New script for field of therapy
The handbook on healing is being rewritten.
As the pandemic triggers a collective trauma, it is transforming the field of therapy. Regulations that were a dam holding back the tide of “telehealth” were demolished by the flood of the pandemic.
People in need of counseling can — at least for now — talk to therapists from home, while getting reimbursed from Medicare, Medicaid and commercial insurance companies. It’s a re-framing of the industry that must stand after the crisis passes.
“You can’t just flip off the switch and just do therapy the old way,” warns Stephanie Haen, senior director of behavioral health for Family Centers, which serves Stamford, Greenwich, New Canaan and Darien.
Remarkably, videoconferencing adds intimacy to some counseling sessions. Clients who may have resisted the stigma of visiting an office now find solace in talking from home. Meanwhile, they see counselors in their own casual settings. The intensity of the relationship is flipped as the clients ask ‘How are you? How are your families?’ ”
“We’re learning they (clients) feel more comfortable in their home space,” Haen says. “... And they see a piece of us.”
Defining boundaries has become more fluid, and heightened vulnerability has hastened progress. But technology also has drawbacks. Screens limit the ability of clinicians to interpret body language.
Many people are seeking counseling for the first time. There are also unprecedented emotional challenges. Postponed memorial services add turmoil to the grieving process. Many Family Centers clients are immigrants, some of whom have relatives facing atrocities in their home countries.
The grief roiling across the nation has experts fearful of an outbreak of suicide attempts. Depression can come with the death of loved ones or the loss of a livelihood.
Others are emotionally overwhelmed because they can’t stop working. People who, in Haen’s words “don’t want to let go,” present a looming reckoning for employers whose staff members are mounting a backlog of days off.
That category often includes those whose mission is to comfort others, now toiling in “high adrenaline crisis mode.”
“We have our own anxieties,” Haen concedes. “It’s non-stop.”
More change is inevitable. Haen offers an extreme example of a hypochondriac who might be terrified to return to a traditional office meeting in the wake of the pandemic.
Lives are being re-scripted every day. As with the rest of our health care system, the therapeutic handbook will need several new chapters.