It is impossible to deny the extraordinary societal impact of the outbreak of the novel coronavirus, severe acute respiratory syndrome 2 (SARS-Cov-2). All of us are bombarded daily with messages and information related to the pandemic. As this virus garners heightened attention from the media, individuals may have difficulty delineating between misinformation and accurate information about the illness.
We are not writing this article to perpetuate increased fear among the counseling community regarding the spread of the novel coronavirus, but rather to:
- Provide resources helpful for staying informed about the impact of COVID-19, which is a disease caused by SARS-Cov-2
- Inform counseling professionals about how they can support clients affected by the virus and its societal impact
What does this outbreak mean to our clients?
It is crucial to understand the social ramifications perpetuated by this outbreak so that we can promote optimal care for the clients we serve.
Individuals who identify as East Asian or appear to be of East Asian descent may be susceptible to experiencing elevated levels of stress related to racism and xenophobia generated by misinformation about the virus. The negative impact on affected individuals ranges from financial and emotional to physical. For example, CNN reported that individuals who appear East Asian have fallen victim to verbal and physical attacks triggered by misguided fears of the infection. Additionally, individuals may be quarantined as a result of suspicions that they have been infected, leading to further stress. Clients who are directly impacted by this wave of racism and xenophobia may experience a vulnerability and lack of safety, perpetuating stress- and trauma-related symptoms.
Although the economic impact of this pandemic has since spread throughout the restaurant industry (and other industries), many Chinese establishments, such as restaurants, were among the first to experience a major decline of business even before community mitigation plans were announced. The financial hit on these establishments has been catastrophic for owners and their families. We must be ready to employ the proper interventions and responses to promote clients’ perseverance, resilience and well-being throughout the tensions that plague our society.
There is no doubt that the novel coronavirus poses a major threat to the entire U.S. economy and the health of our nation as a whole, but concerns are more pronounced among certain populations. For instance, the Pew Research Center reported that approximately 65% of Latinx adults say the coronavirus outbreak is a major threat to the health of the U.S. population as a whole, compared with about 47% of the general public. The same source reports that the outbreak has the potential to hit many of the nation’s nearly 60 million Latinos/as particularly hard. This is in part because a significant percentage of these individuals work in leisure, hospitality and other service industries and have less likelihood of having health insurance.
Of course, many individuals in the general public are fearful (or may become fearful) of contracting the virus. The anticipation of the potential long-term effects of the virus can trigger individual fear and stress-based responses. In addition, an array of compounding or simultaneous stressors can negatively affect individuals’ stress response systems in a chronic manner, meaning that there is no break to return to a healthy physiological state and functioning. These compounding or simultaneous stressors may include:
- Uncertainty about what might happen next to one’s life and health
- The exponential curve of virus-confirmed cases and deaths in the nation as reported in the media
- No access or difficulty in accessing health benefits
- Financial constraints due to a recent job loss caused by the pandemic
Stress-based responses may be worsened among those who lack resources such as social support.
This brings us to the reality that many states and communities have executed states of emergency, prompting individuals and families to enter into social isolation. Considering the potential negative psychological effects that may be manifested by social isolation, mental health professionals must be ready to intervene and provide support.
Social distancing, taken as a preventive measure to slow the spread of the disease, largely compromises individuals’ daily functioning. People are experiencing disruptions not just in the areas of employment and schooling but also in accessing emotional support from others or even in having regular interactions with others. Individuals who may not have access to technology to virtually stay connected with significant others for emotional support are especially susceptible to social isolation. Social isolation is a risk factor for a number of health-related concerns, including depression.
As the virus continues to ravage communities around the world, it is also important to note that people everywhere are experiencing the loss of their prepandemic normalcy. As a result, many individuals are having feelings associated with grief. Although this pandemic is hypothesized to be temporary, the impact on lives may be much longer term.
Consider that many nonessential businesses have closed their doors, leaving employees without work or a sustainable income to support their families. Most individuals at this point are restrained from engaging in social endeavors such as participating in team sports, attending classes, visiting museums or engaging in other fun-related activities. Most people can no longer meet up with friends or family for regular social events and may feel a sense of loss as their former routines vanish. Social distancing has also called for the cancellation or postponement of important events such as college and high school graduations, preventing new graduates from sharing in a momentous celebration with one another.
Furthermore, the mortality rate associated with COVID-19 continues to rise. People around the world are experiencing the deaths of loved ones and fellow community members. Additionally, family members are assuming the role of caretakers as their vulnerable loved ones fall ill to the virus. As the responsibility to care for loved ones increases, individuals may have to forfeit or abstain from other regular tasks and duties.
Recommendations for counselors
Anxiety management: It is understandable that clients may feel anxious about this situation. Counselors should normalize and validate clients’ fears. Counselors should also talk to clients about factors that they can and cannot control. Some factors that clients can control include getting regular exercise, making plans to meet with friends and loved ones over virtual platforms, determining their exposure to news sources, practicing good personal hygiene, and limiting the time spent in places such as grocery stores where there may be larger crowds.
If clients appear stressed and anxious about the situation, it is a good idea for counselors to help them gain the facts so that clients can accurately determine their risks in collaboration with their health care providers and take reasonable precautions. Additionally, it is ideal to assist clients in developing and enhancing adaptive coping skills, such as grounding techniques or breathing exercises, so that they can effectively manage their anxiety.
Information giving: It is important that counselors stay aware of the latest information available on the COVID-19 outbreak through their local public health authorities and on websites such as those from the Centers for Disease Control and Prevention.
In addition, the World Health Organization (WHO) frequently publishes coronavirus disease situation reports to provide updated information on the outbreak in the world. The WHO website also provides reader-friendly infographics and videos pertaining to protecting yourself and others from getting sick, coping with stress during the pandemic, practicing food safety, and staying healthy while travelling.
Neuroscience News & Research from Technology Networks has provided a short, layperson-friendly video clip titled “What actually happens if you get coronavirus?” that describes how the coronavirus affects the human body.
Counselors should also encourage their clients to stay informed by providing the aforementioned resources.
Culturally responsive service in clinical practice: Counselors can serve as protective and promotive factors when working with individuals who are either directly or indirectly impacted by the coronavirus. Counselors can promote the well-being of clients through the establishment of safety in the therapeutic process and providing them with the opportunity to process the implications of this societal issue. Additionally, counselors can facilitate the process of healing and assist in mediating factors that contribute to individuals’ vulnerability and risk. Therapy can be the catalyst for clients’ adaptability to stressors and adversity brought on by the anticipation of potential consequences from the spread of the virus.
It is crucial that counselors uphold the ethical principles of the profession, including beneficence, nonmaleficence, veracity, justice, fidelity and autonomy, when working with clients. Counselors must be attuned to clients’ well-being and do no harm, as well as treating all individuals fairly and justly. Counselors must normalize and validate clients’ concerns while also providing accurate psychoeducation (not only to our clients but also to the rest of our communities).
Counselors should also be aware that certain ethnic groups, such as those of East Asian descent, may be experiencing additional stressors. President Donald Trump has repeatedly referred to the novel coronavirus as the “Chinese virus” because of its origin in China. We believe such language has contributed to the significant and disproportionate number of verbal and physical attacks on individuals of East Asian descent living in the United States.
We encourage counselors to address these social and societal challenges with these clients, including how such challenges may be affecting their well-being. Counselors should be ready to advocate and provide a voice for individuals who may be marginalized and oppressed due to the societal impact of the outbreak.
Our hope is that this article will give professional counselors and counseling students an opportunity to educate the community with accurate information regarding the COVID-19 pandemic. Furthermore, we hope that professional counselors are informed and effectively equipped to provide support for clients who are affected by the virus and its societal impact. Finally, we encourage all counseling professionals to partake in preventative measures against further expansion of COVID-19 in the nation. After all, prevention is one of the philosophical cornerstones of the counseling profession.
For more on this topic, check out the article “Coping with the (ongoing) stress of COVID-19” from Counseling Today‘s June magazine.
Yoon Suh Moh is an assistant professor in the community and trauma counseling program at Thomas Jefferson University in Philadelphia. As a licensed professional counselor, national certified counselor and certified rehabilitation counselor, her primary areas of clinical and research interest include the effects of chronic or toxic stress on mental illness, wellness of counseling professionals, and integrative, healing-centered approaches such as neurocounseling. Contact her at firstname.lastname@example.org.
Katharine Sperandio is an assistant professor in the community and trauma counseling program at Thomas Jefferson University. Her main areas of focus include addictions counseling, counselor education, addictions and family systems, and social justice issues in counseling. Contact her at Katharine.Sperandio@jefferson.edu.