Exploration of Child Counselors’ Experiences Providing Services during COVID-19

Background/ Purpose:

The COVID-19 pandemic has increased stress and anxieties for many individuals, but especially children who have had their home, school, and social lives disrupted with little understanding of the causes behind these changes. Given the traumatic impacts of the pandemic on children, providers are not only at higher risk for vicarious traumatization but also further psychological impacts due to stresses in their own lives as a result of COVID-19. Evidence on the importance of the therapeutic alliance between children and clinicians has documented the association between improvement in symptomatology and strength of the alliance. Clinicians who experience burnout may have difficulty sustaining or establishing this alliance. Though the burden of the pandemic on healthcare professionals is beginning to enter research discourse, there is an absence of evaluation of this burden on mental healthcare workers themselves. Specifically, those who work with children, in which the relationship between clinician and client can play an important role in treatment outcomes. This study explored how clinicians have managed the stresses of their personal life with those of their professional life to survey their experience working during the pandemic. It also provides insight into their view of client’s symptomatology, which can inform possible mental health intervention and service delivery.

Methods:

The present study uses semi-structured qualitative interviews with mental health providers (N=9) across three different states. Providers in three different states, Massachusetts, Colorado, and Illinois across four different license types were interviewed for a one time one hour via Zoom. Providers ranged from 1-25 years of mental health experience and varied in race/ethnicity. Thematic analysis was conducted by hand on information gathered through the interviews to identify relevant themes.

Results:

Results indicate two central themes with four sub-themes for each that were consisted across interviews. The first theme, significant changes in client’s symptomatology with the sub-themes of clinician’s relationship with caregivers, attentional difficulties, and creativity in solutions, describes clinician’s experiences of rapidly changing client symptomatology and how they navigated treatment. Many clinicians came up with creative solutions to address both client’s needs, and parent’s shifting perspectives on therapy during the pandemic. The second theme, clinician difficulties during the pandemic, contains the sub-themes of social unrest, lack of supports, and COVID-19 dangers. This theme explores the many factors contributing to the burnout and frustration referenced by participants throughout interviews.

Conclusions/Implications:

These results suggest a high mental health burden on clinicians during the pandemic and a lack of support for their services. Clinicians had to cope with the traumas of social unrest, economic instability, and fears surrounding COVID while assisting children with the same concerns. Next steps should assess reasons for differing amounts of employee supports during this time period and their impacts on clinicians and by proxy, clinician’s view of their jobs. Overall, these findings point to the importance of employee supports for mental health providers and the severe mental health impact of the pandemic on children and their counselors.