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As the coronavirus pandemic continues to unfold, people are understandably feeling anxious and stressed. Results from a recent survey of Lyra therapists and coaches highlight the widespread mental health impacts of this public health and economic crisis: 60 percent say that their clients’ symptoms are worsening.
And it’s no wonder, considering the significant stressors people are facing, from disruptions to our daily lives to the threats to our health and jobs and a constant stream of news coverage of human tragedy. Even the most “zen” among us are not immune to worry these days —mental health care providers and their clients alike.
Of course, we are all responsible for our own health and the health of our families first. But as a mental health care provider, you may face the additional challenge of responding to clients worried about their physical and mental health. Here, we aim to give you some answers, as well as practical tactics to use in conversations about the coronavirus.
Start with the facts
For the sake of your own health and your clients’ health, it’s important to seek out reliable information about the coronavirus. It can be particularly helpful to put those facts into context as work with clients who are dealing with worry, fear, and other common reactions to the pandemic.
The novel coronavirus is a contagious respiratory illness that as of April 29, had infected more than 3 million people worldwide, with more than 1 million confirmed cases in the United States. Also as of April 29, the Centers for Disease Control and Prevention (CDC) estimates that for most people, “the immediate risk of becoming seriously ill from coronavirus is thought to be low.” Adults over 65 years old and people with serious underlying medical conditions such as chronic lung disease, moderate to severe asthma, serious heart disease, and those who are immunocompromised may be at higher risk of severe illness from COVID-19, according to the CDC.
Discuss media consumption
Encourage your clients to seek out reliable, evidence-based information about the coronavirus as opposed to news from online message boards or YouTube videos. Health misinformation online isn’t always easy to spot, so you might suggest that they rely on one or two reliable resources, such as the CDC or the World Health Organization (WHO).
For some clients, you may suggest that they limit their health news or social media consumption if it is causing undue stress without providing any additional utility. For example, once they’ve chosen a single reliable resource like the WHO, they could limit checking that resource to no more than a few minutes a day. You might also advise that they avoid checking the news before bedtime.
Stick to the basics
Encourage your clients to follow the guidance of local public health agencies on measures to “flatten the curve,” such as staying home as much as possible and wearing a mask when you are in public. The steps needed to protect one’s health will depend on the status of the outbreak where they live and their own health. While you can’t be an expert on all of this, you can help your clients find the information they need.
In addition to some of the more drastic measures needed to mitigate transmission of COVID-19, the current epidemic serves as a reminder to follow guidelines that protect us from contagious illnesses year-round. Follow the WHO and CDC guidelines, including:
- Regularly and thoroughly clean your hands with an alcohol-based hand rub or with soap and water. A thorough cleaning should last for at least 20 seconds. Sing “Happy Birthday” quietly to yourself, twice.
- Avoid touching your eyes, nose, and mouth.
- Cover your mouth with your bent elbow or with a tissue when you cough or sneeze.
- Avoid contact with others if you’re not feeling well or they’re feeling unwell.
- Maintain a 6-foot distance between yourself and other people while in public.
Explore what “reasonable” precautions entail
While you should encourage your clients to take reasonable precautions to protect themselves, that means you may need to discuss what “reasonable” looks like. Even someone who is very careful may still get sick, and that uncertainty is hard to sit with, but it’s still essential to take precautions to reduce the risk. Look out for signs that your client is more focused on controlling their anxiety than following the recommended guidelines to protect their health.
Watch out for thinking traps
Once your clients are operating on good information and taking reasonable precautions, it may be useful to explore thinking traps that could be involved. Thinking traps include common cognitive errors such as probability overestimation, catastrophizing, or black-and-white thinking. For example, some clients may be predisposed to focus on worst-case scenarios, like becoming very ill or losing their job, while devoting less energy to issues they’re more likely to encounter, such as trying to maintain self-care during a period of disrupted routines.
On the other hand, some clients may tend to minimize the risks associated with COVID-19. It’s important to offer them honest feedback if you believe they are likely to put their health at risk. If a client’s reaction to the coronavirus reminds you of how they respond to other stressors in their life, consider whether you’re witnessing a larger pattern of ineffective worrying or other behaviors that may be worth exploring further.
Validate their feelings
Remind your clients that anxiety serves a purpose: to warn us about potential threats. Although the coronavirus is a real threat that should be taken seriously, that doesn’t mean our anxiety always drives us toward the best behaviors. We want our clients to pay attention to anxiety without always needing to listen to it, especially if it’s prompting them to take extreme steps that disregard expert guidance. No matter what we do, there will always be some risk and uncertainty. One of the most powerful things we can offer our clients is helping them learn to live with uncertainty while still investing in the things they care about.
This pandemic is likely far from over. The weeks and months ahead will bring changing conditions, evolving statistics, and more questions from clients. Be prepared with facts and reliable sources, which can you employ alongside your knowledge of each client.
And don’t forget to be kind to yourself. As a provider, you face added pressure not only to keep yourself and your loved ones healthy, but to support the mental health of your clients. That can be a lot. Talk to your fellow providers in consultation groups, keep up self-care routines such as exercise or practicing mindfulness, and seek out more support if you need it.
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DISCLAIMER
The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
ABOUT THE AUTHOR
Shane O’Neil-Hart, LCSW, is the Senior Clinical Manager of the Mental Health Coaching Program Lyra Health and an expert in Acceptance and Commitment Therapy (ACT). He serves as the Vice President of the San Francisco Bay Area chapter of the Association for Contextual Behavioral Science (ACBS), and provides psychotherapy, supervision, and training in ACT.
