The global coronavirus pandemic has been tough for all of us — to say the least.

The further the virus has spread, many of us have had to grapple with the loss of loved ones, causing anxiety and fear across the masses. And in the wake of the trauma faced, therapy has been an outlet that many people have had to turn to to help ease the feelings of uncertainty and worry. In fact, preliminary research on coronavirus in China showcases high rates of mental health issues, including depression, anxiety, insomnia, and distress, which are much higher in nurses, women, and those on the front line.

The unsung heroes of the front lines include those who are not just preserving our physical health, but our mental health as well. Unfortunately, they have far too often been overlooked throughout this entire crisis. Therapists are facing a constellation of unique challenges in the face of the COVID-19 pandemic, that far too often we don’t recognize.

But the better question is — how will it impact their long term mental health needs? And how will therapists and mental health practitioners be able to help us, if they’re not also helping themselves? Dr. Amanda Fialk, LCSW, LICSW, Partner & Chief of Clinical Services The Dorm, shares how COVID-19 is affecting mental health practitioners and why it’s important to recognize, explore and process.

Burnout and Compassion Fatigue​.

Extraordinary times, call for extraordinary measures. And these “unprecedented times,” are considered extraordinary and then some. But of course, if the general public’s individual feelings of anxiety and worry have increased, it’s not surprising that this would happen to mental health professionals as well. But they must be aware of putting on their own oxygen mask before helping others.“In “typical times”, some studies show that between 21% and 61% of mental health practitioners report moderate to high levels of burnout and compassion fatigue,” says Fialk. “These numbers are only exacerbated during an international pandemic as clients are in a state of acute stress and in need of heightened levels of support. Symptoms of burnout include emotional exhaustion, depersonalization, lower self-evaluation (sense of personal accomplishment). Compassion fatigue is emotional and physical exhaustion leading to a diminished ability to empathize or feel compassion for others. Burnout and compassion fatigue negatively impact a practitioner’s capacity to be impactful with clients and are emotionally draining on the practitioner him/herself.

Vicarious Trauma.​ 

Feeling compassion and empathy makes us human. But the same characteristic that we love our therapist to have, is the one that will cause them the most detriment. According to Fialk, “Empathy, attunement, and emotional availability can make a therapist vulnerable to feeling a client’s pain in complex and profound ways.” She continues, “Vicarious traumatization is the transformation in the self of a trauma worker that results from empathic engagement with traumatized clients and their reports of traumatic experiences. Indirect exposure to a traumatic event through the first hand account or narrative of that event produces a trauma reaction in the therapist. During the COVID-19 pandemic, there has been a surge in trauma related diagnoses and symptoms. Practitioners are seeing a surge in clients suffering from acute or ongoing trauma in their practices and organizations. Thus, therapists are more prone to vicarious trauma.”

Blurred Boundaries Between Personal and Professional Life​.

“In a therapeutic encounter a therapist is always mindful of maintaining a professional stance, both to protect the client and themselves. If a client knows too much personal information about the therapist, the information may interfere with the therapeutic process. For instance, if a client needs to work through an unresolved conflict with his/her mother he/she may “turn” the therapist in to his/her mom (transference). If the therapist discloses he/she has 3 cats and the clients mom was allergic to or hated cats, this disclosure or entry into the therapist’s personal life will disrupt the transference and the potential opportunity for the client to work through an unresolved relational issue.

As therapy has shifted to a virtual world and clients are literally entering the homes of their therapists through a computer screen, it is more important (and more difficult) than ever to protect our “personal” lives and space.”

Therapists Are Facing The Same Crisis Simultaneously. 

“Therapists are human!” says Fialk. Did you think that they would be exempt from the same personal crises that we are all currently facing? Think again the next time you’re on a Zoom call with your therapist. “Therapists are NOT immune from the anger, fear, anxiety,” says Fialk, so make sure that you are offering grace as well. “The overall mental health impact their patients are suffering from as a result of the COVID-19 pandemic,” she says. “That said, it is the responsibility of a therapist to take care of him/herself and process all therapeutic interfering feelings and emotions so they do not negatively impact the therapeutic experience of the client. While therapists may use their “self” and personal experiences to inform the process, their “self” should not be used to control the process and the therapeutic experience should never be about the therapist.”

Lack Of Face To Face Contact​.

While technology has been an invaluable therapeutic tool during this crisis, in a virtual treatment encounter it is more difficult to pick up on and read non-vebral communication and body language,” says Fialk. “Non-verbal communication is often relied on heavily by clients who are unable to or uncomfortable with naming or describing emotions. Without an ability to see and interpret non verbal communication, therapists have been challenged in the virtual treatment landscape.”

Therapists must be mindful of their own mental health stake during these times. Fialk’s however offers a few tips for managing your mental health, while you’re helping to manage others: Regular individual clinical supervision; Group supervision and case conferencing with peers; Continued professional development and education; Self care in the form of meditation, mindfulness, yoga, exercise, aroma therapy; Journaling; Personal therapy and self-help groups; Scheduling 10-15 minute breaks between sessions; Creating boundaries; Communicate with family and make plans that protect your private work time to ensure kids, spouses, pets etc don’t walk in on a therapy session.

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