Dr. Tonya Cross-Hansel

Over the last year and a half, there has been no shortage of media coverage about the mental health implications of the pandemic. Generally, these articles fell into one of two broad categories: those which warned of an impending large-scale mental health crisis and those which sought to help the public cope with whatever they were going through during the heart of the pandemic be it the loss of a job, a loved one, or simply cherished routines. Now, we seem to find ourselves in an in-between moment. While the pandemic is certainly not over, and we are seeing surges of the Delta variant in areas throughout the country, those who are vaccinated and not immunocompromised may have already returned to varying degrees of their pre-pandemic lifestyles. As people have done so, however, they may have noticed a sense that all was still not well with themselves. Since the most urgent task for many of them in the earlier parts of the pandemic was simply to keep their heads above water, it’s normal and to be expected that they would only now be noticing certain mental health symptoms such as lingering anxiety, depression, burnout, or physical symptoms resulting from chronic stress. Meanwhile, from the mental health providers’ perspective, we seem to have arrived at a point in which there is a collective sense of, “What now?” A Period of Psychological Adjustment One of the challenges that people commonly face in the wake of a disaster or traumatic event is adjustment. This isn’t the kind of practical adjustments made in the early stages of the pandemic—such as working remotely or having to accommodate for children being at home—but rather psychological adjustment. After a disaster, people feel confused, displaced (physically, emotionally, or both), have a hard time making sense of things, finding purpose, or just generally feeling like something is “off.” In fact, “Something just feels a bit off,” is a common way that people tend to characterize what they are feeling after a disaster. In the case of the Covid-19 pandemic, people’s confusion may be amplified by the lack of situational clarity: Are we still in the disaster? Are we out of it? Something in-between? Helping clients through this period of vagueness, confusion, and adjustment is, and will be, one of the key tasks of social workers, therapists, and mental health providers right now and in the months ahead. Being Direct to Assess People’s Needs While it’s safe to say that most people, if not everyone, maybe feeling a bit “off,” we also don’t want to make the mistake of assuming that everyone has had a similar experience or is currently in the same place. Because of this, social workers and mental health care providers will want to systematically assess the particular needs of new clients seeking services, of which there has been a significant increase in recent months. This may be particularly important for clients from communities of color since their experiences are going to be magnified due to the various disparities in how their communities have experienced the pandemic. There are different ways that mental health professionals can go about this. It could be incorporated into the standard questionnaires and self-assessments that are typically used to assess the needs of new clients. Or, perhaps, some professionals may prefer a more direct and personal method by asking targeted yet open-ended questions as part of the initial rapport-building with clients. For instance, during a first session, a social worker or therapist can ask, “This has been a very strange, difficult year for many people. What might be contributing to your added stress levels, currently?” This is one of the most important components of doing trauma work, which is unless you ask specifically, it can take a very long time until you get around to why a client has come into your office, or until they’re able to make the connections of what’s really causing all the problems. While typically this is allowed to gradually unfold over several sessions, now may be a time when it’s useful, or even necessary, to begin with new clients in a more direct way. Incorporating a Disaster Crisis Counseling Model Another reason why it may be useful to be direct right now, and to help clients address their most immediate problems, is that social workers and mental health providers may only be able to see new clients for one, two, or just a few sessions. While greater numbers of people are seeking mental health services, many of them may not be ready or able, for various possible reasons, to delve into deeper or preexisting mental health issues. While the hope is always to be able to do that, after disasters it’s common for people to seek just one or two sessions. Fortunately, even these limited sessions can be helpful when clients are given specific and concrete tools—for example, the six Skills for Psychological Recovery (SPR). Mental health providers may therefore find themselves, in many cases, having to adhere closer to a disaster crisis counseling model, rather than a long-term therapy. In this scenario, the best way to help clients is to provide them with positive coping methods and strategies that can be immediately applied, especially since many of them may have come to rely on unhealthy coping mechanisms throughout the pandemic. For mental health professionals who haven’t been trained in disaster response, it will almost undoubtedly be useful to look up disaster response methods and incorporate them if possible since they may be what many of their clients need most right now. The aforementioned lack of situational clarity regarding the ongoing nature of the pandemic, and the global scope of it, may preclude the kind of organized mental health outreach efforts we saw after localized disasters such as Hurricane Katrina and the Gulf oil spill which have been found to be effective. In the current absence of such programs, we will likely continue to see more people seek out mental health services on their own. By keeping in mind the principles covered in this article, and by being flexible with the way we might normally prefer to work with new clients in non-pandemic times, social workers, therapists, and mental health providers will be able to help their clients in the ways that they need it most during this period of psychological adjustment.

Dr. Tonya Cross-Hansel

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