It’s the Wild West of the Coronavirus out there!

Coronavirus in Flickr Public Domain

Coronavirus (from Flickr.com in Public Domain, April 8, 2020)

It’s the Wild West of coronavirus out there, and it doesn’t seem to be letting up around here yet! In my previous blog post, immediately prior to this one, I explained that I am a counselor at a mental health facility in the Southeastern United States. Thankfully, especially in situations such as that happening right now with the coronavirus shelter-in-place orders and curfews, I have and been able to keep my part-time hours. However, the Wild West of coronavirus still puts every person at risk of getting it, particularly when people persist in not taking it seriously.

In my prior blog post, I stated that I was exposed to a colleague (who also works at another mental health hospital) who was exposed to a patient who had been hospitalized and in serious or critical condition due to the coronavirus. My exposure to this colleague occurred on March 29, 2020 when this colleague came to work, and we were in the same department office and he was using my desk in that office. I should also state that this colleague worked all day at our mutual workplace the day before that – March 28, 2020. Between those two days and his travels throughout the hospital, he exposed dozens of staff and patients to potential coronavirus. He was informed by his employer of potential exposure on March 29, and left our mutual workplace once informed.

On Monday, March 30, 2020, my colleague got tested for coronavirus, and yesterday, April 7, 2020, was informed that he tested positive for it. Thankfully and with great relief, my colleague has been asymptomatic, as per his reports. It is my understanding, however, that people who are asymptomatic can still (obviously) be carriers of coronavirus and can infect other people with it. It is also my understanding (as well as through my own observations on March 29) that my colleague who worked at our mutual workplace on the weekend of March 28-29 did not wear any protective equipment to prevent a potential spread of the coronavirus until after he stated he received a call from his employer about his potential exposure to it. Only after that call did my colleague begin wearing a surgical mask.

On March 29, I informed the charge nurse at the hospital of my colleague’s potential exposure to coronavirus, as well as my own exposure to this colleague. At that time, she informed the hospital’s nursing director about it. Yesterday, I was informed by my supervisor that staff who came into contact with this colleague do not need to be tested for coronavirus! This is per information from the Health Department, apparently! And, there was no word about informing patients at the hospital of their potential exposure to coronavirus.

So, here we are in the Wild West of the coronavirus, folks! You’re on your own. When you go to work in a healthcare facility, and if you’re a patient at a healthcare facility, you’re risking exposure to – or you’ve already been exposed to – coronavirus! You have to make your own decisions and you have to do your best to take care of yourself, as well as your own famiy. I would guess that there are those facilities such as my own workplace that are not requiring staff or patients to take extra precautions to prevent the infection or spread of coronavirus. I would estimate that there are healthcare facilities such as my own that do not require staff and/or patients to wear masks, gloves, or other personal protective equipment. Recall from my prior blog post that I purchased and have been wearing my own, and I was the first staff member at my facility that I observed to wear any PPE at all. And, to my knowledge, the department office in which I work was not cleaned or disinfected (any more than what it typically is) on the weekend that my colleague worked there, beyond what I cleaned with Lysol after he left.

That stated, I am very confident that I do not have the coronavirus, nor that I’ve passed it to my family. I do my very best to wear my own PPE at work all day, except for when I eat or drink something. When I arrive at home, I put my clothing and gloves in the laundry for washing. However, I have typically been using my N95 masks for an average of three days, which likely increases my exposure if the virus is on the outside of my masks. This is not the safest way to proceed, however I hope that it does extend the wearability of the masks that I have.

Our president is banking on social distancing to eliminate coronavirus in the United States, however so, so much more still needs to be done! Why aren’t factories churning out ventilators? Why doesn’t every person in America have masks and personal protective equipment? At least, if they don’t want to use it or wear it, it still should be made available to everyone, and in plentiful rather than limited supply. More testing for the coronavirus still needs to be done on a greater scale, and people who have coronavirus should not be prevented from being admitted to hospitals, and instead, be forced to stay in self-quarantine.

That’s all just not good enough. That’s not America. That’s not the United States that I know – doing less than the bare minimum in the hopes that our country will get through this. It’s not enough to just get through it. It’s not enough to just have faith – we need intelligent action, too. We should be putting absolutely all of our efforts into eradicating this horrific virus rather than allowing an inept federal administration to continue contributing to the deaths of so many people as a result of delays, denials, and inaction. This is a killer virus not to be taken lightly. In short, more needs to be done to stop the Wild West of the coronavirus!

Multiculturalism and Social Justice in Counseling (By: Michele Babcock-Nice)

Multiculturalism and social justice in counseling are areas necessitating increased understanding and competence. This essay addresses the revised American Counseling Association (ACA) multicultural and social justice counseling (MSJC) competencies (Ratts, Singh, Nassar-McMillan, et al., 2015). Identified will be committee composition and controversial text. Addressed will be competency-meaning to this author, and ways of competency-inclusion in education and practice. Finally discussed will be difficulties regarding competency-integration into education and practice, and ways to lessen challenges.

Multicultural competence is “having…the ability to work effectively across diverse cultural groups and…expertise to treat clients from certain culturally diverse groups…[and]…minority and underrepresented groups” (Tao, Owen, Pace, & Imel, 2015). Social justice in counseling means understanding “societal structures…that marginalize and oppress individuals,” while broadly-addressing inequalities (Roysircar, 2008). The competencies have expansive personal meaning, though are not all-inclusive. An example is that the committee was diverse, though mostly included men and minorities. Most counselors are Caucasian (Hays, Chang, & Havice, 2008), with White women warranting inclusion. Further, divisive wording throughout the competencies, identifying counselors as “privileged and marginalized,” should be revised (Ratts, Singh, Nassar-McMillan, et al., 2015).

There are several ways to include the competencies in education programs. Students can be required to complete relevant courses and intern at diverse facilities. Another way is to require achievement of specific continuing education credits. Potential barriers to achieving this include finances and time needed for program completion. Ways to overcome these barriers are obtaining student loans and adding educational requirements.

Counselors must take opportunities to experience diverse cultures and social justice issues, aimed at practice-application. Therapists must periodically check-in with clients during sessions to ascertain understanding. Challenges to applications in practice may relate to personal background and beliefs. Another challenge may relate to low degrees of diversity in some areas. Counselors must motivate themselves to expand experiences and apply competencies with broader populations to overcome challenges.

Over two decades ago, Sue, Arredondo, and McDavis (1992) encouraged multicultural competency implementation. Those standards were recently-revised, adding social justice competencies. Concerns remain, however, with this overdue revision. Challenges exist regarding competency integration into education and practice, though difficulties can be overcome. The MSJC competencies provide a framework for counselors regarding associated knowledge and skills.

References

Hays, D.G., Chang, C.Y., & Havice, P. (2008). White racial identity statuses as predictors of White privilege awareness. Journal of Humanistic Counseling, Education and Development 47 (2), 234-246.

Ratts, M.J., Singh, A.A., Nassar-McMillan, S., Butler, S.K., & McCullough, J.R. (2015). Multicultural and Social Justice Competences in Counseling. American Counseling Association.

Roysircar, G. (2008). A response to “Social privilege, social justice, and group counseling: An inquiry”: Social privilege: Counselors’ competence with systematically determined inequalities. The Journal for Specialists in Group Work 33 (4), 377-384.

Sue, D.W., Arredondo, P., & McDavis, R.J. (1992). Multicultural counseling competencies and standards: A call to the profession. Journal of Counseling and Development 70 (4), 477-486.

Tao, K.W., Owen, J., Pace, B.T., & Imel, Z.E. (2015). A meta-analysis of multicultural competencies and psychotherapy process and outcome. Journal of Counseling Psychology 62 (3), 337-350.

Author’s Note: This is an essay that I recently submitted for the American Counseling Association’s Doctoral/Graduate Essay Contest.  Fifteen awards were issued, nationwide. Although I was not fortunate to be selected as a winner, I have the satisfaction of having participated in the competition.  It is certainly difficult to create an essay of 500 words or less and include thorough references, as ethically should be done.  I could have included approximately 120 additional words in my essay without the references.  The sponsors of the competition might consider expanding the word length of the essays to 1,000.  I originally wrote an essay of that length, and edited out half of it!

 

Challenges in Mental Health Care: The Sickness v. Wellness Perspective (By: Michele Babcock-Nice)

Mental health care is a challenging, but rewarding field.  There are many positive sides of mental health care, and also areas that need improvement.  One of the biggest rewards of mental health care is observing and experiencing progress, recovery, and a return to wellness of clients.  Healing, recovery, and a return to wellness of clients in mental health settings requires patience, understanding, respect, and sensitivity.  Agency and organizational stability is also needed for clients in order that they receive optimal care.  While each agency and/or organization has its own culture, a culture in which workers live in fear of becoming a statistic in extremely high turnover is unhealthy in itself.

As an individual working toward licensure in the mental health profession, I am one whose perspective is from a position of wellness.  First and foremost, one must view a person as a person.  To perceive and treat a person with respect, kindness, nonjudgment, and impartiality are requirements in supporting and empowering the wellness, healing, and recovery of clients.  In the counseling profession, one based on a view of wellness in people, there exists a positive and supportive hope for the overall optimal health of the individual.

This view is different from many other mental health professions in which the general view of the client is one of sickness.  Certainly, approaching an individual with a perspective of what can be improved is helpful, and for insurance purposes involving payment for services rendered, a diagnosis of the client is required, however it is my perspective that viewing the client from a wellness standpoint is much more healthy for all involved rather than judging a person as being sick.

Those who view and describe an individual as a “sick person” have already negatively judged him or her.  They have not viewed the person as a person, but as an “ill person.”  Such a perspective held by such individuals causes them to treat the client differently, as one who needs more and more treatment, more and more medication, more and more confinement.  In these situations, the positive view of wellness is gone, and is replaced by a judgment that the “sick person” is unable to become well.

While clients have challenges to achieving and maintaining wellness, it becomes even more of a challenge when many in the mental health field view clients as sick, and only they as the professionals who hold those views have the power and expertise to make them well – or they have already judged that they will never become well.  A professional who approaches a client from a perspective of wellness (a perspective that is in the minority), therefore, faces even more challenges, not only for themselves but also for their clients when others view them as sick and unable to become well.  A person is still a person, regardless of their diagnosis or disorder.  A person is still a person, and has the capability of becoming well.  A hopeful perspective toward client wellness must exist in the mental health profession – rather than client sickness – in order that clients are supported and empowered to experience that wellness.

A further challenge in agencies and/or organizations in which a “sickness” perspective prevails is that experienced clinicians fall into the trap of believing that their views and judgments about clients are the best – that they are the experts.  Certainly, the experience of a veteran clinician is extremely valuable in treating clients, however experienced clinicians who believe that only their views, judgments, and culture of sickness are the most helpful approaches create a potentially dangerous situations for their clients.  Clinicians of all levels of experience must be open-minded to considering and perceiving different views – including those from a wellness perspective – so that their clients receive optimal care and so that they profession, itself, can grow and develop in a healthy way.

Clinicians who view clients from a perspective of illness and negative judgment place their clients at risk for further illness.  Clinicians who are set in their ways of expertise toward mental health treatment, and who are unable to be open-minded toward viewing different perspectives regarding it have already erected walls around themselves that are harmful for themselves, their clients, the culture of their agency/organization, and the field of mental health.

What clinicians must always place as a primary priority is that people are people.  As such, people should be treated with dignity, understanding, kindness, respect, and sensitivity.  If a perspective of client wellness is lacking or absent, clients will likely experience a more difficult road to recovery and may not achieve wellness.  What is healthier – being an “expert” clinician whose views of client illness cause him or her to be closed to considering a client’s optimal recovery, or being a clinician who treats a person as a person, and who applies a wellness perspective that supports rather than negatively judges the client?  You be the judge.