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More therapists opt for remote therapy amid coronavirus crisis

News-Journal - 8/8/2020

Five months into the coronavirus crisis in Florida, where more than 8,000 people have died and more than half a million have fallen ill, more people have been in need of mental health services.

To deliver those services at a time when many people are self-quarantined and practicing social distancing, mental health professionals in Volusia and Flagler counties have turned to remote therapy for those seeking help.

But therapy via a computer screen comes with challenges for both the mental health professional and the patient.

Debra Grindstaff has witnessed a rise in anxiety and depression among her clients. The medication-assisted treatment therapist has offered support from behind her computer screen at home, but much has changed since her clients last visited her Daytona Beach office at SMA Healthcare. She has felt an immense pressure to provide the same level of care through a webcam.

The continued rise of coronavirus fatalities and infections across the state has pushed more therapists, like Grindstaff, to transition from in-person to remote therapy. While that has allowed her to maintain communication with clients amid the coronavirus crisis, she and other therapists have felt drained after staring at a screen for hours on end.

"At the beginning, there were a few weeks where I wasn't feeling well, and I didn't know what it was," Grindstaff said. "I found out that the long, extended time of being in front of the screen was causing headaches and dizziness. I've been more attuned to it since then and I've been able to shift out of it a bit."

The use of telehealth or remote services has soared since mental health providers first drew up plans to protect their clients and staff from the coronavirus. In recent months, therapists for SMA Healthcare have counseled most outpatient clients through online video calls. Other staff like nurse practitioners and case managers have assisted clients in the same manner.

SMA Healthcare provided a staggering 20,938 telehealth services between March and July. The mental health and addiction agency serves individuals in Volusia, Flagler, Putnam, and St. Johns counties.

The transition from in-person to remote therapy hasn't been smooth for all involved. Support group sessions have sometimes seemed "chaotic" because of how many participants were on a single video call, said Jennifer Stephenson, senior director of outpatient services for SMA Healthcare.

While clients have continued to attend their support group sessions amid the coronavirus crisis, some have been more hesitant to speak in front of a webcam. Stephenson noted that fewer clients have clicked the raised hand icon to share affirmative comments with one another. She acknowledged that the majority of clients have not preferred the online support group sessions.

"It's probably not the thing that people love the most," Stephenson said. "Unfortunately, it's likely going to be the last service that will go back to happening in person with a good number of people."

While many mental health providers have decided to serve most outpatient clients through remote therapy, others have given clients the option to meet with therapists in their regularly disinfected offices. That has offered relief to clients who have not adjusted to the isolation that comes with being confined to their homes.

"We're social creatures, so the social isolation that has been going on for such a long time is hard," said Patricia Adams, licensed clinical social worker for Lakeside Counseling and Wellness Center in Port Orange. "It can be really depressing for people. I have a couple of clients who come in and say, 'You're my only interaction in person.'"

For months, the Lakeside Counseling and Wellness Center received more than 75 calls a week for new clients with anxiety, depression, or relationship stress. Although there was a tremendous need for services, Adams said Lakeside Counseling and Wellness Center was unable to serve that many clients.

While calls have slowed, the number of clients receiving telehealth services has remained higher than normal. An unprecedented number of clients have elected to participate in remote therapy sessions in recent months. The Lakeside Counseling and Wellness Center provided a total of 1,390 telehealth services from March through July.

Adams admitted she was first reluctant to counsel clients through a webcam because she worried it would be difficult to provide quality care. But her opinion changed after she and her staff began to conduct online video calls with clients.

"I have some therapists who would prefer to do telehealth 100% of the time and continue that moving forward, but I also have some who would prefer to do work in person," Adams said. "Everybody's taken to it because we really had no choice. I think many were pleasantly surprised that you could really do good work using an online platform."

Although more therapists have shifted to remote therapy amid the coronavirus crisis, it comes with challenges anyone working remotely right now can understand.

Many therapists and patients have grown frustrated with how often clients encounter internet connection problems. Time after time, therapists have waited to resume therapy sessions after the image of a client froze on their computer screen.

"There's an indefinable element about being in a room with someone," said Karen Palpant, licensed mental health counselor for Ormond-by-the-Sea Counseling in Ormond Beach.

Despite the desire for social interaction, more clients than normal are opting to chat with their therapists from home. Ormond-by-the-Sea Counseling conducted 155 online video calls with clients between March and July.

Therapists agree that the coronavirus crisis has disrupted the lives of residents in Volusia and Flagler counties, and has heightened anxiety and depression among those with mental health issues.

Inside a Daytona Beach home, Grindstaff recently adjusted her webcam to capture her face as she reassured clients that everything would be OK. After she spent hours clicking out of one therapy session and moving on to another, she took some time for herself.

"There's anxiety on our end to make sure that we're giving the best care possible," Grindstaff said. "We're helping our clients adjust to all of these changes, and yet we're adjusting to them as well."

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