We are living through the threat from coronavirus in real time, along with our clients, families, organisations, the nation and other countries across the world. Behind essential frontline workers such as NHS staff, emergency services and education staff, there’s an army of workers who’ve been shown to be critical in keeping our society working, and who cannot shift to homeworking. They include shop workers, lorry and delivery drivers, cleaners, carers, social workers, local authority planners, environmental health and critical infrastructure workers to name a few.

Wherever we are, every aspect of our lives, and those of our families, clients and organisations, are changing for the long haul. Complex and potentially life-threatening decisions are being made, often in a heightened state of anxiety and fear. As one therapist in an organisation with nearly 10,000 staff said: ‘We are in a live experiment. We have to make a decision at work and then 20 minutes later, someone says, “Yes, but what about…” and what they’ve noticed is vital and we have to stop and listen and start again.’

After the initial shock, people have quickly mobilised and are forming plans as we prepare for long-term periods of self-isolation. Speaking on Radio 4, Professor Susan Michie, Director of the Centre for Behaviour Change at the University of London, said
that people will need three things:

  1. Good financial and practical support
  2. Clear communication and social support and
  3. Clarity about what we are being asked to do.1

One crucial lesson being learnt is the importance of collaboration between citizens and official institutions or between different parts of the organisations, bringing people together (physically or virtually) to work strategically and focus minds on the task ahead. It’s new to most of us, the territory is unknown and there is no map. What we do have are experienced practitioners who are specialists in working with change, anxiety and trauma in organisations and who can share their early responses of how they and their workforce are adapting to the threat of COVID-19.

Coming together – staying apart

Across the UK, offices and buildings were hastily closed down and footfall restricted. In days and, in some cases hours, service managers shifted teams of workplace counsellors from providing face-to-face sessions to online and telephone provision. ‘What’s helped is that as a service we had a Business Continuity Plan in place before the crisis, and an incredibly flexible staff counselling team,’ said Nick Wood, Senior Wellbeing Advisor at Gloucestershire County Council.

Psychological preparation helps, but it’s still an enormous shift and takes its toll. One counsellor walking away from their place of work for the last time, unable to hug her colleagues, said: ‘I was overwhelmed with sadness. I don’t know when we’ll go back or even if we’ll all go back. I look at the lists of people vulnerable to the virus, and then I realise, “I’m asthmatic and I’m one of them.” I’ve never been in the trauma with my clients, but I am now.’

Slow things down

At the University of Leeds, where over 9,500 people are employed, the planning has been on a vast scale, involving every single department working collaboratively: ‘There’s a shared sense at this critical time that if you know something useful, you share it’, says Nicola Neath, Staff Counsellor. And while crucial decisions are being made at speed, regular communication and debriefing are essential, says Julie Hughes, whose service Mind Matters Counselling also provides counselling to the university’s staff: ‘I just need 20 minutes to check in with my business partner at the end of each day. It helps to keep me grounded while I’m experiencing what everyone else is also going through.’

Understandably, people are anxious and feeling under threat, at a time when they’re needed to make good decisions at great speed: ‘It’s crucial that before every meeting, whether online or face to face, that either I or a colleague just asks everyone to stop and to take a moment to centre themselves and take a breath. Everyone appreciates it and they are always better for it afterwards,’ says Nicola Neath.

Keeping people regulated and helping them to get their thinking brains back online is a crucial skill at this time. This is particularly so if we are working with the category of essential workers, whose professional lives are now not only less predictable, but who are also at higher risk because of their exposure to the virus. Based on discussions with colleagues, I’ve compiled some thoughts on how we can best serve our organisational clients with the task ahead.

A new approach to provision

Flexibility: This is no time for rigidly adhering to the 50/60-minute session - it’s not necessarily what our clients find helpful right now, nor do many have the time for it. Services need to consider how we can be flexible for our staff. We must be aware that we are now supporting staff who may be working at home, under pressure, in spaces that aren't fit for purpose. Indeed, these same factors may also apply to ourselves. There are further financial worries for self-employed therapists, some of whom report clients dropping out of sessions because they are time starved and it’s simply another thing ‘to do’.

Practical support: Different times call for different measures and we cannot underestimate the importance of small acts of kindness, check-ins and practical support. At the University of Leeds, the service is looking at a new way of working, including ‘the little and often’ approach. Instead of one long session, clients could be offered shorter, regular, 15-minute check-ins, either via phone or online, but the clients will have autonomy and choice.

Grounding: Moving sessions online or via the phone, means that we must still support clients and help to keep them grounded. The service at Leeds is briefing the team of counsellors to start online counselling sessions on Zoom in similar ways to the face-to-face sessions. This also applies to the internal meetings being held online: ‘eyes down for centring yourself – and then when you’re ready, eyes up and smile at the person in front of you.’

Vulnerable clients: We know that good work is beneficial for us, but what happens if our staff are in an abusive relationship at home or have abusive neighbours? They are now at risk in their place of work, so how do we address this? It’s throwing up new dilemmas, which will demand creative responses and new boundaries. In therapeutic circles, prior to the PM's announcement about the need for restricting our movements, discussions were underway about how we could meet the need of clients in abusive relationships, eg by dog walking or parallel car park counselling (adhering to two-metre social distancing guidelines). This all requires further discussion in supervision with reference to BACP’s Ethical Framework for the Counselling Professions.2

Adapting your practice for COVID-19

At times like this, people in all sectors are being stretched to learn new skills, and it’s understandable that not all therapists will be confident or trained to work online. However, if you’re offering your services as an affiliate counsellor, there are certain things that you will be expected to know, says Julie Hughes, Case Manager at Mind Matters Counselling: ‘We have to be confident that the therapist is able to work proficiently on that platform, whatever it may be, with a client.’ She recommends the following:

  1. Do your research
    Make sure that you know what is involved if you are moving over to working online. Become familiar with the software, attend the free training sessions and watch the demonstrations to increase your confidence.

  2. Practise
    Put your new knowledge to the test and have meetings with colleagues, friends and family, using the platforms. Stress-test the systems for bugs and technological glitches. Consider how your working environment looks and what your clients will see when your session begins. If it’s not suitable, explore options for setting up a virtual counselling room in the background.

  3. Contracting and insurance
    Check out BACP’s website, where you will find current information and guidance related to COVID-19 for contracting with clients online/phone including regarding confidentiality. Check with your insurance company that your policy will cover you for working online.

    BACP is partnering with Onlinevents to bring its members free access to resources for working online. Each week, there is a webinar, 'Coronavirus: Considering our responses and responsibilities', with Kate Dunn and Carole Francis-Smith, which is downloadable. One therapist switching to virtual working said: This webinar helped me to feel connected with my profession at a time when I really needed it. I was left supported and encouraged to try out new ways of working and surprised at how enabling it was.

Looking ahead

The change cycle means that when the initial shock and anxiety subside, we must be ready to anticipate the next phase when people dip into sadness and depression. One colleague’s GP warned him that the counselling profession will have to get itself prepared for an epidemic of mental health need - and for that, we are going to need stamina and collaboration.

As we take up our role in responding to COVID-19, we will have to be resourceful, inventive, creative and informed. It’s positive that we can work virtually and keep our client and supervision work going, but Anne Scoging at the London Fire Brigade cautions us about the demands of virtual working: ‘It’s exhausting working this way, and while it’s tempting to offer that connection in our work, to our clients and our supervisees, it must not be that we overlook keeping all our other connections going, which can support us. Whatever it is, make sure that you are mindful of what you need, whether it’s an online yoga class, singing, drama or talking with friends and family,’ says Anne.

Closing thoughts

Despite the descriptions of us being a nation on a war footing and that, inevitably, we will face heavy casualties, there is much anecdotal evidence circulating that suggests people are already holding hope and finding connection, compassion and community in surprising places. As therapists, we are adept at finding light in the darkness and supporting others to find it too.

I'll give the last word to Vicki Palmer, Chief Executive of Oasis-Talk: 'COVID-19 is a wake-up call. It brings us all face to face with our own mortality and the mortality of our loved ones. We have to ask ourselves, what sort of a world do we really want to live in? Do we want to live in an individualistic world, or do we want to live in a world where we look out for each other and look after each other? We can choose where we put our energy, but it’s the collective effort that always enhances our own wellbeing. Two thought-provoking questions for our clients, ourselves and our wider systems, could be: how would you like the world to be when this is all over? And: how could you contribute to creating that world?’

*This article was written in late March


1 World at One. BBC Radio 4. www.bbc.co.uk/programmes/m000gc4z
2 www.bacp.co.uk/events-and-resources/ethics-and-standards/ ethical-framework-for-the-counselling-professions/