Months into this global pandemic and in the U.S., there’s still no end in sight. We talked with local Mental Health Providers to learn insights into what they are seeing in their clients during this time. We hope this helps a bit to normalize what you and your loved ones may be feeling. You are not alone. We truly are in this together. For the long haul, however long this ends up taking. Towards the end, we provide some tips on finding your own counselor if that might be helpful for you (hint: it likely could be).

Everyone interviewed for this article has a Master’s Degree and lots of letters after their name so first, let’s talk titles:

LMFT: Licensed Marriage and Family Therapist
LMHC: Licensed Mental Health Counselor
LMHCA: Licensed Mental Health Counselor Associate
MA: Master of Arts
MS: Master of Science
NCC: National Certified Counselor
RPT-S: Registered Play Therapist – Supervisor

Second, some people use the terms therapist and counselor interchangeably while some differentiate them. For the purposes of this article, therapist and counselor are used interchangeably. Depending on the type of graduate program they go through and the licensure exam they take, there will be different titles and letters after their name. You can read this article for more.

What differences have you observed in clients pre-Covid-19 versus now? 

Ada Pang, MS, LMFT, founder of People Bloom Counseling: People are dealing with the up’s and down’s of sheltering-in-place during a global pandemic. Some days, it’s “we got this!” while other days, it’s “I’m so over this!” While plans are suspended and trips to the grocery store are an ordeal, many are trying out new hobbies and taking pleasure in the small things.

Amy Langdahl, MA, LMHC: A lack of socialization is a huge thing affecting everyone, especially my teen clients who rely heavily on those interactions on a day-to-day basis. I’ve also seen an increase in family conflict due to the lack of space they have within their homes. Remaining in quarantine doesn’t allow them to have time away from one another and so therefore a decrease in patience as well as increased risk for negative interactions.

Daisy Surjo Vergera, MS, NCC, LMHC, RPT-S, founder of Ohana Behavioral Health: At first, clients were more resistant to telehealth. Now, they’re used to telehealth and most prefer telehealth rather than in-person due to worry about the virus. I also noticed that now, most clients are more worried and anxious about the unknown/uncertainty. I mean, a lot of us or even all of us are. We don’t know what is going to happen.

Trenecsia Wilson, LMHC, NCC: Lots of anxiety! People are worried. Worried about employment, worried about health, worried about money, worried about elections, worried about community violence and racism, worried about relationships, and worried about other family members. Many people even struggle with having hope and feeling that things will get better. Many of these issues feel heavier, more overwhelming than in the past. For most people, the number of stressors that currently exist are much more than they have ever experienced.

It has become incredibly difficult, as time goes on, for people to cope with the number of stressors and the frequency of adjustment, grief, and loss. For those who are still working and additionally managing children at home, the stress is overwhelming. This is especially true for single parents. Many who are working from home find themselves easily distracted and less productive overall.

Bridget Caveat, MA, LMHCA, NCC, psychotherapist at Modern Therapy Seattle: One of the basic components of therapy is a hope that things can get better. Whether it’s reduction in symptoms of depression or anxiety, mending relationships, or feeling safer in our identities. While some goals of therapy remain the same, the uncertainty for the future is definitely stretching hope thin for clients—many of whom didn’t have excess hope to begin with. It is harder to feel hopeful when the future is unclear. It is harder to feel hopeful about our personal goals and changes, when safety (both public and personal) is in jeopardy.

What have you found (in clients and personally) that is helpful during this time? 

Ada Pang: Realizing that Covid-19 won’t just disappear, many people are realizing they need to make more permanent what was thought of as only temporary. That means a more ergonomic WFH setup, a routine for basic self-care of meal prepping, cooking and exercising, and a deliberate effort to connect online or in socially distancing ways.

Trenecsia Wilson: People who are able to connect with their home and natural environment in new ways are having a lot of success. For some that’s gardening, bird watching, walking, yoga, home projects, and more.

People who are able to continue to stay connected to loved ones in meaningful ways also report more positive experiences. It is helpful to support others and to receive support even when social distancing. For some that is virtual happy hour or movie night, and for others that may be a socially distanced walk or chat at the park.

Some have found it helpful to separate their work space from their living space at home while also keeping a structured work day routine as they would if they were going to the office. It has also been helpful for folks to consider that so many people are also experiencing many of the same challenges. They know they are not in it alone. 

Bridget Caveat: Part of my work now includes turning inwards for hope, and assessing progress more through inner change versus outer, environmental change. Clients are also exploring what they have control over, and what they don’t, and facing that dynamic can be scary.

What are some tips you have for dealing with uncertainty (there’s still so much we don’t know about Covid-19, what school will look like in the fall, work…)? 

Amy Langdahl: Uncertainty is hard because things that tend to make us anxious are things that we don’t have control over. Societally, we struggle with not having control, but the reality is that majority of our external world is out of our control. Learning to navigate the uncertainty is where we will succeed. Focusing on the present as well as the elements we CAN control is what is going to help. However, we tend to fixate on all the elements we cannot change.

Slowing down our thought process and identifying the areas we do have control over, asking ourselves the question: do I have any control over this situation or this event that is causing my anxiety? If it is no, let it go (to the best of your ability) and then turn to something you can control. If the answer is yes, navigate and tackle that part of it. Example: do I have control over COVID-19 and when it goes away? No- but I do have control over socially distancing, working from home, limiting my exposure or contact with others, wearing a mask, following CDC guidelines, being clean and sanitary, etc.

Ada Pang: Do stay abreast on COVID news and follow the latest recommendations from reliable, science-based sources. Don’t get too attached to that article or the next rollout at work or state reopening guidelines. Chances are, it will not be the last.

Daisy Surjo Vergera: Create short term goals, doing and planning things one day at a time, and trying to tackle and troubleshoot issues as they come up. Things are changing daily.

What are some strategies for mental wellness during this time (and beyond)?

Ada Pang: Often times, when people think about mental wellness, they think yoga, sleep hygiene, regular exercise. Those are all valid. However, I’d like to divide it into three categories: 1) Doing productive work, whether that’s paid or unpaid. 2) Taking care of basic needs by listening to what your body needs. 3) Making time to play by engaging in activities that don’t feel like a chore.

Ada has written a piece on this topic here.

Daisy Surjo Vergera: Connect with others and do anything you can to ground yourself. This means connecting your mind and body. Regulate your body. This can be done by applying self-care, eating regular meals, meditation, and exercise. 

Trenecsia Wilson:

1. Be really intentional about defining your support system. Who can help with dinner, who can help with kids, who’s available for a phone call, who is your contact at work, finding / talking with a therapist, and staying connected with loved ones.

2. Identify your coping skills. What helps to feel better, what reduces stress, what helps restore calm?

3. Eat and drink. Sometimes when we are stressed and anxious we forget to pay attention to our body. 

4. Stay active. Move around, take a walk, try to get your heart rate up for 15 – 30 minutes a day. 

5. Worry time. As hard as it is, sometimes we must let go of the things we can’t control or change. Designate a time to worry, write those things down and think about it for a specified time frame. Once that worry time is over, let it go and move on to the next task.

6. Time management. Plan your days and when you notice you have a lot of unscheduled time, make plans to engage in some type of activity. When you notice you’re really busy with a little time, make plans for breaks and ways to replenish.  

Amy Langdahl: We are more resilient and adjust better than we give ourselves credit for. Take time to ease yourself into the “new” norm. Be aware of and monitor your exposure to media appropriately for your needs, not others. If that means you don’t watch the news, fine. If that means you need to take a break from social media for awhile, fine. You always have the information and data available to you when/if you want it. Allow yourself some space if that will help your mental health.

What are your tips for those looking to start counseling?  

Psychology Today is a directory of therapists and counselors. You can filter by location, specialty, language, insurance company, and more. You can also contact your insurance company (call the number on the back of your insurance card or visit their website) and they often have a list of providers that are in-network. The one thing about this route is that sometimes their directories aren’t updated. And last, but definitely not least, if you’re comfortable, ask your friends! If they like their therapist, it’s likely you may too.

Finding a therapist that is a good fit is a bit like dating—you may have to talk to a few before you settle on someone that you like and want to work with. Often therapists offer a free “consultation” to chat on the phone before scheduling an appointment (and filling out all the paperwork).

Bridget Caveat: Trial and error is normal and good! Ask questions, try strategies and approaches, find out what works for you. Set yourself up for success. Know that this process is meant to challenge you in order to reach your goals, but in a way that feels supportive and well-paced. This looks different for each of us, as it should! Be gentle with yourself while advocating for your needs.

A note from the author: Jennifer Liu has a Master’s Degree in Counseling Psychology and is a Licensed Mental Health Counselor.