05/01/2020

Coping Strategies for Helpers – A Holistic Approach

By Marty Apadoca, Karen Lucero, Liz Daniels, and Tiffany Martinez-Durant

COVID-19 has directly impacted the lives and routines of people throughout the world. Isolation and forced physical distancing are having a broad effect on physical and mental health, including increased concerns over the removal of normal coping mechanisms, suppressing a person’s immune system, altering sleep patterns, and increasing the psychological reaction to stress (Cacioppo, Hawkley, Norman, & Bernston, 2011). Yet isolation is not solely an issue clients are facing. Helpers and providers continue to hold space for others while adjusting to many of the same feelings and issues clients are facing. In the wake of COVID-19, therapists and helpers are experiencing increased levels of countertransference (Community Care of North Carolina, 2020; Gaby, 2020). It is crucial for helpers to take care of themselves in order to properly care for clients.

Key Issues When Helpers Work Remotely

Although important for healthy workplace and personal functioning of everyone, self-care is also a significant element in the life of helpers. Self-care is impacted by two key issues: the organization in which an individual practices and the workplace systems and processes that effect delivery of care. Now that many helpers’ workplaces have shifted to working remotely, finding a healthy balance of personal and professional functioning may be a challenge.

Chart 1: Model for Professional Fulfillment

^{©2016 Board of Trustees of the Leland Standford Junior University.}

Culture of Wellness

The Model for Professional Fulfillment (see Chart 1) was developed by the Stanford Medicine WellMD Center (2016) in a wellness training for new medical school students and has relevant implications for helpers and practitioners. In addition to self-care, this model serves as a holistic guide to assist helpers in balancing their current practice. The WellMD Center defines a Culture of Wellness as “organizational values and actions that promote personal and professional growth, self-care and compassion for ourselves, our colleagues and our patients” (2016, para. 1). While many helpers who currently work fall under the umbrella of their organization, the organization's ability to actively provide a culture of wellness has been compromised. Working remotely, away from the direct support of the organization, and without access to resource can place additional strain on helpers. Independent practitioners may also find their culture of wellness compromised during this time. Here are some methods helpers may employ to improve their culture of wellness:

• Conduct a Needs Assessment – Spend some time analyzing your current means of operation and identify what is a challenge or could be improved. Voice your concerns and ask for support from your supervisor and organization.
• Stay Connected Professionally – Communication of any kind with fellow coworkers is important. Social distancing and forced separation create an opportunity to connect, or re-connect, in a unique way with others in the field. Reach out to mentors or colleagues to check in and see how they are handling their situation. This can be beneficial to both parties.
• Reflect on Moments of Appreciation – Many helpers have noticed a genuine concern from clients for insight into our wellbeing (Gaby, 2020). As we care for our clients, they too care for us and our safety. Throughout the day, spend a brief moment and reflect on the gifts clients give.

Efficiency of Practice

Working remotely has shifted the way many helpers practice. A common concern from helpers working remotely is they feel that work never ends because they are always at their home office. When meeting face-to-face with clients, it is easier to cue into client non-verbals and the subtleties of language. Helpers at home are now using a different style of practicing in which some clients, and helpers as well, do not have access to an internet service that can support clear video chat. This may create garbled conversations that lacks fluidity. With phone sessions, clients’ appearances and body language are removed from the eyes of the practitioner. The way we help has drastically shifted, but there are procedures we can implement into our daily routine to improve efficiency in our practice:

• Define a Work-Life Boundary – Where does work end and life begin when working from home? Having a dedicated space to only conduct work and sessions can help in this process. Set a goal to conduct work in that area and not to check email, conduct sessions, or work on projects in other places throughout your home.
• Organizing Priorities – Developed by Franceso Cirillo (2006), The Pomodoro is a technique to assist people in alleviating anxiety around completing tasks. At the beginning or your day, spend a moment organizing the tasks that need to be completed. At the beginning of each task, set a timer to (up to 25 minutes but be flexible depending on your needs) to work on the task. When the timer ends, set a break timer for three to five minutes then begin the task again when the break is over. Repeat this process three more times then take an extended break of up to 30 minutes.
• Seek Out Continuing Education (CE) - CE is beneficial to our growth and practice as practitioners and can assist us in better understanding ourselves and the client’s we serve (Meadors, Lamson, & Sira, 2010). Several organizations, NCDA included, are offering discounted and free opportunities for CE. Contact the organizations you are involved in to explore CE offerings.

Personal Resilience

Self-care and personal resilience are the cornerstones that helpers build upon to promote “physical, emotional, and professional well-being” (WellMD, 2016, para. 5). While helpers continually encourage clients to practice self-care, this is at times an overlooked area for helpers. With many outlets for self-care removed, practitioners must be adaptable in caring for themselves. Helpers may need to:

• Define Self-Care – Reflect on the self-care strategies that work for you. How helpers choose to unwind and take care of themselves will vary from provider to provider. Ask yourself what self-care means and what you find fulfilling. Build in moments throughout the day and remove yourself from your work space to implement your self-care strategies.
• Give Yourself Permission to Say No – It is common for helpers to become over-committed, especially during this pandemic when there is a salient need for help. Giving too much of ourselves and time to others is counterproductive in effectively caring for our clients and our personal needs.
• Release What You Can’t Control – When you feel in the grip of stress, reflect upon whether your expectations are aligning with what is currently happening or are they antiquated thoughts originating from pre-crisis conditions? Mindful reflections can aid in the acceptance of the reality of what is and what isn’t in your control.

Your Health Matters

May is Mental Health Awareness Month and naturally clients are encouraged to seek the help they need. Helpers should also take time for mental health awareness this month, now more than ever. It can be easy to lose sight of what can make a work environment efficient and holistic when attending to the needs of others. Evaluating current modes of operation and asking for support when needed can assist helpers in finding reinvigorated fulfillment and purpose in their jobs.

References

Cacioppo, J. T., Hawkley, L. C., Norman, G. J., & Berntson, G. G. (2011). Social isolation. Annals of the New York Academy of Sciences, 1231(1), 17.

Cirillo, F. (2006). The pomodoro technique (the pomodoro). Agile Processes in Software Engineering, 54(2), 35.

Community Care of North Carolina. (2020). Resources during COVID-19 for providers and practice staff. Retrieved from https://www.communitycarenc.org/newsroom/coronavirus-covid-19-information/resources-for-providers-and-practice-staff

Gaby, N. (2020). Rethinking countertransference in the age of COVID-19. Retrieved from https://www.psychiatrictimes.com/coronavirus/rethinking-countertransference-age-covid-19

Meadors, P., Lamson, A., & Sira, N. (2010). Development of an educational module on provider self-care. Journal for Nurses in Professional Development, 26(4), 152-158.

Stanford Medicine WellMD Center. (2016). WellMD professional fulfillment model. Retrieved from http://wellmd.stanford.edu/content/dam/sm/wellmd/documents/2017-WellMD-Domain-Definitions-FINAL.pdf

Marty Apodaca, MA, LPCC, CCC, NCC is a Senior Counselor at the University of New Mexico (UNM) Student Health and Counseling SHAC. He transitioned to SHAC after 12 years with UNM Office of Career Services.   He is past president of the New Mexico Career Development Association, an active member of the National Career Development Association (NCDA), and an alumni of the NCDA Leadership Academy Class of 2017. Marty enjoys sharing his knowledge of mental health and career counseling through presenting both nationally and locally. Marty’s passion is to help clients share, connect with, and ultimately develop authorship over their stories. Marty can be reached at rapodaca@unm.edu

Karen Lucero, MA, LPCC, ICGC-1, LSAA, is a Clinical Mental Health Counselor for the University of New Mexico Student Health and Counseling Center. Karen’s interests include Acceptance Commitment Therapy, Motivational Interviewing, LGBTQIA Community Support, and Tribal Community Support Services. Karen enjoys providing culturally competent treatment by focusing on values-based autonomy and assisting in clients’ unique growth. Karen can be reached at klucero26@unm.edu

Liz Daniels, MA, LPCC, NCC, is Licensed Professional Clinical Mental Health Counselor (LPCC) in the state of New Mexico with a clinical background in individual and group counseling and a focus on life-transitions, depression, anxiety, career counseling, adolescent issues, grief, and substance use. She believes in engendering clients to develop helpful coping strategies for thriving throughout ones life and career. Elizabeth is currently the President of the New Mexico Counseling Association and is a Past-President of the New Mexico Career Development Association. Liz can be reached at liz.danie111@gmail.com

Tiffany Martinez-Durant, is the Health Promotion manager at the University of New Mexico Student Health and Counseling where she creates prevention and wellness programs for students. Her main goal is to ensure that students have the access and means to maintain a healthy lifestyle while in college. Tiffany can be reached at tmmarti@unm.edu