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

thinking. Person has a moderate ability to handle daily life stressors and use coping and resiliency skills. Person transitions inadequately through the phases of pandemic disaster and has very little ability to cultivate new meaning, personal growth, hardiness, and self-care.

      Behavioral Health

      Person has moderate problems maintaining good virus hygiene standards. They lack some awareness of the need for social distancing, stay-at-home orders, and other good virus hygiene habits. Person rarely engages in regular exercise or recreational activities. Nutritional intake is not well controlled because of financial inability and lack of knowledge in purchasing healthy food items. Person demonstrates unhealthy patterns of sleep and rest, has decreased virus-related hygiene, and exhibits only a moderate ability to maintain overall daily functioning. Person is perceived by others as lacking focus, lacking motivation, and rarely goal oriented. They are observed by others as taking little personal responsibility and struggle significantly more than Level 2 individuals. Person demonstrates inadequate interpersonal communication skills and cannot sustain communication at adequate levels. Relationships are moderately strained because of a lack 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 exist or maintain a moderate balance of medical, physical, mental, and behavioral health. Overall, functioning in this area is considered moderate.

      Psychosocial Health

      Person struggles in a wide range of life areas, such as academics, job, career, and economic stability. Person exhibits decreased social and familial connections. Person has a decreased ability for self-motivation and engages in few organized activities such as social clubs, organizations, religious/spiritual life, and recreational activities. Person may struggle considerably 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. Persons at Level 3 have moderate difficulties with their medical, physical, and/or psychiatric health. This may be due in part to poor access to quality health care, inadequate or no transportation, or other sociocultural factors that hinder their ability to achieve optimal resiliency. The balance of home, work, academics, and social life is moderately impaired. Person exhibits moderate adaptation and adjustment to a pandemic disaster. This is because of significant struggles personally, medically, physically, psychologically, behaviorally, financially, and occupationally. Person demonstrates only moderate levels of adjustment in independent living, environmental functioning, and/or the overall ability to sustain success in daily functioning.

      Medical/Physical Health

      Person goes through periods of exacerbation and remission due to medical, physical, and mental health conditions. Person is moderately impaired in their 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 sociocultural factors that hinder their medical, physical, and mental health and overall wellness. They use few 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.

      Level 2 = Mild/Slight Risk

      At Level 2, the person has fair to good mental, behavioral, and psychosocial health. The individual questions the seriousness, lethality, and consequences of a pandemic virus. They are generally compliant with virus hygiene protocols, although there is minimization of the seriousness, lethality, and consequences of a pandemic virus. They are sometimes noncompliant with virus hygiene protocols such as wearing masks, washing hands, and keeping a safe social distance. They are also somewhat confused about the efficacy of taking vaccines. Individuals at Level 2 may experience and react with slight irrational fear and anxiety; however, this is directed more toward their changing environment, which they do not understand, recognize, or feel they have control over because of a pandemic disaster. Individuals at Level 2 are more affected by trigger events (e.g., media reporting of positive COVID-19 cases, COVID-related illnesses and deaths, school and workplace closures) and form their pandemic ideology based on events that may or may not directly impact their lives. Clinically significant psychological/emotional symptoms and conditions are not dealt with in a therapeutic manner, but individuals may consider interventions if the symptoms increase, if the symptoms become persistent stressors, and if treatment is prompted by the home or work environment. The individual exhibits stress-hardy behaviors on an occasional basis. They make take longer to bounce back from adversity compared to individuals at Level 1. Individuals at Level 2 at times endorse public health principles, practices, guidelines, and government mandates, but only in environments where it is socially acceptable and fits with their philosophy regarding public health standards of practice. They generally view good virus hygiene as nonessential protection for themselves and others. Thus, persons at Level 2 take many more virus hygiene risks than persons at Level 1. Individuals at Level 2 struggle with balance, adaptation, and adjustment in relation to their changing pandemic environment. The individual conforms to the socially acceptable standard of grief and loss. However, the extraordinary stressful and/or traumatic events associated with a pandemic virus are ignored because these individuals are internally focused on their own lives and avoid thoughts, feelings, and cognitions associated with a disaster. Persons at Level 2 struggle with balancing the reality of a pandemic disaster with other life responsibilities. They are challenged with moving forward because of life circumstances related to their medical, physical, and mental health conditions. Persons at Level 2 also have mild to moderate academic, job, career, relational, financial, and other hardships that may be beyond their control. Their overall mental and physical well-being is mildly compromised by their inability to cope with adversity. Persons at Level 2 find some meaning in their existence but find it challenging to gain consistent relief during the phases of a pandemic disaster. Adjustment and adaptation to the overall effects of a pandemic virus are challenging for persons at Level 2 because they sometimes struggle with a path forward to achieve overall health and well-being. The mental, behavioral, psychosocial, and medical/physical health of the individual at Level 2 is demonstrated by the following.

Mental Health

      Person has only a few resiliency skills in specific life situations. They struggle within the normal range of psychological adjustment when 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 mental health symptoms and conditions unless they become a persistent stressor and are recognized in the home, school, or work environment. Person struggles slightly with positive optimism and balancing mood, emotion, affect, and rational thinking but does better than persons at Level 3. Person cannot handle daily life stressors with the degree of coping and resiliency skills such as seen in Level 1 individuals. Person transitions adequately through the phases of a pandemic disaster. They have difficulties cultivating new meaning, personal growth, and hardiness. It is challenging to achieve daily self-care.

Behavioral Health

      Person is challenged with establishing a well-balanced life but maintains a healthy routine of virus-related hygiene habits. Person has somewhat of an awareness of respect for self and others concerning social distancing, stay-at-home orders, and other good virus hygiene habits that mitigate risk. Person attempts to engage in regular exercise or recreational activities but is not always successful. Nutritional intake is inconsistent with most dietary standards, but Person has an awareness of good nutrition. They demonstrate inconsistent patterns of sleep and rest, have inconsistent patterns of virus hygiene, and exhibit only a fair ability to maintain overall daily functioning. They are perceived by themselves and others to be somewhat focused, motivated, and goal oriented but have room for improvement. They are observed by others as taking personal responsibility for living in positive optimism but are challenged more than Level 1 individuals.