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Counseling in COVID

How I've chosen to embrace the change.

Steven Ing, Inc.
Source: Steven Ing, Inc.

I have been a Marriage and Family Therapist for the last 30 years. In all those years, never have I (or anyone else in my profession) experienced anything like the impact of COVID-19.

When sane leadership called for social distancing, I realized I needed to hunker down for my own sake as I have at least two risk factors in that I'm male and I'm over 60 years of age. So I did. But not without taking some steps that have led to a paradigm shift in my professional thinking that has helped all of my clients.

Like many others in America, my office received no guidance on some rational way to mitigate the sudden cessation of business as usual. Our first step was to terminate weekly group counseling and to see everyone in individual sessions with six-foot distancing. That wasn't so bad but it was only a day or two after that when we realized this step was inadequate and we moved to telemedicine.

This was a very unpleasant choice for me as my own journey to my profession was paved with both individual and group counseling experiences. The idea of giving up my idea of normal was hard, particularly given that I'd had maybe a small handful of telephone sessions over my career and then only because of some individual need. I was full of apprehension about missing the very important component of body language, famous for containing perhaps the majority of what clients were communicating.

Thinking I might mitigate some of the distance between us, I first considered video sessions. Then I started thinking of all the professional trainings and meetings that were in video format. Yikes! Even the best of platforms are just glitchy enough to mess with any interpretation of what is "really" being said. It's the same even with the failure to synchronize the audio and the speaker's lips. Finally, and most subtly of all is the weird eye contact where the speaker's eyes are looking right in your eyes—but they're not because the camera conveying the image of their eyes shows they're clearly not looking at me—even when they're looking at me. So we went old school: the telephone.

Steven Ing, Inc.
Source: Steven Ing, Inc.

Some of you are old enough to remember high school and what it felt like talking to a sweetheart late at night when the rest of the house was quiet. Sometimes we'd talk for hours, right? And remember how intimate those conversations could become? The telephone offers less data (like knowing just how awkward and uncomfortable my client looks chained to their device for video presentation) and more real connection. With that small voice in my ear, my clients never seemed bigger in my consciousness. In comparison, with all the glitchy video issues, clients shrank down to a size small enough to fit on my monitor.

So here's the scoop on counseling in an age of COVID: It works and it may work better than counseling in my office ever did. That's a disappointing conclusion to that part of me that picked out just the right black-and-white photography with the most tasteful frames you can imagine. Low key, elegant, but not ostentatious. And the books and the exact right furniture in the waiting room that transitioned oh so well into the group room and the family suite. Not to mention me in all my counseling regalia: sensible shoes, relaxed silhouette, smarty-pants glasses perched on my nose and only removed to use as a pointer for dramatic effect. "Yes, that's it Mr. Jones, right there, yes!"

My sessions on the phone in the last two weeks have been some of the most rewarding of my professional life. I have found that my clients, even those who objected ("You want me to pay what for a phone call?"), have consistently come away from our appointments with a pleasant and surprising sense of their own empowerment as they worked through their problems. And I have come away from those same appointments with the clarity that counseling was never about the nice office or the angle of the seating arrangement because good counseling was always about making meaningful connections in a therapeutic alliance.

For those of us who carry no illusions about churches needing to fill up by Easter, the long haul is a concern. My office has already made a decision there that may seem surprising for someone in the business of counseling. If, and more likely, when my clients lose their ability to pay for treatment they will continue to be served without payment, even without accruing a debt.

In this catastrophic end times of an economic zombie apocalypse, what else are we all to do? We help one another because we can; getting paid just makes it all more sustainable. While none of us can go out, staying home while helping people carry on and even thrive seems like the best way to define who I am as a brother to our big American family. I encourage my colleagues who haven't stumbled upon this as I did to give it a try. It feels great.