Not seeing how your behavior harms others is a problem if you're a Mental Health Counselor.
In a recent online thread for therapists in Austin, Texas, a mental health counselor asked how the rest of us, her colleagues, were feeling about the mask mandate being lifted by Governor Greg Abbott in Texas. One respondent was “Ecstatic.”
She and the other three people in her practice, two interns and a massage therapist, had not worn masks throughout the pandemic and had seen all clients in person. The practice is not technically in Austin, Texas, a liberal city, but in Georgetown, Texas a more conservative community thirty miles outside of Austin.
Also coincidentally, or not, she and her staff are all white. In addition, she is married and therefore has a two income household.
These descriptive facts are all important. Her being white, married, and in a conservative town potentially blinds her to the privilege she exhibits by not wearing a mask while seeing her mental health clients.
She works with young children, some of whom are deaf. She also works with older deaf clients, as well as abled individuals and groups. Her clinic conducts groups without anyone wearing a mask.
Every suggestion we offered, she had an answer for. Clear shield masks were too expensive for her to buy for herself, her staff, and her clients. There are only four staff members. She does have 100 clients, so it would be expensive to buy them for all clients. 100 clients also mean most of them meet in groups.
She claims they practiced six feet of social distancing. I’ve led lots of groups. Everyone sitting six feet apart is not conducive to group therapy.
She claims she needs to see deaf clients in person so they can read her lips. I’ve worked with deaf clients, and reading lips is difficult enough three feet apart, much less six. On video, you can get as close as you need to read lips.
She claims they haven’t shared COVID at all during this past year. And yet, she says she's had COVID twice. Although she stayed home when she had symptoms, the medical field assures us we can be carriers and transmit the virus before symptoms appear. The second time she says she got it from her daughter, and quarantined for two weeks.
Privilege shows up in many forms. Not being able to see how your behavior harms others less fortunate than you is the main one.
Having two incomes, and the money from groups and interns, made staying quarantined for two weeks a manageable situation. Not necessarily true for some clients. If her staff transmitted the virus to a child or teenager who gave it to their single parent, that parent would suffer financially as well as physically. If any of her clients died from the virus, there’s the financial as well as the overwhelming emotional distress of the family that results.
Assuming that a client who is exposed to or contracts the virus during in-person therapy can afford to take two weeks off work to quarantine is elitist. As a therapist myself, two weeks or more of being off work, or being hospitalized for longer, means I’m not making any money during that time. That’s true for any contract employee, hourly worker, interns, or sole proprietor.
Most of us on the thread agreed that we should “first do no harm.” Seeing clients in person without masks during a world-wide pandemic is the perfect storm for doing harm. Even liability insurance companies recognize the harm we could cause by exposing clients to COVID. My malpractice insurance and hers covers this possibility. The very fact that it’s recognized as a valid risk by insurance is a reason not to take the chance.
Mental health services are difficult enough to access in the U.S. without adding the stress of possibly contracting a fatal disease during session.
While it can be argued that having access to a computer and WiFi is also privileged, most do have phones of some type. In addition to video computer sessions, phone sessions, FaceTime and other free face-to-face digital apps are also safer options for clients.
Most of my clients prefer video or phone sessions now. They appreciate not having to drive in Austin, Texas traffic. In fact, it’s much better for those who don’t have transportation, and those with limited funds for gasoline. Something a therapist seeing clients in person hasn’t taken into account.
All professionals need to continue to do our best to “see” clients while doing no harm. Until most people are vaccinated, telehealth is the safest.
If you or someone you know is in need of therapy, please look for verified therapists on Psychology Today or Therapy Den. On those and other referral websites, you can sort for ethnicity, treatment philosophy and modalities, and whether the therapist offers video counseling. Until everyone is vaccinated, video counseling is the best for now, and the majority of therapists offer it. You can also look for a therapist on your insurance website. If you need help, please reach out. Help is a only a phone call or video away.