Preserving Therapist Well-being During the Covid 19 Pandemic

The current pandemic has brought about unanticipated changes in people’s lives. It has been a difficult time for many people, given the uncertainty, worry about infection, and further challenges brought upon by social distancing norms. As a result, the need for mental health services has risen, and professionals in India have responded with fervor by making their services available through various online mediums.

In helping clients deal with these unprecedented times, some psychosocial concerns can come up for therapists themselves. For one, now more than ever, therapists may be constantly exposed to high levels of client distress. This may be especially true for those working with clients experiencing an increase in domestic abuse due to the lockdown or other vulnerable populations. To add to this, therapists and mental health professionals may be experiencing the same or similar kind of difficulties as their clients- they are not immune to the uncertainty, fear, and isolation that have been brought upon by this pandemic. This dual exposure to one’s own challenges during the pandemic, as well as the vicarious exposure to clients’ concerns can be an overwhelming and stressful experience. Research has also shown how shared trauma, that is, when the client and therapist simultaneously share a collective trauma, has the potential to lead to experiences of anxiety, avoidance, hyper-arousal, as well as a blurring of professional and personal boundaries for some therapists (Tosone, Nuttman-Shwartz & Stephens, 2012).

Furthermore, the pandemic also poses some practical implications for practitioners. Most therapists who are used to practicing in face-to-face sessions have the challenge of adapting to technology-based mediums. This comes with a range of concerns for therapists such as learning to adapt one’s skills to the online medium in a short period of time, finding a private space to practice within the home, and maintaining a healthy work-life balance. Client concerns for privacy and safety during sessions and comfort with a new medium are also some aspects that therapists need to be mindful of. Dealing with multiple changes in the professional realm in a relatively short period of time can be a stressful and anxiety-provoking experience. Moreover, the limitations on reaching some clients through online modes could contribute to feelings of guilt or helplessness for having to ‘abandon’ the client.

Distress Management:

Here are some ways that therapists can deal with such concerns:

1. Prioritize self-care: While the world is experiencing a global pandemic, and clients are going through extremely distressing situations, one’s own self-care as a therapist may not seem like a priority or may take more energy than usual. However, this is a time where taking care of one’s own well being is especially crucial, to ensure their ability to be present for their clients.

Taking short breaks between sessions whenever possible, staying connected with friends or family, incorporating physical activities within one’s routine, and practicing mindfulness or meditation are some ways to practice self-care. These are only a few ideas that could help. Remember that self-care can look different for different people- it is not simply about checking tasks off a pre-set list. Find what soothes you and try to incorporate some of that into your daily routine.

1. Practice Self-compassion: Self-care also involves embodying an attitude of care and kindness to oneself. Practicing self-compassion means adopting a non-judgemental attitude towards oneself, and reducing the voice of self-criticism. Check yourself for such self-critical comments (for eg, “I am not doing enough”), acknowledge that these are difficult times and that you are doing the best you can. Recognize and be realistic about the limitations in the present circumstances, and focus on what is within your control. Mindfulness is another aspect of self-compassion that helps one to reduce self-criticism, and can provide a balanced outlook to situations. 
2. Stay connected with colleagues and seek supervision: Having regular discussions with fellow mental health practitioners can be a good reminder that you are not alone in your struggles. It may also help create a collective sense of meaning in the work that you are engaged in. Supervision could offer a space where you can explore the challenges of transitioning to online practice, and develop ways of adapting.
3. Create a separate workspace: As one moves to a work from home practice, the boundaries between personal and professional may get blurred. If possible, creating a space that can be used exclusively for work- perhaps by making some small changes to the existing layout of the home such as shifting a table to the corner- may help enforce some boundaries.

Tosone (2011), in her research on shared trauma, found that although these can be challenging times for therapists in multiple ways, they can also offer opportunities for new therapeutic experiences. Therapists may experience a sense of purpose as well as a sense of having a positive impact on the world. Furthermore, it can offer a unique opportunity to deepen the relationship between the client and therapist as they acknowledge their shared experience of being in a difficult situation together. Thus, as therapists, by engaging with ourselves with care and compassion, one may find that it allows us to direct our energies on the things that we are able to do and ways in which we are making valuable contributions during a truly challenging time in human history.

How SWAASTHI can help:

Recognizing the challenges being faced by mental health professionals and other healthcare workers during this pandemic, iCALL in collaboration with UNFPA has launched Swaasthi, a psychosocial helpline dedicated to the concerns of counsellors and healthcare professionals working during the Covid-19 Pandemic. This helpline is operated by professional counsellors and is aimed at providing emotional support and referral linkages to healthcare professionals. It is a free and multilingual helpline where you can avail counseling in the following languages: Hindi, English, Marathi, Bengali, Malayalam, and Kannada.

If you are feeling overwhelmed or distressed, you can reach out to Swaasthi for help. The details of the helpline are as follows:

Swaasthi helpline number: 9152987824

Timings: Monday to Saturday, 10am to 6pm

References:

Tosone, C. (2011). The legacy of September 11: Shared trauma, therapeutic intimacy, and professional posttraumatic growth. Traumatology, 17(3), 25–29. https://doi.org/10.1177/1534765611421963

Tosone, C., Nuttman-Shwartz, O., & Stephens, T. (2012). Shared Trauma: When the Professional is Personal. Clinical Social Work Journal, 40(2), 231–239. https://doi.org/10.1007/s10615-012-0395-0

Clay, R. A. (2020, March 31). Self-care for psychologists during the COVID-19 outbreak: Clinicians, researchers, professors and other psychologists need to take care of themselves as well as those they serve. American Psychological Association. Retrieved from https://www.apa.org/news/apa/2020/03/psychologists-self-care

Counseling in a Time of COVID-19: Dealing with Guilt. (2020, April 30). American Counseling Association. Retrieved from https://www.counseling.org/news/aca-blogs/aca-member-blogs/aca-member-blogs/2020/04/30/counseling-in-a-time-of-covid-19-dealing-with-guilt