In a recent Facebook thread, a mental health counselor asked how the rest of us, her colleagues, were feeling about the mask mandate being lifted in Austin, 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. By the way, or maybe not, her practice is not in Austin, a liberal city, but in Georgetown, a predominantly Republican 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 another income in addition to her practice.
These descriptive facts are all important. Her being white, married, and in a conservative town blinds her to the privilege she exhibits with her pride in not wearing a mask while seeing her mental health clients.
She did offer arguments for her position within the thread. She works with young children, some of whom are deaf. She also works with older deaf clients, as well as abled individuals and groups. Yes, she leads groups during the pandemic 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 member. 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. There’s no way they could be sitting six feet apart in a circle and be able to be heard.
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. I can see the mouths of my clients very clearly on video, and they can see mine.
She claims they haven’t shared COVID at all during this past year. And yet, she says she has had COVID twice. Although she stayed home the first time 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. I can’t help but wonder how she can be so sure she didn’t get it from a client and give it to her daughter. Or give it to a client before she tested positive.
Privilege shows up in many forms. Not being able to see how your behavior harms others less fortunate than you is the main one.
Being married, and maybe the money she rakes in with groups and interns, made staying quarantined for two weeks a manageable situation for her. Not so for some of her clients. If she 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.
Simply 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, or sole proprietor. It’s true of her interns, unless they have a second income.
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. However, that’s not a reason to take the risk. The very fact that it’s recognized as a valid risk 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. Part of our job as therapists is to help clients accept and cope with reality.
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, after a year of receiving therapy that way. 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. Privilege again.
My clientele is represented by most ethnicities, ages, gender identities, and socioeconomic status. While I don’t see children, and have great empathy for therapists and teachers who’ve had to make video work, I believe even they benefit from video sessions as it keeps them safe. It is my dearest hope as a professional that all of us continue to do our best to “see” clients while doing no harm.
For now, and until everyone is vaccinated, it’s urgent that therapists offer video and phone sessions. Currently insurance covers these therapies. If you are a client or plan on becoming one, please call or email your insurance company to request they continue to cover telehealth, during the pandemic and after. Also, consider using only a therapist that provides telehealth. They are taking your physical health and theirs into consideration. You want a practitioner who cares about you as a whole person. I hope you also want one who doesn’t see their job and the world from a privileged, elitist position.
If you are a therapist, please consider our main priority in mental health is to “first do no harm.” Our second is to meet the client where they are, and also to help them accept and cope with reality. Our current reality includes a world-wide, potentially fatal pandemic, that statistically affects and harms more people of color. If we therapists can help stop the spread through using telehealth, we should.
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.
This post was previously published on aninjusticemag.com.
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