Health & Wellbeing: Counselors address mental health during the pandemic


Many states are reopening their businesses and providing outdoor seating at eateries as the pandemic curve has slowly started to flatten across the country. Regardless, COVID-19 is still a very real concern, and the lasting effects of this public heath emergency go further than just the physical. 
The impact of this pandemic on the psyche is far reaching and everyone is having their own experience with it. Although globally the world is experiencing this pandemic together it does not mean that every individual is experiencing it in the same way. 
It is no secret that the COVID-19 pandemic has brought about changes to the routines of millions across the country and billions around the world. It has also brought attention to mental health, in a new light. Anne Hopkinson is a Licensed Independent Clinical Social Worker, or LICSW, who works at Shorewell Community Health Center in Shoreham, and Amy Dingman-Parini is the Associate Director of Counselor Training at Middlebury College Counseling. 
Given their professional background and experience the Independent reached out them last week and asked each about COVID-19 and the psychological effects that it has had on Vermonters.

What population do you work with? 
I work with the entire community and have a specialty in teens and emerging adults.
How are you working these days (remotely, or in-person, telehealth, video conferencing, etc.)? 
I was working remotely from mid-March to June 1. I arrived back in the office yesterday where I am doing about 50% telemedicine and 50% in-person sessions.
What are the challenges you’ve faced in providing your work during this pandemic? 
Adjusting to telemedicine has taken time for both me and my clients. There are many logistical hurdles to overcome: internet speed, access to technology, learning to read emotions over a screen, etc. However, I feel the switch to telemedicine has been a huge success; my no-show and cancellation rate has gone down drastically and I have learned that while it has its drawbacks, telemedicine can better serve many clients over that of face-to-face visits. For example, folks with physical disabilities, limited access to transportation, lack of childcare, or limited funds for gas can much more easily access help.
How has the isolation aspect of quarantine affected children and teenagers? Is technology playing a positive or negative role for them when it comes to connecting? 
Technology is certainly playing a role; we don’t really have the research to understand what the long-term outcomes will be for this generation. We do know that social connection face-to-face is very important to social development. What I am hearing from many young people is that they are desperate to get together with friends and talk with people face-to-face. 
What we do know is that kids are using and interacting with technology in much different ways than they did before social distancing, and not just for socializing and entertainment. Technological meet-ups and productivity tools like zoom, google and slack, which traditionally were used by adults in a professional setting, are now being used for younger age ranges, and the formats are not necessarily translating well to supporting the social-emotional development that happens in an in-person classroom setting.
Is there concern that this pandemic will have negative effects on children’s and teens’ development? 
Social distancing is of course a concern for all developmental stages that focus on socialization. This is particularly true of middle and early high school, when socializing with peers is not just crucial to development but also general happiness and mood regulation. It is really important to be talking to your children about creative ways that they can connect with their friends and keep up their social and emotional growth. 
It may be a good time to introduce technology as a bridge to socializing; however you want to be sure to have open (family) conversations about socializing via technology and introduce the idea that technology is a good support to in-person socializing but it is not a substitute. 
I am suggesting that my parents of teenagers and young adults take a harm-reduction approach to face-to-face socializing. Talk with your family about what kind of socializing feels safe. Is it always outside, does everyone wear a mask? Is it only certain friends and family? What size groups feel comfortable? How will you know when to tighten or loosen these guidelines? Answering these questions with your kids instead of giving a blanket statement such as “make sure you socially distance” can allow for safe socializing without having to make pressured decisions in the moment.
Given that you are living in the midst of the pandemic, as are those you are treating, do you feel that has affected you and your approach to treating your clients? 
As a therapist who is sharing many of the worries, fears and difficulties that my clients are feeling, I deeply understand what my clients are going through in a way that is unique to me. Many health professionals are adapting very quickly to the new needs our clients are facing — for many people we have had to quickly adjust their self-care plans and use substitute activities that bring them happiness, joy and connection in their lives. 
For example a young person returning from college may need to replace their regular workout at the gym with a new running routine in their neighborhood and may need to make an extra effort to keep in touch with their college friends as well as re-connect with older high school relationships. They may also be finding that they need to take extra time to themselves while living at home to assist in their transition to adult independence.

What is the population you work with? 
College students (ages 18–26), and language school students (adults of all ages) during summer.
How are you working these days (remotely, or in person, telehealth, video conferencing, etc.)? 
Remotely from home using a secure video platform to provide telehealth services.
What are the challenges you’ve faced in providing your work during this pandemic? 
There have indeed been challenges with the move to remote work and therapy, particularly around licensing laws and providing services across state lines. There are also individual circumstances that prevent some students from accessing remote therapy, everything from connectivity to privacy. 
Telehealth video therapy sessions are also very tiring! There is a certain effort in connecting through the screen that makes therapy feel more taxing even beyond the now well-known phenomenon of “Zoom fatigue.”
What do you think the lasting mental health implications are going to be from this time? Do you expect people will experience versions of Post Traumatic Stress or other lasting effects? More so for some populations than others? 
I do think there are added stressors for all of us. This is particularly pronounced for those who were already struggling with their mental health, and/or with other challenges around resources and safety. I think this time will have ripples into the future for us both individually and collectively, and we will all find our new normal, rather than things going back just as they were before the pandemic.
For some that may take the form of a diagnosable traumatic stress response or new anxiety disorder; any marginalized population is going to be at greater risk from the economic and social impacts we are experiencing currently. My hope is that our new normal post-pandemic does a better job of caring for and respecting all people and recognizing and redressing these systemic inequities.
When it comes to mental health and the pandemic, is there anything you have seen crop up that you didn’t expect to see? Anything you haven’t seen that you are surprised has not come up yet? 
It has been informative to witness the challenges of continuing care with telehealth for some. While not having to go into an office is an advantage for some, for others there are barriers related to internet connectivity, phone service, ability to access private spaces, and access to self-care activities. It has been sad to know that some people can’t access mental health care because of their crowded living conditions and lack of privacy or safety in talking in their home environment.

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