Social Distancing? More Like Social Isolation

Supporting families in the time of COVID-19.

Posted Jun 23, 2020

By Shaina Gordon, LCSW on behalf of the Atlanta Behavioral Health Advocates

Source: Awesome_art_Creation/Shutterstock

Facilitating therapeutic family interventions as a behavioral health clinician during this pandemic has been interesting and challenging. For example, I have had to merge five family members who are all at different phone numbers only to have someone hang up accidentally and then have to call the five numbers again and make sure everyone is still there before the session could proceed. I have also had the experience of having a parent, who is part of their adult child’s support network, have to drive to their son’s house to wake him up for our family session. Having everyone in the family participate is vital to the success of Open Dialogue.

Open Dialogue Atlanta came to Grady Health System, a public health care system that serves predominantly low-income individuals from racial and ethnic minority backgrounds, in 2016 in hopes of changing the way we work with families. We include the client, family members, and any other support person in every session. We make treatment decisions altogether, not behind anyone’s back. 

Open Dialogue is a social network-oriented approach to mental health care. Open Dialogue meetings include family members, friends, and other concerned people in the support network of a person experiencing psychotic symptoms or in a psychiatric crisis along with the person who is having mental health difficulties. Members of the social network serve as key partners in the recovery process. Rather than focusing on symptoms, this approach to mental health care involves listening and responding to the individual with mental health problems in a way that conveys how valued they are and how invested support network members are in being by their side. This process reduces people’s feelings of aloneness and isolation during a mental health crisis and empowers them to share their perspectives and make choices about how they want to lead their life. Flexibility and mobility are key features of Open Dialogue and working remotely has forced us to practice what we preach.

Pre pandemic we were meeting with clients with significant psychiatric problems along with members of their support network primarily in an outpatient mental health clinic. Once in a blue moon, we would go to the family’s home to meet. During the pandemic, we are meeting in everyone’s home remotely. At one point during the pandemic, I had a client who joined the zoom link from his van in the backyard while his mother joined the zoom call from the backyard but outside of the van. This gave us an opportunity to see this family in their natural habitat, together—yet so far apart. The Open Dialogue process enabled us to engage in conversation about this mother and son’s closeness and distance.

Engaging in the Open Dialogue process via telehealth throughout the COVID-19 pandemic has allowed us to meet with families more frequently since they do not have to deal with the usual transportation barriers. It has fostered more open conversations because the discussions are taking place in an environment that is familiar to everyone in the family and thus more comfortable. We appreciate the opportunity to continue to serve our clients and their networks during these challenging times, especially given that most everyday activities have had to stop.

My client in the van stated, “We don’t have to drive an hour and a half to you anymore ... let's just do this forever.”

I said, “Umm, I hope to see your face soon in person but this will work for a while ...”