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

resource for mental health counselors and allied helping professionals. This work identifies, discusses, analyzes, illustrates, and differentiates characteristics of the COVID-19 pandemic from other natural disasters. It offers a compass to facilitate the use of pandemic disaster strategies with adults, adolescents, and children. A key asset of this work is the pandemic risk and resiliency continuum (PRRC) theoretical model, which offers mental, behavioral, and psy chosocial health benchmarks that can potentially be tracked throughout phases of a pandemic virus. The PRRC model has been critically reviewed by a panel of eight experts in disaster mental health response, epidemiology, medical and psychosocial aspects of illness and disability, and applied behavior science. Feedback from the subject matter experts was integrated into and is reflected in the PRRC theoretical model.

Counseling Practice During Phases of a Pandemic Virus is essential reading for members of the counseling, psychology, and public health professions. The ongoing public health crisis has created documented medical, physical, and mental health impacts on our overall well-being. We cannot watch from the sidelines: Failing to respond is not an option if we care to thrive, rather than just survive, during this pandemic virus. So how do we come out of the darkness and into the light and bring new meaning to such catastrophic and traumatic events? How do we facilitate good medical, physical, psychological, emotional, social, psychosocial, occupational, spiritual, and cultural healing during a pandemic disaster?

      Most COVID-19 cases are identified and treated in health care settings by medical professionals who have little or no training in the assessment, diagnosis, and treatment of psychiatric conditions associated with mental, behavioral, and psychosocial health conditions. Thus, education and training regarding the screening of mental, behavioral, and psychosocial health issues would enhance patients’ overall medical, physical, and mental functioning. This work is a unique resource for mental health and other allied helping professionals who work in a variety of clinical, school, and community-based health care settings. The intention is to prepare professionals to meet the intense challenges of pandemic viruses in the 21st century. More specifically, this work

      1 identifies children, adolescents, adults, and families who are at low, moderate, and high risk for mental, behavioral, and psychosocial symptoms related to pandemic viruses with the intention of triaging the most at-risk persons for follow-up services;

      2 discusses the use of specific intake interview questions and appropriate functional assessments to assess low-, moderate-, and high-risk clients;

      3 illustrates how risk and resiliency factors occur on a continuum during pandemic viruses using the PRRC theoretical model;

      4 differentiates mental, behavioral, and psychosocial symptoms that are healthy-normal and unhealthy-abnormal as they relate to a pandemic virus;

      5 appraises salient features of the assessment, diagnosis, and treatment of mental health conditions that interfere with daily functioning in multiple life areas;

      6 explores the grief, loss, and psychosocial experiences associated with pandemic viruses;

      7 describes the various phases and stages of pandemic viruses that should be anticipated for the application of prevention and treatment approaches;

      8 illustrates specific adjustment and adaptation stages of a pandemic virus and how they impact mental, behavioral, and psychosocial functioning;

      9 delineates through the phases of pandemic rehabilitation model the essential tasks of navigating and transitioning through critical stages of a pandemic virus;

      10 identifies coping and resiliency resources for persons that can serve as a means of prevention and treatment of mental, behavioral, and psychosocial symptoms during phases of a pandemic virus; and

      11 discusses how to recognize and prevent the symptoms of empathy fatigue so professionals can function optimally and provide services to those in need during a pandemic disaster.

      Overall, Counseling Practice During Phases of a Pandemic Virus provides a new paradigm for professionals dealing with the mental, behavioral, and psychosocial health of individuals, groups, communities, and cultures. The material presented is based on the opinions of subject matter experts; extensive research in disaster mental health counseling; theories of trauma-informed counseling; and clinical applications in the fields of counseling, psychology, traumatology, epidemiology, behavioral health, and public health sciences.²

      Notes

      1 1 At the time of this writing in April 2021, the COVID Generation does not have a unified definition and has relational meaning in the literature primarily to children and adolescents.

      2 2 The Centers for Disease Control and Prevention’s (CDC) guidelines for COVID-19 have been dynamic during 2020–2021 as they have offered interim guidance to healthcare professionals, businesses, educational systems, and the general public. Guidance on appropriate virus hygiene protocols such as use of masks in public schools and other settings reflects the current state of epidemiological concerns of COVID-19 infections, disease transmission, geographic hot-spots of variants, and mortality. Thus, the CDC guidelines for good virus hygiene have been adapted by some states, institutions, and organizations but dismissed by others based on their unique circumstances. Readers should consult the latest federal, state, and local health institutional guidelines for appropriate virus hygiene and disease containment issues in their area of the country.

Chapter 1 Theoretical Aspects of Risk and Resiliency During a Pandemic Virus

      The purpose of this chapter is to discuss, analyze, recognize, and illustrate risk and resiliency factors that are of clinical significance in individuals seeking mental health and allied helping services during a pandemic virus. My theoretical model, called the pandemic risk and resiliency continuum (PRRC) model, is illustrated in Chapter 2. It offers a unique perspective, with two separate models: resiliency (excellent to poor resiliency) and risk (low to extreme risk), each assessed on a 5-point scale. The models of resiliency and risk each comprise four major categories of characteristics and traits: (a) mental health, (b) behavioral health, (c) psychosocial health, and (d) medical/physical health. The foundations for good mental, behavioral, and psychosocial health are explored in this chapter. The focus is on individual resiliency and risk factors observed during phases of a pandemic disaster. The intention is to enable helping professionals to anticipate, prepare for, and prevent adverse mental, behavioral, psychosocial, and health reactions.

      Research generally suggests that during other natural disasters 30–50% of individuals will acquire adverse medical, physical, and psychological conditions. Short- and long-term consequences can negatively impact individuals’ overall medical, physical, and mental health and well-being. Reconceptualizing disaster mental health models and applying the results to phases of a pandemic virus will assist practitioners in appraising risk and resiliency during a pandemic virus. Ultimately, clinical researchers and practitioners may want to develop pandemic disaster prevention and intervention approaches with the intention of decreasing the mental, behavioral, and psychosocial risk factors that predispose individuals to depression, anxiety, substance use, and posttraumatic stress disorders.

The PRRC is based on extensive research in disaster mental health response; theories of trauma-informed counseling; and clinical therapeutic applications in the fields of counseling, psychology, traumatology, grief, death, and dying, which is generally reflected throughout this work (e.g., Baker & Cormier, 2015; Biddlestone et al., 2020; Boss, 2006; Dong & Bouey, 2020; Echterling et al., 2005; Fiorillo & Gorwood, 2020; Garfield, 1979; Germani et al., 2020; Lopez Levers, 2012; Manderscheid, 2007; J. E. Miller et al., 2020; Morganstein & Ursano, 2020; Muratori & Haynes, 2020; National Center for Health Statistics, 2020; Ornell et al., 2020; Pappas et al., 2009; Razai et al., 2020; Reyes et al., 2013; Shigemura et al., 2020; Shultz et al., 2016; Steardo et al., 2020; Stebnicki, 2000, 2005, 2007, 2008b, 2016a, 2017, 2018b; Stebnicki & Marini, 2016; Updegraff & Taylor, 2000; Wind et al., 2020; Worden, 2009). Additional considerations have been given to a variety of clinical observations,