Counseling Practice During Phases of a Pandemic Virus. Mark A. Stebnicki

Person has difficulty with self-motivation and rarely engages in organized activities such as clubs, organizations, religious/spiritual life, and recreational activities. Person struggles with balancing home, work, academics, and social life. Person exhibits only fair adaptation and adjustment to a pandemic disaster. This is due to only a fair ability to maintain their personal medical, physical, psychological, behavioral, financial, and occupational health. Person also lacks skills in independent living and environmental functioning and has fair daily functioning.

      Medical/Physical Health

      Person goes through periods of exacerbation and remission due to medical, physical, and mental health conditions. Person has only a fair ability to maintain personal responsibility for their medical, physical, behavioral, mental, and psychosocial health. They rarely use support systems, resources, or technology to live life in optimal wellness.

      Level 1 = Poor Resiliency

      At Level 1, the person has poor mental, behavioral, and psychosocial health. The individual has very little respect for the seriousness, lethality, and consequences of a pandemic virus. They are generally noncompliant with virus hygiene protocols and do not endorse getting vaccinated, wearing masks, washing hands, or maintaining a safe social distance. There is an overall lack of recognition of the seriousness, lethality, and consequences of a pandemic virus. Individuals at Level 1 experience and react with irrational fear and anxiety; however, this is directed solely toward their changing environment, which they do not understand, recognize, or feel they have control over because of a pandemic disaster. Individuals at Level 1 may or may not be triggered by specific events (e.g., media reporting of positive COVID-19 cases, COVID-related illnesses and deaths, school and workplace closures). This is because they lack awareness of a pandemic disaster and how it could potentially adversely impact their present life. Clinically significant psychological/emotional symptoms and conditions exist but are rarely dealt with, except during a crisis. The individual does not exhibit stress-hardy behaviors. The ability to bounce back from adversity is poor because of inadequate coping and resiliency skills. Individuals at Level 1 do not endorse public health principles, practices, guidelines, and government mandates associated with a pandemic disaster. They view virus hygiene and adherence to public health guidelines as nonessential to the protection of themselves and others. They do not recognize the importance of public health guidance and government mandates. Thus, persons at Level 1 take many more virus hygiene risks than persons at Level 2. Individuals at Level 2 struggle with balance, adaptation, and adjustment in relation to their changing pandemic environment. They typically do not have the capacity to respond to the grief, loss, and extraordinary stressful and/or traumatic events associated with a pandemic virus because they are much too internally focused on their unhealthy thoughts, feelings, and cognitions. Persons at Level 1 struggle with balancing the reality of a pandemic disaster with other life responsibilities. They cannot move forward because of life circumstances related to their medical, physical, and mental health conditions. Persons at Level 1 also have marked academic, job, career, relational, financial, and other hardships that may be beyond their control. Their overall mental and physical well-being is compromised by their inability to cope with adversity. Persons at Level 1 find very little meaning in their existence and find it difficult to gain relief during phases of a pandemic disaster. Adjustment and adaptation to the overall effects of a pandemic virus are poor because they do not recognize a path forward to overall health and well-being. The mental, behavioral, psychosocial, and medical/physical health of the individual at Level 1 is demonstrated by the following.

Mental Health

      Person has poor resiliency skills with a significant degree of psychological adjustment in dealing with critical life events and major life stressors (e.g., job loss, the death of a family member, divorce, personal illness, injury, disease, disability). Person avoids taking therapeutic responsibility for any mental health symptoms and conditions. Person struggles significantly with positive optimism and balancing mood, emotion, affect, and rational thinking. Person cannot handle daily life stressors with the degree of coping and resiliency skills such as seen in Level 2 individuals. Person does not transition well through the phases of a pandemic disaster. They have considerable difficulties cultivating any meaning, personal growth, or hardiness, and self-care is significantly deficient.

      Behavioral Health

      Person does not have a well-balanced life but maintains a poor routine of virus-related hygiene habits. Person has little if any awareness of respect for self and others concerning social distancing, stay-at-home orders, and other good virus hygiene. Person does not engage in regular exercise or recreational activities. Nutritional intake is poor because of financial inability and lack of knowledge in purchasing healthy food items. Person demonstrates unhealthy patterns of sleep and rest, has poor virus-related hygiene, and exhibits a poor ability to maintain overall daily functioning. They are not perceived by themselves and others to be focused, motivated, or goal oriented. They are observed by others not taking personal responsibility for living in positive optimism and struggle significantly more than Level 2 individuals. Person demonstrates poor interpersonal communication skills and cannot sustain communication at adequate levels. Relationships are poor and often strained because of interpersonal communication skills. Person is not viewed by others as action oriented or a contributor. They have a narrowly defined environment in which they can maintain a balance of medical, physical, mental, and behavioral health and would be considered poor in this area.

      Psychosocial Health

      Person struggles considerably in a wide range of life areas, such as academics, job, career, and economic stability. Person exhibits poor social and familial connections. Person has poor ability for self-motivation and does not engage in organized activities such as social clubs, organizations, religious/spiritual life, or recreational activities. Person struggles considerably to maintain food, shelter, and clothing. This may be because of issues of systemic racism, low education, poor job skills, or lack of ability to transfer skills to more highly skilled and better paying occupations. It may also be because of medical, physical, and/ or psychiatric disability; poor access to quality health care; inadequate or no transportation; or other sociocultural issues that hinder their ability to achieve optimal resiliency. A balance of home, work, academics, and social life is nonexistent. Person exhibits poor adaptation and adjustment to a pandemic disaster because of significant struggles personally, medically, physically, psychologically, behaviorally, financially, and occupationally and significant struggles with independent living, environmental functioning, and/or the ability to sustain any level of daily functioning.

      Medical/Physical Health

      Person goes through periods of exacerbation and remission due to medical, physical, and mental health conditions. Person has a poor ability to maintain personal responsibility for their medical, physical, behavioral, mental, and psychosocial health. This may be because of health disparities; poor access to quality health care; or other socio-cultural factors that hinder their medical, physical, and mental health and overall wellness. They do not use support systems, resources, or technology to live life in optimal wellness. This is due in part to a lack of access to transportation, isolation in a rural geographic region, little or no health care benefits, and other issues related to health disparities.

The PRRC Model: Risk

      The second model of the PRRC model assesses risk factors during a pandemic virus and is rated on the following Risk scale:

Risk Scale

5 = Extreme Risk

4 = Severe Risk

3 = Moderate Risk

2 = Mild/Slight Risk

1 = Low Risk