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

Washington, DC-based crisis response team the National Organization for Victim Assistance and North Carolina’s American Red Cross Disaster Mental Health crisis response team. He served on the crisis response team for the Westside Middle School shootings in Jonesboro, Arkansas (March 24, 1998), and has done many stress debriefings with private companies, schools, and government employees after incidents of workplace violence, hurricanes, tornadoes, and floods. His youth violence program, the Identification, Early Intervention, Prevention, and Preparation Program, was recognized nationally by the American Counseling Association Foundation for its vision and excellence in the prevention of youth violence. Other honors include consulting with President Bill Clinton’s staff on addressing the students at Columbine High School after their critical incident (April 20, 1999).

Dr. Stebnicki has served in many statewide and national professional counseling associations and on several accreditation boards. He has written a total of 10 professional texts, most recently Clinical Military Counseling: Guidelines for Practice (2021, American Counseling Association), Disaster Mental Health Counseling: Responding to Trauma in a Multicultural Context (2017, Springer), The Psychological and Social Impact of Illness and Disability (7th ed.; edited with Irmo Marini; 2018, Springer), and The Professional Counselor’s Desk Reference (2nd ed.; edited with Irmo Marini; 2016, Springer). He has written more than 40 journal articles and book chapters and has presented at more than 100 regional, state, and national conferences, seminars, and workshops on topics ranging from military mental health, traumatic stress, and empathy fatigue to the psychosocial aspects of chronic illness and disability.

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      Introduction

      Chasing plagues had never entered my consciousness as a mental health and rehabilitation practitioner, counselor educator, and researcher. However, those who work in the laboratory, out in the fields, and in bat caves to collect data on viruses that could potentially alter the history of humankind are champions. Who would have thought that spending months collecting samples of bat feces and saliva could be such important work? Indeed, viruses have existed on planet Earth since the beginning of humankind. The nature of viruses is that they change their genomic sequences and mutate into highly infectious diseases such as the novel (meaning “new”) coronavirus (COVID-19). The constant comingling of different genomic sequences globally has created dangerous new pathogens that have lethal consequences for humankind.

      Counseling Practice During Phases of a Pandemic Virus was inspired by my more than 30 years of experience as a mental health and rehabilitation practitioner, counselor educator, clinical supervisor, and researcher. My areas of interest are chronic illness and disability, disaster mental health response, and traumatic stress. My work has guided me to provide mental health and rehabilitation services to active-duty service members, veterans, veterans with disabilities, and military families. I have worked in hospitals, a physician’s office, nursing homes, outpatient clinics, and a variety of rehabilitation programs. My interest in disaster mental health response was accelerated when communities where I lived and worked were at the epicenter of school shootings, workplace violence, hurricanes, floods, tornadoes, and earthquakes. Despite all these experiences, I am a student all over again studying a new type of natural disaster—a pandemic virus. So now I am chasing plagues.

      Metaphorically speaking, the new anthem in disaster mental health response may not look like the old mental health hymnal. There are human casualties, restrictions on our freedoms, government mandates, and public health guidelines for protection and safety. We as Americans have made multiple attempts to try and restore some normalcy in our lives. It requires a significant amount of psychological/emotional real estate to build a treatment center within our mind, body, and spirit to try and make ordinary sense out of an extraordinary stressful and traumatic event. The operation tempo is relentless because the viral enemy combatant never sleeps or takes a day off. Thus, it is essential that we prevail on the COVID battlefield. Overall, the medical, physical, and psychological costs of fighting an unseen enemy such as COVID-19 and its mutant strains have been imprinted on our mind, body, and spirit.

The fields of psychology and counseling must cultivate new research and training opportunities for mental health and allied helping professionals to work across all age groups and cultures during phases of a pandemic disaster. We must create pandemic identification, prevention, and therapeutic intervention programs. We should never again delay a disaster mental health response as we did during the summer and late fall of 2020. The current and predicted increase in anxiety, depression, posttraumatic stress, and substance use disorders is pervasive across all age groups. The COVID-19 pandemic has spawned an increase in suicidality that is the direct result of untreated, undertreated, and unrecognized mental health symptoms and conditions. Accordingly, the psychology and counseling professions are challenged with recon-ceptualizing disaster mental health programs and services for pandemic survivors using new technology (i.e., telebehavioral health) and other therapeutic interventions yet to be developed and implemented.

At War With a Pandemic Virus

      We need to cultivate a fighting spirit in the COVID war as we enter the COVID Generation.¹ Disaster mental health response throughout phases of the pandemic virus necessitates a high level of empathy and compassion toward individuals, groups, communities, and cultures who are COVID survivors. As a profession, we are challenged to reconceptualize disaster mental health response as we transition throughout phases of a pandemic virus that some experts project will kill up to 700,000 people in the United States. So how serious is it? The U.S. Department of Defense met the Federal Emergency Management Agency’s request during April 2020 to ship 100,000 body bags to aid state and local governments in managing the growing number of COVID-19 fatalities (Entress et al., 2020). It is worrisome that some Americans still do not take coronaviruses seriously by not using good hygiene, rejecting the COVID-19 vaccines, and dismissing the overall positive effects of the federal government’s immunization program on decreasing deaths related to COVID-19 and its mutant variants. The rate of spread of the infection, accompanied by the severe illness, mortality, and mutant variants of COVID-19, has resulted in long-lasting aftereffects that will likely be with us for the next several years.

We have been at war since the start of 2020 with an unseen enemy combatant, COVID-19. New radical insurgencies of coronavirus mutations have emerged as a threat to humanity. One splinter cell first identified as VUI-202012/01 began its assault in England and moved to the United States in January 2021. By February 2021, this variant as well as South African and Brazil variants had spread throughout most states. The problem with these mutant viruses is that they can spread 50–70% times faster than the original COVID-19 virus. Worldwide, other coronavirus variants have been identified also. The enemy we are confronted with is invisible except to virologists, infectious disease specialists, epidemiologists, and public health experts.

      The coronaviruses of the 2020–2021 pandemic have left scars within our memories and hearts, with more than 30 million infections and well more than 550,000 COVID-19-related deaths by early 2021. We have COVID fatigue that manifests as serious medical, physical, and mental health concerns. So how long can we sustain both the pandemic virus and mental health crisis in the United States? Now that the vaccine rollout and immunization have begun, we are trying to restore some normalcy and balance to our lives by reopening schools, businesses, the service industry, entertainment venues, and other areas. It is critical that we try and make ordinary sense out of an extraordinary stressful and traumatic event by adjusting and adapting our strategies on the COVID battlefield.

Will There Be an End to the Coronavirus Pandemic?

      Infectious viruses and diseases have been with us since the beginning of time. They are a naturally occurring phenomenon. They can adapt and survive in a variety of conditions but must have a human and/ or animal host to exist in their virulent and highly contagious state. It may be that viruses inherit the earth (Tyson, 2007). So is there an end in sight to COVID-19? This is much like asking “How long will it take before the sun’s fuel burns out?” It is helpful to understand that there is no beginning or end to a viral contagion.