Tag Archives: Self-care

Opening keynote underscores a holistic approach to self-care

By Lindsey Phillips April 5, 2021

ACA’s 2021 Virtual Conference Experience started off strong with a keynote panel on self-care.

We all know self-care is important, but it can be difficult to define because there is no “correct” way to engage in self-care.

Gerald Corey, one of the four keynote panelists, stressed the importance of reflecting every day — even if it’s just for a couple of minutes — on how your day is going and what changes you want to make.

“Think of self-care holistically, and not just [as] physical exercise. Think of it in terms of relationships, meaning in life, having fun, recreating our existence, engaging in life rather than pulling back and disengaging,” says Corey, professor emeritus of human services and counseling at California State University at Fullerton.

Michelle Muratori, a senior counselor at the Center for Talented Youth at Johns Hopkins University, finds when she is tending to her self-care needs, her own internal boundaries are stronger, which allows her to be emotionally present with clients in session and let them have their own pain.

Gerald Corey, Michelle Muratori, Jude T. Austin II and Julius A. Austin, co-authors of the ACA-published book Counselor Self-Care, presented the opening keynote of the American Counseling Association’s 2021 Virtual Conference Experience on April 5. The theme for the first week of the monthlong conference is self-care.

Create a self-care plan that works for you  

Counselors can have insight and awareness, but if they don’t have their own self-care plan — one that’s simple and realistic — then change won’t happen, asserts Corey, an American Counseling Association Fellow. This plan provides counselors with an opportunity to reflect on ways they can change what they’re doing to function better personally and professionally, he notes.

“It does help to have [the self-care plan] in writing and [to] talk to somebody about it and be accountable. Think of a way to get support to carry out your plan when it becomes difficult,” Corey adds. One useful exercise may be to think about what change you want to see six months or a year into the future, he suggests. Maybe you want to make more time for a hobby or write in your journal more often.

Jude T. Austin II, an assistant professor and coordinator of the clinical mental health counseling track in the professional counseling program at the University of Mary Hardin-Baylor, advises writing this action plan in pencil because obstacles will arise that force you to readjust your plan. He loves to work out in his garage, but when it’s cold outside, he has to find another way.

Counselors can also incorporate their self-care plan into their current routines, notes Julius A. Austin, a clinical therapist and the coordinator for the Office of Substance Abuse and Recovery at Tulane University. For example, they can check in with family or listen to an audiobook during their hour-long commute to work.

Muratori, co-author of Coping Skills for a Stressful World: A Workbook for Counselors and Clients, reminds counselors that they don’t have to do self-care perfectly. Often, doing their best is good enough, she says.

Get to know your stress

Jude Austin shares advice he received from a supervisor: “Make … stress [and] anxiety your best friend. Sit them next to you and get to know them. Understand what stress does to you [and] how it influences you. What are your triggers? How do you deal with it? Who are the people around you that it affects?”

Considering these questions allows people to be intentional about how they approach self-care because they better understand their unique kind of stressors, he explains.

This reflection should also extend to one’s relationship with other people. Carefully consider who you want to be around professionally and personally, advises Jude Austin, a licensed professional counselor (LPC) and licensed marriage and family therapist associate in private practice in Temple, Texas. It’s OK to fire a supervisor or not to be friends with every colleague if the relationship isn’t working for you or makes you feel bad.

Finding ways to cope with stress can be challenging. The keynote speakers, co-authors of Counselor Self-Care, share some activities that help them better manage their stress:

  • Find some type of physical activity that you enjoy doing and that fits within your lifestyle and do it relatively consistently, Corey says. And it doesn’t have to be time consuming, he adds. You can take the stairs rather than the elevator, for example.
  • Learn something new. When graduate school became overwhelming, Jude Austin started growing bonsai trees to help him cope with the stress of having things outside his control. He still finds learning something new every year helps him manage his stress and fosters his curiosity.
  • Connect with others. Julius Austin, an LPC and adjunct professor at Southeastern Louisiana University, takes time to check in with his family, friends and colleagues. Even just a five-minute phone call with his family gives him a sense of warmth and calm after a stressful day.
  • Muratori watches late-night comedy as a way to decompress.
  • Enjoy nature. Corey advises counselors to step away from their desks and spend at least 30 minutes outside in nature every day. Jude Austin sometimes finds it challenging to leave his office, so he brought nature inside by adding a few plants to his workspace.
  • Find meaning and purpose in your life. Think about what makes you want to wake up in the morning, Corey says. He notes that spiritual involvement and service to others can often be a source of meaning for many people.
  • Go to counseling. All the speakers stressed the importance of counselors seeking their own counseling throughout their lives.

Revising self-care plans

Each new career stage presents new stressors that require counselors to constantly adjust and revise their self-care plans.

Julius and Jude Austin, co-authors of Surviving and Thriving in Your Counseling Program, are in the early stages of their professional careers, and they’ve noticed new professionals often quickly say “yes” to every professional opportunity because they are building their careers and gaining self-confidence. But this behavior can lead to burnout, so they caution new professionals to be more intentional with the job responsibilities they assume.

Corey suggests counselors say, “Let me think about it,” when approached for a professional opportunity. And then they really have to consider if that opportunity is a good one for them in that moment.

Jude Austin also finds it challenging to balance all of his daily responsibilities between his work and personal life. “Your career and family are sometimes growing in parallel,” he says. And juggling these roles is often when he feels the most out of balance.

Mid-career is often a time when people assume more work-related responsibilities, Muratori says. And they may need someone to hold them accountable and ensure they aren’t taking on too much. She also points out it’s a time when counselors may experience new family stressors such as a child going off to college or caring for older parents.

Corey credits his long, productive counseling career with two things: 1) He took the time to create a self-care plan that worked for him and encompassed all facets of wellness, including physical, emotional, relational and spiritual health. 2) He took the time to reach out and connect with colleagues. “This can be a lonely profession,” he notes. “Don’t wait for somebody else to … reach out. … It’s important for us to reach out to those friends and colleagues and take the initiative.”

Counselors shouldn’t feel guilty for taking time to care for themselves. “Pay attention to yourself; listen to yourself; allow yourself to guide you through this [self-care process],” Jude Austin says. “If something doesn’t feel right, doesn’t feel comfortable, then reevaluate. … Self-care is flexible. It’s not selfish. It’s responsible. So, just be kind to yourself.”

 

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This keynote panel kicked off a month of virtual events, including hundreds of educational sessions and three additional keynotes, that lasts through April 30.

Find out more about the American Counseling Association’s 2021 Virtual Conference Experience at counseling.org/conference/conference-2021

Registration is open until April 30; participants will have access to all conference content until May 31.

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Lindsey Phillips is a contributing writer to Counseling Today and a UX content strategist. Contact her at hello@lindseynphillips.com or through her website at lindseynphillips.com.

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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.

Voice of Experience: Spokes of a wheel: A lesson in physics

By Gregory K. Moffatt March 29, 2021

I can’t count the number of calls and emails I’ve gotten over the past year, in addition to the many times I’ve been asked to speak (virtually, of course), on the same topic: How can we help people cope during the pandemic? In fact, I recently spoke on this topic to one group for the second time in the past year.

Who could have known this pandemic would go on for so long and how our lives would be disrupted? We are all fatigued. Not only do I have to help my clients manage their fatigue, but I am also focused on the needs of my clinicians and supervisees. No one is immune.

There is no single answer to the best way to cope. As is the case with almost any issue in mental health, we encourage our clients to eat right, sleep right and exercise. This is what I call Moffatt’s Mantra. The treatments for depression, anxiety, grief and a host of other common diagnoses must include these three common components.

But beyond that, coping is idiosyncratic. Things that bring me peace might bring you stress, and vice versa. For example, I just finished a five-day business trip to the Gulf Coast. I stayed in a luxury estate, had a private chef for suppers and ate catered meals otherwise. All of the refrigerators were stocked with just about anything you could imagine. I was paid very well, my workload was light, and I had plenty of time for sailing, deep-sea fishing and the beach.

But I don’t like the beach. I’d rather be in the mountains. I also find it very hard to relax when I’m working, even in luxury accommodations like the ones I experienced. I’m happiest sleeping in my own bed. I may be the only person who wouldn’t find this consulting trip relaxing, but I am intensely introverted. Social events leave me feeling drained, and I’m always “on” when I’m in environments like that.

As odd as I am, I’m not alone in my idiosyncrasies. Some of you reading this might list coping strategies that perhaps nobody else would find helpful. In other words, we shouldn’t assume what would be a healthy coping strategy or stress relief technique for our clients. Our clients need to teach us those facts.

So, here is the physics lesson. The individual spokes on a bicycle are quite weak. Even a child could easily bend one. A bike with only one spoke wouldn’t go very far. In fact, the weight of the bicycle alone would crush that single spoke. But when you put multiple spokes around the rim — with several dozen of them sharing the load — the bicycle sustains its own weight and that of the rider. And the pliability of those spokes — the ones a child could bend — helps the repair person true the rim so that it doesn’t wobble.

This brief foray into physics teaches us something about coping. If you were to ask the bicycle specialist which spoke was most important, they would laugh. All of the spokes are important, and they all have to work together. Our ability to cope with stress, frustrations, anger, relationship problems and grief — all magnified by the pandemic — is based on multiple strategies working together. The more the load is shared, the better.

Even though one strategy — exercise, let’s say — may usually work, it might not always work. Healthy coping involves many skills from which one can draw.

A minimum of three clear strategies, tailored to the individual, is a starting point. We might think of these strategies as legs of a stool. With at least three legs in place, a stool will remain standing, and the more legs on the stool — like the spokes of a bicycle — the harder it will be for something to break it.

So, my response to all those media questions about how we can help people cope during the pandemic is the same. Examine your own life. What tools, skills and strategies have you found helpful in the past? The longer your list, the more spokes you have to sustain you when you feel you are reaching the point of fatigue.

I exercise religiously — almost every day, rain or shine — because I know it helps me avoid fatigue and depression. I nurture relationships — especially my family relationships. I know they are important spokes in my wheel. I need solitude, quiet, predictability and routine. These are some of my spokes, and I might even add my own pillow and my own bed as two others. So, even though a lucrative consulting gig on the Gulf might sound good, I limit them because limiting that kind of work is a spoke for me too.

Know your own spokes and help your clients brainstorm their personal lists. We can’t do that for them. With overt tools to lean on, we will see our way through these very challenging days.

 

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Gregory K. Moffatt is a veteran counselor of more than 30 years and the dean of the College of Social and Behavioral Sciences at Point University. His monthly Voice of Experience column for CT Online seeks to share theory, ethics and practice lessons learned from his diverse career, as well as inspiration for today’s counseling professionals, whether they are just starting out or have been practicing for many years. His experience includes three decades of work with children, trauma and abuse, as well as a variety of other experiences, including work with schools, businesses and law enforcement. Contact him at Greg.Moffatt@point.edu.

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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.

Primum cura te ipsum: First, heal thyself

By Samuel Kohlenberg August 17, 2020

During this bizarre and painful epoch beset by pandemic, racial trauma and social injustice, there is a growing emphasis on clinician well-being and self-care, and rightfully so.

Countless articles and blogs have been written about self-care for counselor clinicians, and here is one more. Why write another one? Because as a counselor educator and supervisor, I want to sell you on a goal other than being OK enough to work. Because avoiding burnout is not enough. We need to set the bar higher to competently render care. Make no mistake, this is an ethical issue.

Like many, perhaps, I have always found Latin venerating in a way that underscores the importance of a phrase or idea. Whether carved into cornerstones or encircling university seals, the tradition has gravitas. One idea I find worthy of such reverence, as it pertains to psychotherapy and behavioral health, is that clinicians need to “do their own work.” Therapists need to heal.

Whether it is through traditional talk therapy or other means, therapists need to attend to their own trauma, developmental journeys and growth. While the oft-cited phrase attributed to Hippocrates, “primum non nocere” (first, do no harm), is a vitally important doctrine in mental health, I am suggesting that there is an overlooked and more sequentially vital step in terms of primacy required to avoid doing harm: that therapists confront and deal with their own issues.

Although therapists are often told that they need to take care of themselves and “do their own work,” I do not believe there is enough understanding regarding why this is so crucially important. Yes, it benefits the therapists, it may mitigate burnout, and it may increase professionals’ longevity in the field. But from my perspective, not enough emphasis has been placed on the idea that people who are not OK do not make competent therapists.

This is not to say that people who have endured trauma or have previously met criteria for a behavioral health diagnosis should not pursue jobs as therapists. Far from it. Many of the best therapists I know are as good as they are in large part because of the difficult roads they have had to walk.

There are many ways to describe how therapists doing their own work might affect them professionally, but I am going to focus on three ideas:

1) Your nervous system is an instrument for attachment work and relationship, and it is shaped by how much work you have done.

2) Doing your work helps you project less and become more aware of your projections.

3) Having done the work means being able to genuinely relate to what your patients are going through instead of just understanding. (Note: Although I say “patient,” please feel free to substitute “client.” The reason I prefer patient is that I feel it better emphasizes the connection between the physical and psychological realms, and given the field’s current understanding of the interconnection between the two, I intentionally use language that fits in both lexicons.)

The nervous system

In a typical stress response, a perceived threat can activate the amygdala, leading to the release of epinephrine and coordinating a sympathetic response to the stressor. Typically, this sort of sympathetic activation means that you are no longer using the circuits associated with optimal social engagement (consider, is it harder to tell how other people feel when you are angry?).

The social engagement system is characterized by the feeling of social connection, the ability to read social cues, eye contact, voice modulation and comfort. All of these things shut down when we go into sympathetic activation as part of a stress response.

Imagine a therapist who has yet to “do their own work” sitting in their office listening to their patient describe a traumatic event. Even if an activated therapist gives no obvious facial expression or gesture, how do you think the person sitting across from them will be affected by the therapist’s nervous system switching gears from social engagement to fight-or-flight?

Imagine for a moment a scared child running to a parent or caregiver and being met with warm eyes, a soft smile and a soothing voice. Now imagine the same child being met with scared eyes, decreased facial muscle tone and a flat voice. In which situation is the child going to be more OK?

Similar dynamics play out in therapy. This means that therapists’ ability to stay in their social engagement system affects patients’ likelihood of being OK while doing things such as trauma work. Part of a therapist’s work is using their nervous system to help resource a patient’s nervous system. For some, it will take significant and ongoing work to be able to do this well. 

Awareness

Awareness and projection share a simple relationship: The more aware you are of your projections, the less likely you are to inadvertently allow those projections to affect your relationships with others.

Regardless of theoretical underpinning, modality or clinical philosophy, virtually all types of psychotherapeutic work regard the relationship between therapist and patient as instrumental. Thus, if the therapeutic relationship itself is one of the primary means by which therapists ply their trade, and a lack of awareness can lead to one’s projections interfering with relationships with others, there is an argument to be made that therapists are on ethically dubious ground if they practice without having cultivated enough awareness and done enough work to overcome this potential pitfall.

You are missing your patient if all you can see is your projection. You are not going to realize that it is a projection if you have yet to cultivate enough awareness. 

Relating

There is a difference between understanding what someone is going through and being able to truly relate to it. While psychotherapists are undoubtedly an empathetic bunch, helping someone engage in the process of developmental therapeutic growth beyond where you yourself have grown is no easy task.

Imagine for a moment a 40-year-old in the midst of an existential crisis. Now imagine an empathetic and well-meaning 14-year-old attempting to help that 40-year-old. Unfortunately, a developmental stage is not always as clear as chronological age, and this can lead to blind spots for clinicians that may negatively affect quality of care. Being able to genuinely relate to what your patients are going through is important, and the 14-year-old is going to have a heck of a time helping the 40-year-old.

Keep doing your work

The thing that all of the above ideas boil down to is relationship. It is your job to ensure a helpful clinical relationship, and the relationship itself is the greatest clinical tool that you have. Ensuring that this primary tool is going to be functional, let alone optimal, can require time, effort and a willingness to endure the discomfort necessary for growth.

Of course, more basic day-to-day self-care is still important for fighting burnout and for resourcing one’s self, especially when you are tasked with taking care of others and especially during times in which nobody seems to be OK. The invitation, the challenge, the mandate, is to not stop at “resourced.”

Aim higher. Embrace catalysts for growth and development. Get comfortable with discomfort when it means a potential breakthrough. Do it for you. Do it for them. Do it like it’s your job.

 

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Samuel Kohlenberg is a clinical psychophysiologist, licensed professional counselor and behavioral health educator specializing in the treatment of stress. He is a master of education in the health professions fellow at Johns Hopkins University and a postdoctoral fellow at Saybrook University and works in private practice in Denver. Contact him through his Facebook page or through his website at denverstressclinic.com.

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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.

The revised meaning of self-care in the wake of COVID-19

By Scott Gleeson August 4, 2020

Practicing proper self-care is often the prescription that professional counselors will share with their clients to help manage life stressors and mental health symptoms during their day-to-day lives.

That emphasis has taken on new meaning over the past several months as self-care routines have been offset by quarantining measures from the COVID-19 pandemic. Suddenly, sleeping patterns were thrown off by newfound anxiety. Routine pleasures such as listening to a podcast or playlist during the morning and evening commute disappeared as working from home became the new norm. With gyms closed, people were forced to adjust their exercise routines and workout habits. Typical avenues of social escape — restaurants, movie theaters, salons — were also closed. Even parks and hikes were off-limits in some states for a time.

In spite of the limitations, self-care has never been more meaningful given the conditions that people found (and, in some cases, still find) themselves in. Stephanie Burns, an associate psychology education professor and coordinator of the clinical mental health counseling program at Western Michigan University, says the unprecedented times prompted unprecedented human responses.

“Two things were happening at once for clients coming into therapy: They were going through their own already-existing struggles of depression and anxiety. Then there’s the trauma from what this crisis brought. Trauma is really about anything providing discomfort or distress to where an individual feels overwhelmed. It’s not something as obvious as getting hit by a car. Consciously, you can think some of this doesn’t bother you. But in the subconscious mind, trauma can exist. Everyone lost something from COVID. People lost jobs, loved ones and, by and large, their daily lives.”

On the positive side, the pandemic’s conditions have presented new opportunities for self-care for many people — with extra time at home for projects such as painting, playing music and experimenting with cooking and baking, more quality time with pets, additional emotional space to journal and a renewed premium on daily walks.

“There’s such a protective element to our routine, and our emotions get caught up in that pattern,” says Eric Beeson, president of the American Mental Health Counselors Association. “By being at home for several months, we had to readjust by finding normal in the abnormal. Normal had to be reconceptualized.”

That concept of normal was flipped upside down for clinicians too. The same focus on self-care needs to extend to therapists in their own lives and can be a unique blind spot, according to experts. Burns says she often reminds her counseling students that self-care works both ways and to practice what they’re so often taught to preach to clients.

“As counselors, when aspects of the client start matching you, then we run the risk of aligning with them and assuming what’s working for us is working for them,” says Burns, a member of the American Counseling Association. “Because of COVID, we were all going through the trauma and the grief process of our everyday lives at the same time. We cannot as clinicians expect to not be impacted by all this at the exact same time on a personal level. Then we add the extra layer of vicarious trauma from clients with intensified needs where we take on their pain. That all adds up to extra layers that cannot be neglected.”

“There’s been an overall shift in how we think about self-care as clinicians,” Litherland says. “Particularly during COVID, we should be asking ourselves, ‘How can I meaningfully and effectively engage in clinical work? Personally and professionally, am I able to buffer any side effect of burnout and compassion fatigue?’ Maybe we need 15-20 minutes in between each client because of our added pressures. Pace certainly matters for us because the speed of life right now feels fast.”
Gideon Litherland, a licensed clinical professional counselor at Veduta Consulting in Chicago and a Ph.D. candidate at Oregon State University researching supervision effectiveness, says emotional pace is an area for clinicians to pay attention to in working with clients.

Litherland adds that with the heavy increase in telehealth sessions during the pandemic, self-care has become even more integral. “The volume can take its toll,” he says. “Particularly when we’re connecting through a computer screen, a video monitor, it’s a different mode of attending for us. We’re working harder to extract more information from limited data. The sessions might be doable, but the wealth and richness aren’t as easy to pick up as in person.”

Carol Park, CEO and founder of the virtual platform company Thera-LINK, says telehealth was already on the rise before the coronavirus pandemic. But shelter-in-place orders prompted a huge increase and reliability on digital therapy. The benefits for both clinicians and clients can be widespread, but Park notes that she’s found treating virtual sessions slightly different than in-person sessions can be helpful for clinicians’ self-care.

“People who were having struggles pre-COVID, now they were needing connection even more,” Park says. “Telehealth really has filled that void for clients. For therapists, it’s important to know that you’re not quite getting that neuroconnectivity element. You sort of lose that sixth sense. As a therapist myself, I’ll leave feeling a little bit more depleted. You work a little bit harder.”

As states have started to gradually open up establishments and shelter-in-place orders have lifted around the country, private practices and therapy businesses are also opening their doors. With some clients returning to work, that gradual adjustment can be mended in the therapy room.

“I think one of the most important things is being gentle with ourselves, accepting that things are different,” Litherland says. “We’ve all been through something. We have to look at what previously worked for us and feel out how it fits into a new reality.”

Beeson, who is also a licensed professional counselor in West Virginia and a professor at Northwestern’s Family Institute, says the initial concept of easing back into day-to-day life as a clinician (mirroring the process many clients were experiencing) was interrupted by current events. The killing of George Floyd while in the custody of Minneapolis police officers sparked nationwide protests and, from Beeson’s perspective, put a renewed focus on clinicians’ roles being about more than just sitting in the counselor’s chair.

“When you look at wellness models, they’ve become accentuated more now,” Beeson says. “Continued racism and violence and health care disparity have always been there. But they’re highlighted more now. So, my sense of getting back to normal might be more cannonball-like considering the sense of urgency I feel in my role as a professional counselor, leader and person. Sometimes that sense of purpose can be part of our self-care too. As we come back to our daily lives, things have changed. There’s a need to collaborate and come together now more than ever.”

 

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Scott Gleeson is a licensed professional counselor at DG Counseling in Downers Grove, Illinois, and Chicago. Contact him at scottmgleeson@gmail.com.

 

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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.

Coping with the (ongoing) stress of COVID-19

By Lindsey Phillips May 21, 2020

The COVID-19 pandemic is affecting everyone differently. Some are coping with the loss of a job. Some are risking their lives caring for those who are sick. And others find themselves deeply contemplating existential questions of mortality and the meaning of life.

The pandemic could also be compounding underlying mental health issues for some clients, notes Robert Haynes, a member of the American Counseling Association. For instance, clients who were already battling depression or obsessive-compulsive disorder may now be dealing with a significant amount of anxiety and stress on top of that related to COVID-19. Those confronted with social injustices because of their race, ethnicity, sexual orientation or disability may also be more affected, he adds.

“People are going to be all over the spectrum as far as how they’re doing, what they’re doing and how it’s affecting them,” Haynes says. “Don’t assume anything, even if you’ve been working with a client for some time. This [pandemic] may be a huge setback for them.”

Many people have not dealt with this level of stress before, and some are having newfound anxieties, which can be jarring, says Shainna Ali, a licensed mental health counselor (LMHC) in Orlando, Florida. The pandemic may also uncover an unaddressed mental health concern that could benefit from counseling, she adds.

Coping with uncertainty

People’s ability to cope with stressful events has been and will continue to be tested by the COVID-19 pandemic. During this time when mental health is moving to the forefront of the public’s consciousness, professional clinical counselors are in a prime position to help clients cope with uncertainty and loss, build resilience, adjust their coping strategies and self-care routines, and identify their individual and community strengths. And counselors, of course, can best help their clients by remembering to also take care of themselves during this challenging time.

Uncertainty surrounds this global crisis. No one is quite sure what to expect or what the next day will hold. The uncertainty, fear and unknown with COVID-19 creates the perfect formula for anxiety, says Haynes, co-author, with Michelle Muratori, of the recently published ACA book Coping Skills for a Stressful World: A Workbook for Counselors and Clients.

A common response to this uncertainty is trying to seek control, Ali says. Throughout this pandemic, Ali, owner of Integrated Counseling Solutions, has constantly been reminding clients, “Manage what you can. Release what you can’t.” Fixating on what you can’t control leads only to rumination, but focusing on what you can manage is one way of coping with a stressful situation, she says.

For example, an adult client might worry about their parents and how well they are isolating during the pandemic. The client may want to visit their parents but also fear making them sick. Ali would advise this client to find another way to check on them (one that aligns with the Centers for Disease Control and Prevention guidelines) such as calling or doing a video chat.

“Focusing on what we can control might help us to feel more grounded,” says Muratori, a senior counselor at the Center for Talented Youth and a faculty associate in the school of education at Johns Hopkins University in Baltimore. Counselors can help clients set small, achievable goals and take time to reflect on what they have accomplished each day. For example, clients can ask themselves, “What is one thing I can do today to move toward accomplishing my goals?”

People can also control the type and amount of information they consume. As Stephanie Dailey, an assistant professor of counseling at George Mason University, points out, overexposure to media tends to increase people’s levels of distress, fear and anxiety during disaster situations, regardless of whether they were involved in the crisis.

“Accurate and timely information is important,” says Dailey, a licensed professional counselor in Virginia. “But if a client is constantly on social media and is accessing sensationalized or erroneous information, it’s going to undermine their mental health.” She advises counselors to inquire about how much access (or overaccess) to information clients might have.

Coping with loss

Not all loss is obvious. A couple mourn the cancellation of their vacation plans. A high school senior is upset because he won’t be able to experience graduation with his friends. A young child misses her first Broadway show. Neighbors are no longer able to relax and celebrate the end of a workweek by having dinner with one another in their homes on Friday night. Baseball fans lament the start of the season being postponed.

Loss is upsetting because it highlights what we no longer have or what we could have had, explains Ali, a member of ACA. She helps clients more fully understand what they are truly mourning and validates their appropriate emotional responses to the loss, such as sadness, anger and frustration. But she also helps clients see possibilities for experiencing gratitude even in the midst of loss.

For example, if a client is upset about not being able to get married when originally planned, Ali first reassures the client that feeling that way is OK. She may then ask the client to think about something for which they are grateful. The client may respond, “I still have my partner.”

Ali, author of The Self-Love Workbook and the blog A Modern Mentality (hosted by Psychology Today), finds gratitude a particularly valuable coping skill currently because “right now, it’s really easy to get distracted by the negative.” Encouraging clients to be grateful and to look for the positive isn’t meant to undermine or minimize negative emotions, she asserts. Rather, it deters clients from ruminating on the negative. 

Ali might also ask the client upset about their postponed wedding, “How can you still honor what you have?” This question would help the client refocus their energy on what can be managed (such as revising their wedding plans or planning an at-home date night) rather than wrestling with what is beyond their control, she explains.

Building resilience

Haynes and Muratori say that resilience is one of the key components of being able to cope with stressful events. Some people incorrectly assume that resilience is innate, but it can be learned, asserts Haynes, a clinical psychologist and producer of psychology video programs for Borderline Productions. “Resilience is more what you do than it is who you are,” he explains. And like any other skill, it grows stronger with practice.

Counseling techniques that help clients connect with others, adjust their thinking and beliefs, become more optimistic and flexible, practice self-care, attend to the spiritual dimension of life or promote self-compassion can bolster resilience, Haynes says.

In Coping Skills for a Stressful World, Haynes and Muratori share an exercise for strengthening client resilience. It involves clients tracking their reactions to stressful events for a period of two weeks and asking themselves some questions: What did they feel and think about the situation? What actions did they take to resolve the crisis? How effective were those actions? What did they learn? The exercise encourages clients to consider their own strengths and the ways they already cope with stressors. Clients come to the realization that they can use these same tools that they already possess when facing future crises, Haynes and Muratori explain. (The use of out-of-session exercises and activities such as this one is a major focus of their workbook.)

Ali works with clients to create their own toolkits of general self-care and coping skills that may be helpful during difficult times. It is important that people establish a general self-care practice rather than waiting to focus on coping skills during a crisis, Ali notes. She says that everyone’s coping skills during a stressful event will look different, but she advises clients (and counselors) to break into their “emergency coping kit” and find activities that help them manage stress.

Dailey, an ACA member who specializes in disaster mental health, finds ways to tap into her clients’ strengths to promote resilience and coping. If a client enjoys art, for example, Dailey may recommend painting or drawing as a possible coping tool. If a client is a natural helper, Dailey might have them brainstorm ways they could support others during the COVID-19 crisis, such as making masks or volunteering virtually. Spiritual or religious practices also provide an enormous amount of strength for some clients, she adds.

“Communities and individuals are innately resilient,” says Dailey, co-author of the 2014 article “Shelter-in-place and mental health: An analogue study of well-being and distress” for the Journal of Emergency Management. “Everyone has strengths, and this crisis can be an opportunity to find those strengths.”

As Muratori, an ACA member, points out, learning coping skills and resilience is not just something that will help clients get through the current COVID-19 crisis. It will also prepare them for future crises, large or small.

Adjusting coping and self-care strategies

“One of the skills in being resilient is also having some flexibility,” Muratori says. That is particularly relevant now because the COVID-19 pandemic has forced people to constantly shift and reshift their schedules while also creating new routines.

It is natural for people going through challenging times to engage in rigid thinking such as “I can’t stand this,” Muratori says. She advises counselors to remind clients that they are standing this; they are adapting and adjusting.

Many of Ali’s clients thrive with routine, but those routines have repeatedly been disrupted by physical distancing, quarantine and gradual reentry. Some of her clients were used to having a clear distinction between their home lives and work lives, so being forced to work from home has created new challenges for them around establishing and maintaining boundaries.

Ali works with these clients to recognize their personal boundaries and to establish some sort of new routine for themselves. She encourages clients to use a semistructured routine, in which they set their intentions for the day but also remain flexible to accommodate new circumstances as they arise.

Dailey also advises clients to maintain a regular routine as much as possible. She encourages them to focus on the basics, such as waking up, showering, eating and going to bed at the usual times.

Ali says that social connectivity remains an important coping strategy during the COVID-19 pandemic. “Social distancing and social isolation are not the same,” she emphasizes. Ali advises clients to think of creative ways to continue meeting their social needs. For example, if clients previously coped with a stressful workweek by going out to dinner with friends, perhaps they could consider hosting a virtual dinner party.

Likewise, clients may need to adjust their self-care regimens right now. After first defining self-care, Ali says, counselors can help clients brainstorm self-care techniques that have worked for them in the past and then look at how they can adapt those strategies (if necessary) to work in an environment of physical distancing or gradual reentry. For example, if a client previously coped with stress by going to the gym, how could they still fulfill that need while gyms are closed? Could they take a remote fitness class or go for a run instead? (For more on this topic, read Ali’s ACA blog post “Self-care & social distancing: Helping clients adjust during COVID-19” at tinyurl.com/ACAMemberBlogAli.)

“Any tools that will support relaxation are really critical at this time,” Dailey emphasizes. She finds mindfulness an effective technique for helping clients regulate their emotions because it encourages them to pause for a moment and let their bodies catch up with their brains. In turn, emotion regulation helps clients successfully manage their symptoms, maintain focus for day-to-day problem-solving and attend to physical needs such as eating, sleeping and taking the proper medications, Dailey says. Clients can journal, go for walks, spend time outside, exercise, meditate, do breathing exercises or do grounding exercises to manage their anxiety, she adds.

Counselors can also play a role in making self-care fun. To help boost self-care, Ali challenges clients (and herself) to combine various coping strategies. For example, a client could livestream a fitness class with a friend, or a family could do a gratitude reflection together at dinner.

Coping as a community

Muratori says that the COVID-19 pandemic exemplifies communal shared trauma — a traumatic event that affects an entire community directly, indirectly or vicariously. The good news is that community members are finding ways to support one another.

In Dailey’s community, neighbors stood on their porches one night and clapped into empty space to show their support for health care workers. They also placed stuffed bears with hearts on the chests in their windows to show their love for one another. Members of Haynes’ neighborhood also placed stuffed bears in their windows so children could go on a “bear hunt.”

Counselors can encourage clients to look around their communities and notice these resilient acts, Dailey says.

Ali specializes in individual mental health counseling, so her clients typically come to her to work on their own individual concerns. But since the COVID-19 crisis began, Ali has noticed that her clients are also showing more concern for the mental health of those around them, including family members, friends and neighbors.

Ali’s clients are also passing along their coping skills to others. One client noticed a roommate was anxious and suggested that they color together because coloring had previously helped the client manage stress.

Some of Ali’s other clients have been modeling the coping and communication skills they learned in counseling for their children at home. This includes using “I” statements, taking breaks and practicing self-care.

Ali also found a way to use her expertise to serve her community. Ali noticed a pattern of heightened stress among people in her life (herself included) because of the pandemic, but as a counselor, she also knew that this reaction was normal. She realized, however, that others in her community might not understand the emotions they were experiencing or know how to cope with the increased stress.

“This [pandemic] is not just exacerbating mental health concerns for people who are in counseling. This is also highlighting mental health problems for people who are not in counseling,” she says.

Of course, Ali couldn’t provide counseling to her entire community, so she and two other LMHCs, Candice Conroy and Sanya Matani, started offering a free virtual lesson to help people better understand and cope with the stress they might be experiencing because of COVID-19. The three LMHCs made it clear that the lesson wasn’t a substitute for counseling and provided resources for people to seek professional help.

Coping as a counselor

Haynes and Muratori express concerns about the stress levels counselors might experience throughout the pandemic and even after the initial threat subsides. “They need to take care of themselves better than they ever have before,” insists Haynes, author of Take Control of Life’s Crises Today! A Practical Guide.

Counselors need to apply the same coping strategies and tools to themselves that they give to clients, Haynes says. These include getting proper sleep, exercising, connecting with others, taking breaks, processing their emotions, turning off the news and getting outside.

Ali acknowledges that she has been feeling the stress of handling her own anxieties and concerns about the pandemic while also maintaining her current caseload. At first, the pandemic was the main topic for all of her clients, but this is evolving, she says. Now that most of her clients have adjusted to a new routine, they are again discussing their primary concerns that originally brought them to counseling. Still, Ali thinks it is important to do a quick check-in with her clients about how they are coping with the ongoing stress of COVID-19.

Self-care becomes even more important for counselors when sessions all deal with the same topic, giving clinicians few breaks to escape from it, Ali says. She has been coping with her stress by journaling, doing yoga, dancing, walking her dog, practicing mindfulness, reading, doing video chats and exercising.

Counselors need to remember that they are affected (whether directly or indirectly) by this pandemic too. Before the pandemic, most of Ali’s clients used traditional counseling, but with physical distancing rules in place, they now mainly use telebehavioral health. Ali acknowledges that staring at a screen for long periods of time has been taxing for her.

Taking breaks from the screen and using a semistructured schedule for both her personal and work schedules have been helpful coping strategies for her. When she feels particularly overwhelmed, she also practices a “digital detox,” putting her digital devices away for a day and focusing on her self-care to find her equilibrium. If a complete digital detox seems intimidating to counselors or clients, she encourages them to create small, manageable digital boundaries such as stepping away from their devices for a few hours or setting a timer to minimize their use of electronics.

For counselors in private practice, isolation can be another pronounced risk during the pandemic, Haynes points out. He highly recommends that counselors seek out colleagues for consultation, support and supervision during this stressful time.

Much like counselors advise their clients to look for individual and community strengths, clinicians can listen for examples of clients’ resilience, Dailey says. This may result in vicarious resilience, a concept developed by Pilar Hernandez-Wolfe, David Gangsei and David Engstrom in which therapists experience their own personal growth by witnessing and recognizing the growth of their clients.

Adjusting to a new normal

Even after the number of COVID-19 cases subsides, life won’t just go back to normal. The reentry process is going to upset people’s routines all over again, Haynes predicts. For that reason, he and Muratori advise that counselors prepare to take a more directive stance with some clients and focus on their life skills during the transition back toward a “new normal.”

Counselors may need to provide clients with guidelines, instructions or demonstrations, or they may have to model or teach clients new skills, Haynes and Muratori say. For instance, some clients who have been laid off may need help filing for unemployment, conducting a job search or applying for new jobs. Others may need guidance on how to safely reenter their workplace or physically interact with family, friends and community members for the first time in months.

Counselors will also have to help clients manage expectations, Dailey says. For example, many clients may now be dreaming of returning to work, but when that finally happens, they could very well find themselves stuck in meetings again and wondering what their kids are doing at home. Likewise, parents feeling impatient about their children returning to school may have forgotten what the old morning struggle was like to get everyone off to school and work on time.

Adjusting back to something resembling the previously normal routine as stay-at-home orders are lifted will take time. Dailey thinks the adjustment will come in phases. People returning to work will be one round of adjustments. Then there will be another adjustment period as schools attempt to reopen in the fall. 

It is also important to note that clients won’t just be going back to “work as normal,” Dailey says. Even if they return to the same job and the same physical work location, things promise to be different in the wake of COVID-19. These differences may cause some clients to feel relief, whereas others will experience a new round of anxiety and fear.

Dailey compares these adjustment phases to a flipbook. Everybody has their own unique story with the pandemic, and every page of the flipbook represents a new experience, a new adjustment. Counselors can help clients process and cope with these adjustments by “flipping” through their stories, stopping at certain points, and assessing how the clients reacted and coped with that part of their story. The tools they used to cope — making art, meditating, sewing, exercising — are ones they can use again in the future as they adjust to a new phase, Dailey says.

The COVID-19 pandemic possesses the potential to change the counseling field and how professional counselors work with clients now and in the future, Haynes says. Since the turn of the century, it’s true that the United States has experienced major crises such as 9/11, large-scale natural disasters and the Great Recession, but, as Haynes points out, there hadn’t been a crisis on a global scale like a world war until COVID-19. This experience could shift the focus more toward prevention and preparation (both for individuals and for systems on a national level) for future crises, he says.

Adjusting to this new normal doesn’t have to be all negative. Once we reenter society after the threat of COVID-19 subsides, we will be able to celebrate regaining some of our old coping strategies as well as the acquisition or discovery of new strengths along the way.

Counselors are in position to help clients gain greater perspective and self-awareness while coping with the stress and loss that the pandemic has introduced, Ali says. To aid in that process, she sometimes asks clients who have already adjusted and are successfully coping with this stress and loss, “What are you learning during this time?”

In asking that question, Ali has found that several of her clients now understand how the coping skills they previously learned in counseling have helped them handle this stressful moment in history.

How we cope with the stressors of COVID-19 can tell us a lot about ourselves, Ali says. While it may be unpleasant, we can use these times as learned lessons that will help us continue to adapt and manage stressors in the future.

But for now, just take a deep breath.

 

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Lindsey Phillips is a contributing writer to Counseling Today and a UX content strategist. Contact her at hello@lindseynphillips.com or through her website at lindseynphillips.com.

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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.