COVID-19: 1 Year Later – Distress Centre’s counselling program response
This is part two in our multi-part series exploring Distress Centre’s response to the COVID-19 pandemic, one year after we first activated our business continuity plan and went remote for the safety of our staff and volunteers.
This story looks at our counselling program’s response. Please be aware of our “Dos” and “Don’ts” when using any data from this story.
Distress Centre’s counselling program was the first to be majorly impacted by the COVID-19 pandemic. Counselling is one of our few in-person services at Distress Centre (alongside our programs at SORCe).
Distress Centre formed a COVID-19 response team on March 9th, 2020 and by March 13th we had made the decision to stop having in-person visitors at the office unless they had a scheduled appointment. Drop-in counselling was suspended.
By March 18th at 5pm, our operations were completely remote. Moving to remote work was a big change for our counselling program, as generally our counsellors see that majority of their clients face-to-face. But the team adapted quickly.
“The initial stress was getting everybody technology competent and set up. Since then, for the most part, it has been pretty smooth,” said David Kirby, Clinical Services Manager at DC.
Adapting to a virtual world
Initially counselling sessions were only available by phone, while we developed the capability for video counselling, which was introduced on April 25, 2020.
“For the most part everybody on the counselling team has had some pretty exhaustive experience either on the crisis lines providing on call, or doing coaching shifts, so for everyone on the team there is a lot of sophisticated awareness around nuances of voice changes, silence, etc.” said David.
“The real learning was around the video counselling,” David continued. “We had to develop some informed consent around that, identify who has responsibility if the signal drops, or we lose audio, who does what and how do we restart. Just trouble shooting the things that can happen with technology.”
David said that there have been positives from the operational shake-up.
''We had no precedent for being technically minded as social workers and psychologists.'' - David Kirby, Clinical Services Manager
“We have a cool opportunity, all of us on the team, to think creatively about how we do the work and to consider letting go of things that were not working well in the first place,” David said. “Everybody is thinking innovatively about how do we make the most of this service, and how do we respond to what the clients are looking for. We had no precedent for being technically minded as social workers and psychologists. ”
Counselling during COVID-19
Zoom and phone counselling isn’t a good fit for every client. David said that around half of our clients have the technical resources for Zoom counselling, the other half don’t have access or simply aren’t interested.
“Given a choice most clients would prefer Zoom over phone counselling but many are limited by not having secure Wi-Fi or even having an email address,” said David.
David said with phone and video counselling, it’s helpful if the client has previous experience with counselling, so they know what to expect in a session. But for those without experience, our counsellors will provide more coaching and usually start with a phone session before we suggest video counselling.
The top issues clients have presented in sessions has remained consistent throughout the pandemic. Anxiety, depression, suicide ideation, grief, substance use, social isolation, relationship conflict, and domestic violence have been the most frequent issues month-to-month.
''Grief is the one issue that has been showing up much more during the pandemic than prior to. I suspect that it really is the #1 issue and that all the other issues are components.'' - David Kirby
“Grief is the one issue that has been showing up much more during the pandemic than prior to,” said David. “I suspect that it really is the #1 issue and that all the other issues are components.”
One year later, counselling is still being delivered by phone and video only, and it is not clear when we will be able to bring back in-person services. On average, the demand for counselling has increased by 15-20% each month, compared to the year before. Virtual counselling can be more exhausting for the counsellor, so David says it’s important that counsellors unplug at the end of the day, practice self-care and take time off when they need to.
The counselling program has focused on the growth of Zoom counselling, with around 55-60% of counselling sessions currently taking place over Zoom Health. Though the methods by which we are offering counselling has remained the same over the last year, the counselling program itself has not remained stagnant.
“We’ve been developing research ideas for better understanding if there are any outcome differences between phone and Zoom based modalities and more general questions related to the number of optimal sessions for client progress,” said David. This work has included the development of customized reports to track the impact of COVID-19 on clients and work toward constant quality improvements.
The pandemic has forever changed Distress Centre’s counselling program.
“We’ll continue to provide phone and Zoom counselling even when the local state of emergency is lifted and we get the ‘all clear’ to resume face-to-face counselling,” said David.
“It will be critical to continue to provide flexible service options for clients.”
David is concerned about the potential for a “tsunami” of mental health issues as people reach their breaking point after over a year of dealing with the pandemic.
“Hospital emergency wards are already seeing increases in families and youth presenting with substantial impacts related to isolation, anxiety, depression, panic, and eating disorders,” said David.
At Distress Centre, our counselling program saw a 64% increase in clients experiencing suicide ideation. That number is frightening and David says he expects DC’s counselling program to be even more in demand in the future than we are now.
“This underscores the importance of community collaboration to ensure the system of care maintains capacity for new clients,” David added.