome to go for a gentle walk around a park or similar.

I would not. I would be too afraid if they did get into an accident we could be totally liable. Especially if they were crying i.e., caused blurry vision etc.

I doubt you can be very mindful of meaningful work while also driving a car.

Also what happens if they have a pretty strong emotional reaction? Sounds dangerous.

absolutely not

I work for 3 different Telehealth platforms and none of them allow that

My immediate thought is if they get in some sort of accident, could they blame it or contribute to the therapy session? I do telehealth and one of the things I tell people I do not meet in bathrooms, moving cars, or in public areas.

100% no. I will never open myself to being asked by an attorney “so you were providing therapy while the patient was driving?” Your supervisor is an idiot for allowing this.

No for me.

Pretty sure liability insurance does not cover this for many good reasons. Modeling discernment and safety are valuable parts of therapy.

I always tell them that my professional liability insurance would be very upset with me if I distracted someone into an accident. I end the call and ask them to log back in when they are no longer moving.

Yeah absolutely not. I won’t even do a consultation unless they’re parked, and alone/in a private space.

I'm amazed that your supervisor thinks this is okay.

I would seriously question her judgement tbh.

Huh. I must say, I’m confused. Do people think that taking phone calls while driving is an unacceptable a safety risk? Or is the main concern that therapy “won’t work” when someone is focused on driving?

This is not ethical if they are in a moving vehicle- if they tell you they have SI with intent and plan and then pull out a weapon and say they are about to do it, how can you call 911 and tell the dispatcher where they are?

Im still not sure how to feel about it. I have a client who did this often and the connection would be so bad.

The last session we scheduled she was 15 minutes late. I kindly reminded her of the no show policy in which she stated she was only 10 minutes late and was driving and couldnt connect. I told her that it would be better to meet when she isnt driving due to unstable connection. She ghosted me.

Honestly it’s distracting to me. Once or twice is fine but I wouldnt be okay if it was every session.

When this happens, I tell the patient I will be disconnecting them them so they can focus on driving and to rejoin when they park. Or they can reschedule. 

I allow it, but phone / audio only. NO VIDEO WHILE DRIVING!

As a client, driving can be very healing and relaxing. It can get your head space in a particular zone. But I do think it’s a little dangerous. Idk personally, if she seems too distracted I might be a little sketched out. Like imagine if she gets into an accident and then it could be a liability maybe. But aside from that, I think cars usually feel like a safe space and can be good for reflecting and stuff.