Samuel Bearer, a licensed professional counselor in St. Louis, remembers hearing a podcast interview back in fall 2020 with sociologist and author Brené Brown in which she described how the initial shock of the COVID-19 pandemic and its effects on people’s day-to-day lives had helped many individuals push through the early stages of the crisis, but after several months of pandemic living, people were starting to wear down.
“When there’s a sense of ‘I’ve been dealing with the unknowns for so long,’ there’s more and more energy it takes to maintain that level of hypervigilance,” Bearer says. “That comes at a high cost.”
At that point in the pandemic, many counselors began witnessing an increase in anxiety and depression among their clients. Some providers shifted their practice from one that had focused on supporting clients with self-actualization to one that supported clients with learning survival skills.
“You can’t self-actualize if you don’t have your basic needs met,” says Ashleigh Jackson, a licensed mental health counselor in Melbourne, Florida. “So, if there was a job loss or a partner’s job loss, money and paying bills became the priority.”
Fast-forward 12 months, and the levels of exhaustion and stress felt by many were even higher. The need for further decision-making and risk assessment turned a new corner as people started returning to work and school amid a surge in COVID-19 cases resulting from the delta variant.
As breakthrough cases mounted, dampening some of the initial excitement about the vaccine’s promise to significantly slow the virus’ spread, many people were left to wonder when or if the pandemic would end. Add to that the heated political debates around mask wearing and vaccine mandates, as well as a deluge of negative media coverage, and you get a recipe for increased levels of anxiety, depression and fatigue.
Counselors were faced with supporting clients as they navigated even more change, with added layers of uncertainty, during this reentry phase. Despite the challenges and the continued strain on many individuals — including counselors themselves — some providers began to identify opportunities for growth, both for clients and the profession.
Reassessing values around work and home
For some people, the initial reentry phase was an exciting time — a chance to return to old activities and familiar ways of life. But for others, it presented added stress for any number of reasons, including individual health concerns, the complexity of navigating a “new normal” and, for some, the realization that they were now very different from the person they had been 18 months earlier when the pandemic began.
To help clients manage some of the uncertainty around the reentry phase, Bearer says he tried to help clients see the opportunities in the transition. “The reentering is also about ‘Do I want to go back to doing what I was doing, or do I want to make a switch?’” Bearer says. “Anytime we face a crisis like that or we lose a piece of our identity, which might have been part of the work that we did — and all of that might have gone up in the air — there’s a sense of ‘Has this fundamentally changed me or not?’”
Some of those changes might include minor adjustments, such as changes in appearance or office attire. “I’ve seen several clients transition back to work and wonder, ‘Do I have to do my hair again?’” Jackson says. “But you don’t have to do these things. Those were all things that we thought that we had to do, and now we learned that we don’t.”
Some shifts that people were experiencing were more significant, however, such as deciding whether they wanted to return to working in an office setting or whether they even wanted to keep their jobs. Both Jackson and Bearer say that being a sounding board for clients to explore alternative work or employment scenarios became an important part of their work. Bearer also used the opportunity to help clients assess their values around work.
For example, Bearer found that for various clients, 18 months of teleworking had different effects on their work-life balance. Whereas some found the extra time valuable to devote to personal or family needs, others struggled with delineating their work and home lives and subsequently felt overwhelmed.
“To whatever degree that we have been affected by the pandemic, there may be moments that we come to where we can clarify for ourselves, to say, ‘Hey, if I’m feeling the tension between the value of work and the value of home, how do I clarify that for myself?’” Bearer says. “It’s normal that we fluctuate through life, but now we are learning more how to recognize which stage we’re in and what we need to prioritize.”
Bearer hopes that as more people reenter the workplace or return to pre-pandemic commitments, they get the opportunity to identify a new balance among all of their responsibilities, whether that’s at work, school, home or with family. He encourages people, where possible, to recognize this as an opportunity not to default to the broader culture, but rather to make individual choices that better resonate with their unique goals and lifestyles.
More people taking risks
In addition to decisions around work and how to return to an office or workplace, Jackson says she has noticed more clients taking large leaps of faith and making significant life changes as things began to open up more. “People are learning that life is short and everything can be gone in a moment,” she says, “so some are taking drastic risks, moving across the country, ending relationships, ending careers.”
The combination of those life changes with the physical reentry process can be a lot to manage at one time, adds Jackson, who compared the reentry phase during COVID-19 to reentering the world post-divorce or after the loss of a loved one. “We’re not the same,” she says. “But we have to figure out ‘Who am I now?’ integrating everything that’s happened, and then determine ‘How do I show up?’”
Jackson says that encouraging clients to reintegrate slowly and giving clients “permission” to not be awesome at reintegrating right away was helpful in her work with individuals feeling tension around the reentry process. She also helped to normalize clients’ fears and concerns, taught grounding and mindfulness strategies, and recommended that clients take advantage of collective resources, such as meditation and breathing apps.
Managing added stimuli
Those techniques are also helpful when dealing with the overstimulation that can come with reentry, says Emily McNeil, an LPC who owns the Mariposa Center for Infant, Child and Family Enrichment in Denver.
“Meeting all the demands of work and family and extracurriculars … it’s a trigger for a lot of depression and anxiety because people went from very low stimulation, in a lot of ways, to incredible stress and more demands, on top of the fact that we’re not out of the pandemic,” McNeil says. She incorporated a healthy dose of mindfulness, breathing and somatic techniques to help clients focus on the present moment and encourage them to take one day at a time.
McNeil and other clinicians in her practice also began referring clients to other providers, including acupuncturists, psychiatrists, massage therapists and craniosacral therapists. Given that she primarily works with children, McNeil and her colleagues also found themselves reaching out to schools more frequently. “We’ve been creating community with schools to make sure that the schools and the family and the community-based providers are all on the same page with how to support children who might be struggling,” she says. “So, our amount of case management at this time is really high.”
Not only are people being barraged with added stimuli from the physical reentry process, but many are also feeling overwhelmed with the noise coming from the media.
“It seems like we’re constantly being bombarded with breaking news and information and opinions right and left, and this can often take us out of the present space and into a pseudo reality,” says Kristin Prichard, an LPC in Houston. “Then you compound that with a novel worldwide pandemic and the restrictions and lockdowns, and it can cause our brains to go into survival mode and trigger a recurrent fight-or-flight response.”
Prichard also noticed that some clients began to create rigid opinions or reactions to try and compensate for and feel safer amid the influx of information and differing opinions. “They want to go to an extreme and say, ‘I’ve weighed it, this is my decision, and I’m not going to waiver from it,’” Prichard observes. “It’s like a protection mechanism.”
To help clients manage this type of fixed thinking, Prichard says she tries to meet clients where they are and model flexibility. “Something that I’ve tried to help individuals navigate in therapy is being more open-minded and taking in that information, but finding a way to process it before just automatically going to an answer,” she says. “[It’s about] exploring options.”
Encouraging flexibility was helpful when supporting clients as they navigated interpersonal relationships at a time when more people were gathering but not everyone was on the same page about risk and safety precautions. Prichard urged clients to have an open dialogue, as much as possible, with those they were involved with. “The best thing to move forward is to recognize that nothing is set in stone, and you really need to have open communication with others and have patience and a general level of respect,” she says.
Despite the increase in mental health disorders and the challenges centered on navigating a new normal, another theme that many counselors noticed as the pandemic wore on was a rise in demand for therapy services. This can be interpreted as a sign of resilience, according to some providers.
“While at times it is difficult to navigate, and there are lots of challenges and setbacks as we progress and then take a step back and then progress forward, overall I’ve recognized that more people are reaching out for help,” Prichard says. “You’re seeing the resiliency of individuals and people wanting to reach out for support.”
The reentry phase provided yet another pivot point — or opportunity, depending on how you look at it — to help reframe people’s mindsets from one of discouragement and frustration to one of strength and adaptability.
“There are so many times when I’ve felt, and when I’ve heard from colleagues, clients and supervisees, that I can’t take one more thing, and then there is [one more thing], and people keep going,” McNeil says. “They figure it out.”
McNeil began using examples of people’s resilience to help validate their strengths. “A lot of people who are coming to counseling say things like ‘I’m broken,’ and I never agree with that, but this has been an opportunity for people to look within themselves and see all the things that they continued to do over the last year and a half and hold the mirror up and say, ‘Actually, you’re not broken. Look at how resilient you are even as hard as this has been. You’ve gotten through it, or at least to this point.’”
While counselors were helping clients recognize their personal resilience in the face of one more hurdle, many professionals were also recognizing their own limits and fatigue. Thus, a potential side effect, or benefit, of the pandemic’s longevity was the realization among some counselors of the need for greater personal and professional well-being to ensure effective and sustained practice.
“I’m a huge proponent and advocate for therapists having their own therapy,” says Jackson, who realized a greater need to engage in personal therapy during the pandemic. “Everyone was in crisis, as opposed to a few [clients] every week, so I had to enlist my own support to process how this was all affecting me.”
In addition to therapy, some counselors found themselves reaching out more to colleagues and others in the field who were facing similar experiences.
“I think it is really helpful to build a community of support,” McNeil says. “So, having colleagues who have your back, whether you work with them or whether they’re peers who you get coffee with or connect over Zoom with. [Having] other people who really get what you do and can share notes with you about what it’s like to work in a virtual world when we’re a relational profession.”
A new balance?
The reentry phase also presented an opportunity to assess the value of teletherapy, which became a necessity in the early stages of the pandemic but less imperative once the vaccine became widely available.
“At first I, as well as some of my colleagues, were leery of telehealth,” Prichard says. She explains that the fear of losing a sense of physical presence and connection with her clients, as well as the potential difficulty of picking up on clients’ nonverbal cues, initially made her question the effectiveness of teletherapy. However, after several months of providing virtual services to clients, Prichard says she came to respect the benefits that telehealth provides.
“What it does offer is a sense of calmness or peace for the client to know that at any time, they can check in for a therapy session from wherever they are, and they can do it in their own space, feeling comfortable, and they don’t have to deal with all the stressors and ins and outs of going into a session like traffic and parking,” Prichard says. “From that standpoint, I think it’s been a unique but rewarding thing to realize that we can provide good service care in different forms than we first recognized.”
While there are very real benefits to teletherapy, in-person therapy continues to have its benefits as well. So, what will the future delivery model for professional counselors look like? Maybe a mix of both.
“You can move forward with the new technology and a new way of doing things while still respecting other ways that you’ve done things before and finding a balance between the two,” Prichard says.
This balanced approach may also present the opportunity to serve more clients, especially if licensure portability can keep track with the technology, Jackson adds. (To learn more about the Counseling Compact effort that the American Counseling Association is supporting, visit counselingcompact.org.)
“I am encouraged that the pandemic has brought a lot of counselors to virtual,” Jackson says. “It has increased accessibility for so many people who otherwise would not get therapy, and I’m really hopeful that this will carry over into more portability for us so that we can see people in different places. We will be dealing with the effects of this for a really long time, so we need to be able to help as many people as we can in the ways that are ethical.”
Katie Bascuas is a licensed graduate professional counselor and a writer in Washington, D.C. She has written for news outlets, universities and associations.
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.