2020: The year that never stopped surprising — and often horrifying — us. Rampant wildfires on the West Coast. A record-breaking hurricane season. The violent police confrontation and resulting death of George Floyd that gave rise to widespread protests once more proclaiming that Black Lives Matter and demanding an end to racial injustice and police brutality targeted at Black communities. A marked increase in terrorism by white supremacists. An acrimonious and bitterly divisive presidential election.
And overlying it all? The devastation of the novel coronavirus COVID-19, responsible for the deaths of more than 300,000 Americans.
Throughout it all, counselor practitioners have been navigating an ever-changing landscape. Pandemic safety protocols necessitated a swift shift to telehealth sessions, testing counselors’ flexibility and technological savvy. Caseloads soared as the year progressed. Counselors adapted, helping clients process anxiety, stress, grief and trauma while coping with many of the same issues themselves.
CT Online asked counselors to reflect on this extraordinary year. We wanted to hear about their challenges and successes, their losses and unexpected gifts. How have they adapted? What have they learned? And what advice might they give to their colleagues?
Here are a few of their stories:
Kimberly Johnson is a licensed mental health counselor specializing in compassion fatigue practicing in Long Beach, N.Y. She is also an assistant professor in the clinical mental health counseling program at Touro College in Brooklyn, N.Y.
The impact of working alone was unexpected. I am used to interacting with clients and counseling students on a regular basis. Suddenly my dogs and husband were my constant companions. Those I worked with — be they clients, students or peers —were two-dimensional and on Zoom. I felt my world was being lived from the waist up. I found myself learning to read people differently, to connect in a way that actual eye contact (one of my mainstays) was not guaranteed due to technology. I learned to find new ways to connect to my counseling world. Trainings, podcasts and chat groups — never really my things [previously] — became invaluable.
I learned that I had to make a more definitive boundary between my work and my home life. Work stayed in my home office and, once I left, no work went into my home life (unless I intentionally made the choice to cross the boundary). “Down time” took on a whole new meaning — I had to make a more conscious decision to be off.
Therapy via phone and video can be powerful and meaningful. I am old school — practicing from before the internet was a meaningful part of our counseling discussion — before cell phones or Zoom or texting. I believed that the best therapy is in person. I learned that I could practice good therapy remotely. I learned to change my approach, to look differently at clients and use new tools and senses to connect with clients and counseling students. I will not be unhappy when I return to a more traditional counseling and teaching approach — but I know I will be better at both therapy and teaching because of this experience.
Be open to the idea that what you thought was the best clinical practice can be reimagined. Be flexible — life throws the unknown at us and we can adjust. Be able to say no — self-care has been the most important part of 2020 (sometimes I can come first). Let yourself grieve — it’s okay to acknowledge that sometimes this can really “suck” for us too.
David Lawson is counseling psychologist, licensed professional counselor (LPC) and clinical supervisor at the counseling company Change Incorporated, located in St. Louis. He is also a professor of counseling at Palm Beach Atlantic University.
Over the last 25 years, I have had the privilege to walk with people through many crises. Although personal crises are generally the most painful, there have been two other times during my practice that I remember needing to support clients and therapists alike who were overwhelmed by the fallout of a national crisis.
In 2001 I sat with many who were absolutely devastated and mourned the innocence that was lost as we wrestled with one of the most significant attacks on American soil. And in 2008, I spent a great amount of time helping people work through the losses of their homes and businesses as the economy felt like it was unraveling and came close to crashing around us. Both crises were overwhelming and absolutely life altering, but in each of these cases we were able to come together, to join others in support for the pains and losses, and that made the difference.
But nothing could have prepared us for what happened in 2020. And the only reason we have survived this crisis as long as we have is because humans are highly adaptable. For short periods of time, we can hold tremendous stress and pain and can withstand continuous physical challenges. But the pandemic of 2020 – and especially the stress that counselors have been under since the beginning of this – has challenged even the most capable and is radically different in almost every way from 2001 and 2008.
Counselors have needed to hold space for all of the challenges they’ve been under, including managing physical and emotional stress, the stress of family and friends within their support system, the general loss of support systems that were relied upon, confusing educational demands for children, and simultaneously holding the stress of their clients.
We’ve had to re-learn to sit with and manage mutual layers of stress that comes in waves as the constantly shifting environment impacts each of us in different ways and at different times. For many, COVID-19 initially felt far away, a distant blip on the radar of life. Over time those who were not impacted directly watched as circles of family and friends who had remained free from the disease shrunk until the pandemic was upon them. Many counselors have watched as other therapists and friends slowly succumbed to the desire to escape their isolation and loneliness and became infected or were quarantined because they were around others who were infected, thus increasing the loneliness in their own lives.
It is this part of the pandemic that has been the most painful and egregious for counselors – and what has been most different from the previous crises. The lack of clarity and confusing messages from medical leadership about the effective protective precautions, as well as the general vacuum of leadership at the national level, left many counselors confused about what’s appropriate and what’s risky, and this has only added to the general level of confusion and stress. The continual isolation and loneliness, whether from the lack of interpersonal connection or the inability to touch others, has intensified every feeling — especially negative feelings — causing therapists and clients alike to experience almost delusional or hallucinogenic states.
Even those who have been effective at dissociation have not escaped the grasp of isolation and loneliness because no one can dissociate long enough to completely avoid what is happening without completely crashing. Ultimately our adaptive ability has saved us yet again, and we are surviving, and some are thriving in the middle of the pandemic.
Counselors have started discovering new ways to connect and interact with each other. One year ago, no one had heard of Zoom, and now it is a lifeline between therapists and clients as well as a great hangout. We have learned how to meet outside, while it’s still warm, sharing space at a safe distance. We have learned to read people’s eyes more clearly because for many, that’s all we can see as we’ve donned masks. We have also learned how much time we spent mindlessly shopping and running around. I think this is one of the greatest lessons I have discovered for myself and found in working with other counselors.
And most of all, I think many have started taking time to be still, to be quiet, to enjoy simple things. Being present is such a lost art even among counselors, and I think the pandemic has given us an opportunity to be present again.
Marina Brink is an LPC with a private practice in Pittman, N.J. Her specialties include counseling for anxiety, depression, highly sensitive people, maternal mental health and intuitive eating.
This has been a challenging, transformative and special year. When quarantine started in March, fear gripped me. I worried about my family’s health and how I would continue working. Some colleagues appeared unconcerned, saying everything would be “business as usual.” However, it was soon clear that our world was about to be rocked. If I wanted to keep working, I had to embrace telehealth. Honestly, it was unnerving at first. I’ve always been self-conscious in front of a camera. I was basically forced to undergo “exposure therapy” for my video anxiety! Now I’m used to seeing my face on video on a daily basis.
Some clients didn’t want to do telehealth sessions. However, by May, I was suddenly getting more client referrals than ever. The uncertainty of the time affects us counselors, too. I had to “put my money where my mouth is” by embracing self-care. I started doing daily guided meditations. I read more books this year than ever before. Walking outside cleared the cobwebs from my mind.
Yet, there are still many tough moments and days. Not knowing when the pandemic will end is nerve-wracking. The racism and political tension in our country is akin to cancer cells. We all need to heal from multiple traumas. As a white, cis-gendered female, I need to keep educating myself about system inequities and actively work towards change.
As a mother and therapist, I am constantly learning how to juggle my roles. My children are learning remotely, while my husband and I are working remotely. I miss my commute, where I enjoyed the time and space to decompress before and after seeing clients. Yet, I love wearing my comfortable yoga pants while working. Since I have younger children, I need to supervise their remote learning, which has made me appreciate their teachers more than ever. I’ve had to juggle my schedule with clients. Doing it all from home, sometimes I feel guilty when I can’t work with more clients because I currently need to prioritize my children’s learning needs.
This special year has taught me to appreciate everything that I have. It’s a cliché, but health is so important. I’m very thankful that my family and I have been healthy. I was deeply saddened when a friend’s parent died from COVID-19. My heart broke for another friend whose sibling committed suicide. Our shared humanity is so fragile and beautiful. I’m truly grateful that I chose to be a counselor. I’m honored to do what I can in my little corner of the world, to try to make a difference.
Cheryl Fisher is a licensed clinical professional counselor in private practice in Annapolis, Md. She is director and assistant professor for Alliant International University California School of Professional Psychology’s online MA in Clinical Counseling. Her research interests include examining sexuality and spirituality in young women with advanced breast cancer; nature-informed therapy; and geek therapy.
2020 has been a challenging year and no one knows it better than mental health care providers. I transitioned from face-to-face sessions to telehealth in March. With the increase of uncertainty around the pandemic, the level of anxiety from my clients soared. My practice soared. My emergency slots were filled every week and the breaks between sessions quickly became obsolete. Day after day I would sit in my home office and listen to the fears of my clients, some of whom are medical responders describing the worst of the worst cases of COVID-19. I would aid each client in identifying and utilizing tools for self-care, take a deep breath and press “start meeting” to launch my next Zoom session. I experienced hours and hours of telehealth sessions fraught with client fears that began to merge with my own.
One evening, following the lift of phase 1 COVID restrictions, my husband and I went on a drive through our small town of Annapolis. It looked like Mardi Gras — minus masks of any kind or social distancing. My husband commented on how nice it was to see everyone out. However, I went into a tirade about how these people were being irresponsible. Didn’t they know how hard the medical providers were working to save the lives of people in the COVID-19 units? Didn’t they realize people were dying?! I was so upset. After more than 20 years of clinical practice, I was surprised to realize that I was experiencing secondary trauma. My self-care routine already includes daily workouts and meditation, but these were not enough to endure the level of stress I was navigating in my own life and in my practice. I regrouped, immediately stopped accepting new clients, and created breaks throughout my day where I could go for a walk, eat food and play with my dog, Elsa.
The blurring of boundaries with telehealth became apparent early on with the invasion of client homes and the use of virtual backgrounds to conceal my makeshift home office in the spare bedroom. My beloved 12-year-old golden doodle co-therapist, Max died suddenly during the summer leaving both me and my 2-year-old poodle therapist-in-training, grieving. In her grief, Elsa insisted on being nearby — all day long — and when she became bored with the screen time, she would crash telehealth sessions trying to get my attention or bark at neighbors passing by. It was both frustrating and comical, but I learned to lean into the unpredictability that accompanies working from home. Clients now ask for Elsa and we share screen time.
Zoom fatigue was another surprise! Initially it was so wonderful to be able to see friends and family in virtual gatherings. However, after weeks and weeks of telehealth, I began to unplug whenever I could. Being outdoors has always been a priority for me but now it has become a necessity. I even began doing telehealth in the privacy of my backyard. Earbuds in and privacy screen up, I sat out among my potted herbs and bird feeders conducting virtual ecotherapy sessions that benefited both me and the clients.
Yet, with all the challenges, the thing that stands out the most to me is how resilient we are as counselors (and people). The pandemic allowed me to review my priorities, improve my self-care, embrace the unpredictable, and covet my time connecting with nature and her creatures. We continue to tackle the day-to-day obstacles with compassion, innovation and imagination — becoming better therapists and human beings in the process.
Lauren Thayer is a provisionally licensed professional counselor practicing at the counseling company Change Incorporated, located in St. Louis.
This past year has certainly been the year of challenges. Every facet of 2020 shone a light on the many ways in which our society is still unjust — and the uncertain and difficult path forward. The year also revealed how divided we are as a populace. These challenges in themselves are not new to society or this particular moment in time —they have existed from the beginning of civilization. The challenge, however, in the current time is that both are coexisting simultaneously and creating a force that pushes us further away from one another both in terms of physical proximity and moral grounds. With every turn, whether it be exposure to media or snippets of conversation, we may find ourselves presented with an awareness of one of these challenges. This awareness tugs at our sense of what is moral and just, but can also threaten our sense of self-preservation. This conflict may shake us at the very core of our identity and sometimes elicit defensive responses to a perceived threat, not just to ourselves but society as a whole.
With this realization, as a therapist, I have had to learn how to challenge and question myself and my awareness of my own truths while also coming to terms with my fears and unspoken anxieties regarding the present state of the world. Awareness, I feel, is necessary to be able to create empathy and understanding in situations that may be vastly different from our own values. This, in itself, of course, is an ever-changing and difficult process during which I try to allow myself as much grace as I would grant another clinician or client.
Thus, taking my own self-awareness into a professional dynamic, this dividedness has been an unexpected opportunity for me to challenge myself to sit in discomfort on the other side of the fence. Often as a clinician, I have found it easier to sit with the discomfort and challenging emotions of clients while still distancing myself. In that way I was able to avoid my own discomfort and confront it only within the safety of my own space. In this past year, however, the unavoidable awareness of white privilege; severe brutality against people of color; a looming threat to our physical well-being; and a government that has prioritized money over people has made this discomfort unavoidable in any facet of life. So, I began to bring my own reactions into work and have found so many of my clients have shared similar feelings of uncertainty as they have been forced to navigate awareness and emotions they formerly avoided. This has created a sense of compassion and understanding that previously felt hopelessly distant.
Derrick Paladino is a licensed clinical mental health counselor in Winter Park, Fla. He is also a professor of clinical mental health counseling at Rollins College.
“I am tired of white people.” “I am tired of my white friends.” “I am tired of my white clients.” Hearing any of these statements, as a counselor or a supervisor, is an absolute privilege and honor. This means that you have created an environment that opens the door for bravery. As I reflect on recent years and ongoing events, I am repeatedly disturbed by the increased explicit nature of racial injustice. This is not new for anyone. As a minority, I have been weaving my life around racism, discrimination and hate since my youth. What we are experiencing today, in my humble opinion, is a lightning rod that has created a safe place for increasing numbers of individuals to openly impart hate with no consequences – leaving those without power even more powerless. We have also been witnessing demonstrations for racial and underrepresented justice that show the hurt, pain and anger of those living without privilege.
These demonstrations call attention to the covert and overt nature of systemic “isms” that hit hard. When you hear the phases, “I am tired of white people,” “I am tired of my white friends,” and “I am tired of my white clients” you are experiencing a client or supervisee struggling with an indifferent system. Your job is to listen, and your job is to believe your client or supervisee.
In addition, your job is not to wait for it. When you wait for clients and supervisees to express certain things there is a chance you may never hear this important part of them. Using advanced cultural empathy to ask your underrepresented client or supervisee how they are doing within current events is normal. This creates compassion, gives power and invites safety. As we are all in a field that requires constant reflection and education one should look upon their clinical style and past sessions to discern if they consistently create environments that allow for these experiences to be spoken freely. If not, then it is not too late, and we still need you. Counselors and supervisors should be vigilant in this personal assessment because the world weaves through your client’s presenting issues and experiences as a cultural being. Clients and supervisees live within ecological systems that we should understand.
Whether you are a professional that holds privileged or underprivileged identities, please know that this work is so important. As an underrepresented counselor and supervisor myself, it is not odd for me to feel the same way towards our privileged society and hold stress. I must also do my own work and reach out for consultation to think about how that may impact the environments I create in session.
My final message is to all underrepresented counseling students and supervisees reading this. It is normal to feel struggles with the impact of the world and system around your clinical responsibilities. Know that you will not find a safe space with every professor, supervisor and counselor – and that is a fact. Discover those in and outside your program and colleague circles that are actively open to hearing your experiences. Share with those that know how to hold the space for these thoughts and feelings. Remember, it is the counselors’ and supervisors’ responsibility to create that space, not yours.
Ulash Thakore-Dunlap is a licensed marriage and family therapist with a private practice located in San Francisco. She specializes in coping with anxiety, school-work-life wellness needs and supporting communities of color.
My biggest challenge as a practitioner during the pandemic has been to navigate working from home. Before the pandemic, I enjoyed physically going to my workplace to see clients and teach. This really helped to separate my work and family life, so when I got home I could focus on hanging out with my family. The pandemic has challenged me to set boundaries at home, because I can easily keep working until late into the weeknight and during weekends.
To separate my work from home life, I have had to learn to set strict limits: scheduling a specific time to stop working, scheduling clients in blocks and incorporating more stretch breaks into my workday. These strategies have really helped me to better manage my work schedule and sustain myself and have helped me feel less fatigued and overwhelmed. Also, what has been most helpful in supporting my wellness is to force myself to schedule a day off every four weeks. I have noticed this has been an immense help with taking care of myself and reconnecting to my family during my day off.
Another challenge is feeling a sense of guilt in not being able to take on more clients. I have a very small practice because I teach full-time in a master’s-level counseling program. The pandemic and continuing racial injustice have increased stress for all, but especially for communities of color. Since the pandemic began, I have been receiving an increase in the number of calls and emails from BIPOC individuals seeking counseling. I feel guilty not being able to serve all of my community members, particularly because many people of color have never sought counseling or have not had past positive experiences in counseling. I have learned to deal with this by working through my guilt at being unable to see more clients and by referring people to other trusted clinicians of color.
The pandemic has positively impacted the way I work in my practice and how I support my clients. Working from home, I have learned to be more authentic with my clients in sharing the realities of working from home. In addition, like my clients, I too have struggled with balancing work-family-life and dealing with the racial injustices. When appropriate, and if it is part of my client’s treatment goals and plan, I have shared my struggles without sharing any specific details. Just naming the pandemic struggles, such as “I too have challenges with work-life balance” or “I too have experienced racial injustices” has helped my clients feel that I am an authentic therapist. Also, I believe providing telehealth and online counseling requires great skill. Due to COVID-19, all of my counseling sessions are now via telehealth. I have had to adapt and learn new online strategies to support my clients. I feel I have grown so much learning in how to effectively support clients through teletherapy.
Finally, the lesson I would like to share with my fellow counselors is during these times, please pay attention to burnout and fatigue. Like our clients, we may also be experiencing stressors in our life. I encourage my fellow counselors to engage in self-care and tap into their support networks.
Ron Laney is a provisionally licensed professional counselor practicing at the counseling company Change Incorporated, located in St. Louis.
Without a doubt, my biggest takeaway from this past year has been the affirmation of how important self-care is to my overall well-being. When the COVID-19 pandemic first took hold here in mid-March, I expected it to be merely a month or so before we returned to life as usual, and here we are now, more than ten months in with another nationwide surge in infections. While I’m acutely aware of and sympathetic to the enormous suffering being experienced by people worldwide as a result of this virus, part of me finds the mandate to slow down quite freeing. It’s as if I’ve been given permission to live at my own pace and not feel as if I should be doing this or that simply because it’s ingrained in the culture that I would somehow be happier or more successful if I did.
With that said, there are certainly times when I would love to go out and socialize with friends or spend more time with my two adult children. It’s just that, at least for now, I feel fortunate to not be experiencing the degree of disappointment or fatigue that others may be encountering while unable to return to a pre-pandemic way of life. During those times when I am struggling, however, I gently offer myself the same encouragement I extend to clients who are having difficulty navigating this trying time: Namely, be kind to yourself — you have a lot going on these days: the pandemic, a toxic political climate, social unrest, isolation, etc. And when feelings of loneliness inevitably do arise, I bring to mind those in my life whom I love, remembering that I am loved in return.
Concerning my work as a therapist, I would have to say that the supervision, support, and encouragement I’ve received from my company colleagues have proved most helpful. While we might not currently be able to say hello as we pass in the hallway between sessions, we do meet virtually for an hour at least once each month to check in and see how we’re doing. We also gather online quarterly for daylong, facilitated group experiences, from which I always walk away energized and emotionally lighter due to having had the opportunity to share what we’re going through individually as well as collectively, both as professionals and, perhaps more importantly, human beings.
Tammi Lewis is an LPC at Valley Health Systems where she provides medication assisted treatment and behavioral health care services.
To say that 2020 has been an interesting year would be an understatement. My state, West Virginia, was the last state to have any positive cases of COVID-19. However, our governor did his best to get ahead of it by shutting schools down and putting a stay a home order in place. That meant our practice had to go convert to telehealth.
I provide medication assisted treatment (MAT) and behavioral health care services at Valley Health Systems, an integrated care facility.
Everything shut down in March, so we had to figure out how to provide services with as little interruption as possible and quickly. At our site we provide both individual and group therapy and we wanted as little disruption as possible. Our behavioral health department shifted to telehealth swiftly, particularly with our individual clients. At the site that I work at we only missed one week of group therapy with our MAT clients before switching to Zoom. Our program functioned as it normally did for the clients – the format in how services were provided was the only real change for them.
As for us as clinicians, we didn’t realize how fatiguing doing telehealth was going to be on us. That was the first challenge — fatigue. We were moving less doing telehealth, not getting up to go get clients to bring them to our offices. So, we were sitting more than we normally would during the day. I have a sit-to-stand desk convertor on my desk, which was helpful (and I would highly recommend) to take the pressure off the back. I’m also a personal trainer, and sitting is the worst thing we can do for our bodies.
Another challenge we faced was that our schedules had not changed. They remained full, with back-to-back [clients] and then we had an increase in the number of clients we were seeing due to increased anxiety, depression, and stress secondary to COVID-19. However, we didn’t realize how these stressors were adding up until we were many months in and we were feeling burned out, tired and exhausted. This was not good for us or the clients. Because we work with the substance use disorder population, we had the additional stress of making sure they had the tools they needed to remain sober.
I had also not taken any time off since all of this started and it was starting to wear on me. In addition, as the primary caretaker of my 96-year-old grandmother there was the stress of making sure she was safe and healthy. In addition to the issues surrounding COVID-19, as the killing of George Floyd inspired widespread protests calling for social justice, I faced the stress of being a Black clinician working with primarily white clients and my status as the only Black staff person in my building.
At one point of exhaustion and frustration, I sought out supervision from a friend and mentor for guidance and direction. We talked for about two hours (socially distanced) which was helpful. As a result, two counselor colleagues and I formed a peer support group to discuss the challenges that we had and provide support to one another. This has been very helpful, and I highly recommend such groups to other clinicians. I also started putting two 30-minute breaks in my schedule, at the suggestion of our administrative team, which gives us a chance to document, get up and move, or just be away from the computer screen.
I think one of the things that has bothered me throughout this is the discussion regarding the frontline workers and all the work they have done, which is true. However, they have been told to make sure they keep up their mental health and seek out counseling if they need it. But no one ever thinks about the people they are getting the counseling/therapy from. We don’t wear capes and it has been a difficult eight/nine months for us as well. But we must put our own anxieties aside and do what we need to do, just as those other frontline workers. And we are happy to do so because it is the job we chose to do.
Lastly, one of the of things I learned and have tried to get my clients to understand is gratitude. If a pandemic had to happen, this was the best time for [it] to happen. I know there has been a lot of talk about isolation, however, it could have been much worse. If this was 1986 or 1990 we would not have had the technology we have now to keep us connected in the way that we have been able to that allowed us to maintain contact with our clients (or families), providing them the access they needed for treatment. The isolation could have been much worse and I believe that’s an aspect we have taken for granted.
Add your own reflections on 2020 – the year’s challenges and bright spots – in the comment section, below.
Laurie Meyers is a senior writer for Counseling Today. Contact her at firstname.lastname@example.org.
Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.