Continuity of care is essential for clinicians who are committed to treating a variety of conditions. With the shift to virtual classrooms, fitness apps and telehealth during the new coronavirus pandemic, clinicians have pivoted quickly to maintain standards of therapy care and avoid abandoning their patients during this high stress time.
“Barriers definitely exist for many of the clients I am treating,” says Tess Tracy, a social work graduate student in Syracuse University’s David B. Falk College of Sport and Human Dynamics . Tracy works with third- and fourth-graders as part of an internship to fulfill her master’s degree. “Families sometimes have only one phone for mode of communication. Many don’t have a computer or internet access at home. Parents are trying to work. It can be really challenging to get that full counseling.”
When New York State announced it was closing schools on March 16, students who are enrolled in clinical internships had to quickly transition to providing teletherapy with their clients in Onondaga County, who range from 6 to 70 years old and have social and emotional health issues, as well as behavioral health concerns, depression and substance addictions. Working with local partners at BOCES and Liberty Resources, Falk College organized distribution of Chromebooks, arranged free internet service and set up Google Classroom for clients when they learned schools would be closing. While Tracy normally works with eight students during the school day, she has seen only three of them for virtual counseling.
“When it worked out to see my client, I was sobbing. I miss them so much,” Tracy says. “When I get little messages, they are a glimpse of hope.”
Reimagining Delivery of Services
The COVID-19 pandemic exposed an already vulnerable population who may have difficulty accessing therapy due to cost, transportation and their residential location.
“What’s clear is that although this is really a great way for individuals to access therapy, the inequity in our client base is also playing out,” says Tracy T. Walker, director of field instruction at Falk College. “Individuals may have to choose if they use phone minutes for therapy or connecting with their mom. As we move forward, further inequities will be exposed in terms of who can receive services. How do we look at policies, and what is essential in a person’s life as a basic need versus a luxury?”
While students continue to weave the basic tenets of therapy into their distance internship experiences, other benefits of the transition are quickly emerging, Tracy says. While she misses the face-to-face interactions and conversations before an in-person class, her classmates are really opening up and sharing information through multiple lines of communications.
The impact is that telehealth is not so unknown, and our students are now part of this first wave of professionals in a system that will transform and shift.
“We’re talking even more and sharing information,” Tracy says. “It’s been great. We used to have time to talk before classes, but now we have even greater lines of support and have made more of a community. The overall positivity has gotten people to grow and share, be more creative and think about the opportunities.”
Walker and her colleagues are already exploring how to incorporate this new form of teaching into the educational plan moving forward. While the telehealth piece is not new, the transition has revealed alternative ways to deliver services. “The impact is that telehealth is not so unknown, and our students are now part of this first wave of professionals in a system that will transform and shift,” she says. “One of the changes that may occur is an examination of policies and their impacts, so we avoid setting up another system of inequity in our society.”
As this crisis starts to shift from acute health and medical needs, mental health professionals—especially social workers—will be the front line of services. “This is a great example of how crisis equals opportunity,” Walker says. “How do we reframe this to see what we can due to innovate, shift and enhance the way that we teach and do our work.”
Walker recognizes that the COVID-19 situation has forced both agencies and clinicians to quickly innovate and prepare students so they are equipped with the skills to best serve clients.
“In social work practice, we build relationships and connect with clients. This transition isn’t the same kind of ending process with a client,” says Walker. “The ending and goodbye process can be scary. When it’s done well, people can move on in a strength-based way and feel good about it. We can’t do it the way we’ve done it before. I am so impressed with what we’ve been able to do.”