Counseling Practice During Phases of a Pandemic Virus. Mark A. Stebnicki

Counseling Practice During Phases of a Pandemic Virus - Mark A. Stebnicki


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health with addictive and behavioral health concerns (Zvolensky et al., 2020). From a mental health perspective, risky patterns of behavior (i.e., suicidality, depression, anxiety, posttraumatic stress, substance use disorders) are well defined by diagnostic categories and decision trees in the fields of psychology, counseling, and mental health.

      Risk also involves (a) the assessment of a situation, (b) the use of cognitions in the decision-making process, (c) acting on a decision, (d) the influence of neurobiological mechanisms on feelings and emotions, and (e) the navigation of complex environments associated with risk-taking behaviors (H. F. Chan et al., 2020). Regardless of how simplistic or complex the decision to take a risk is, the psychological adjustment and adaptation involved in living during phases of a pandemic virus creates unrelenting stress, anxiety, and fear for many Americans. Thus, the impact of taking risks during a pandemic virus may not be immediately known. For example, leaving your home to go shopping, go to work, and/or attend school may create apprehension and conflict between yourself, your family members, your environment, and society. Social, interpersonal, and intimate relationships are particularly strained during a pandemic virus. Risk-taking is inherently involved in maintaining these types of relationships and interactions. Thus, a risk–reward decision-making process occurs as the average American takes daily risks in many different life areas, such as virus hygiene and living intentionally with good medical, physical, mental, and behavioral health.

      Overall, there are critical pathways to taking unhealthy risks during phases of a pandemic disaster. Mental health practitioners are trained in distinguishing healthy risk-taking (e.g., asking the boss for a raise, trying out for the soccer team) from unhealthy risk-taking (e.g., using drugs and alcohol excessively, having unprotected sex, practicing poor virus hygiene). It is critical to recognize and understand the unique risk-taking behaviors of persons transitioning through phases of a pandemic disaster.

      Resiliency

      Resiliency is often described as the capacity to adjust to difficult life situations. It is closely aligned with the construct of coping, in which individuals attempt to protect themselves from a psychologically distressing event. A new science emerged in counseling and psychology beginning in the early 1970s that uses a biopsychosocial approach to discover a person’s resiliency and coping characteristics after exposure to trauma. The literature is robust, and researchers suggest that persons who are more stress hardy and stress resistant have a greater capacity for empathy and possess better overall health and wellness. These individuals enjoy what Siebert (2005) referred to as the “resiliency advantage,” which comprises eight factors: making a conscious choice in life, harnessing the power of positive thinking, taking responsibility, having an internal locus of control, being self-motivated, not being afraid to try out new and different things, taking control of one’s life, and practicing positive approaches in life. Positive psychology and complementary, integrative, and behavioral health care strategies have had a significant influence on resiliency programs in the disaster mental health response (Stebnicki, 2017).

      The PRRC theoretical model proposed here is useful for evaluating a variety of mental, behavioral, and psychosocial health risk and resiliency characteristics as they relate to the COVID-19 pandemic. Pfefferbaum and North (2020) suggested that most COVID-19 cases are treated in health care settings by medical professionals who have little or no training in the assessment, diagnosis, and treatment of psychiatric and psychosocial conditions. Thus, education and training regarding the screening of mental, behavioral, and psychosocial health issues would enhance patients’ overall medical, physical, and mental health.

      Although reliable and valid self-assessments exist for clinically diagnosing anxiety, depression, posttraumatic stress, and substance use disorders, the unique characteristics and measurement of the psychological distress experienced during a public health crisis such as COVID-19 have not yet been identified in the literature (Feng et al., 2020). A preliminary scale, the COVID-19 Related Psychological Distress scale, is under development by Feng and associates (2020) to measure psychological distress due to the COVID-19 pandemic in healthy individuals. Feng et al.’s paper presents a scientific review and discussion of this instrument.

      The intent of the PRRC theoretical model in this early stage of development is to provide a global theoretical measure of a person’s experience of risk and resiliency during the phases of the COVID-19 pandemic disaster. Risk and resiliency are measured within the core areas of mental, behavioral, and psychosocial health with implications for medical and physical functioning. The psychological distress caused by pandemic viruses and its implications for mental and behavioral health practice is a unique area of study in disaster mental health response. This distinctive area involves a constellation of psychologi cal states, traits, behaviors, and other factors that range from daily stressors to extraordinary stressful and traumatic events.

      Mental Health

      The PRRC uses the diagnostic criteria and clinical characteristics reflected in the American Psychiatric Association’s (2013) Diagnostic and Statistical Manual of Mental Disorders


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