The Counseling Program at Looking Glass continues to be a vital service for youth, adults, and families in Lane County during the COVID-19 pandemic. Our counseling team has adjusted to this crisis and is now offering telehealth services. We sat down with Carlyn Wierda, our Outpatient Services Director, to learn more.
Are telehealth services new to your team?
Other than our psychiatry services, using telehealth for mental health and substance abuse services is completely new to our staff.
What are the benefits or upsides to telehealth?
I definitely think that telehealth has a lot of positive aspects. Some clients do feel more comfortable at their own homes, and telehealth eliminates barriers related to transportation. Telehealth can open up a lot of possibilities to access rural communities more easily as well. Some clients love showing off their homes, and we get to meet a lot of our clients’ pets!
What are the challenges or barriers that you have encountered?
I think we have adapted well—it has certainly been a big learning curve in a very short period of time. Unfortunately for some of our clients there are also barriers to telehealth services, such as access to high speed internet, or a computer, tablet or smartphone.
Some of our clients have conflicting relationships within their homes, and some homes may also feel chaotic. Some clients feel uncomfortable in their home, and some do not feel safe. For those clients our offices can be an important part of our work, in providing them a safe place during a therapy session.
As a whole, it seems like telehealth has been going well. Some of our clients might prefer to continue to receive telehealth (after the Covid-19 crisis is over).
Do any of your team’s clients lack a stable internet connection and/or webcam? If so, are you still able to provide services to them through other means?
We can provide services by phone if needed. Sometimes we do this due to internet or technology limitations, or other barriers, and sometimes a client may prefer to use the phone.
How do you ensure privacy when using telehealth?
We use a HIPAA compliant platform, VSee messenger, for our telehealth services as much as possible. We discuss the risks of telehealth services with every client and get their consent before providing treatment. At the beginning of each session, we ask clients to show us the room they are in, so we are aware of any other people that might be present. If needed, we also come up with a safe word with clients, so they have a way of safely indicating to us that they may not have privacy anymore. With that knowledge we can figure out the best way to proceed.
Have you noticed changes in the types of issues that clients are dealing with during this pandemic?
There is a significant increase in concerns related to interpersonal violence and abuse, as well as substance abuse. Unfortunately, I anticipate that we will be seeing more of these things come up for our clients, although clients may not currently be able to disclose that.
There has been an increase in suicidal ideation as well. A lot of our clients experience depression and anxiety, and for many of them the pandemic amplifies these struggles. If they were learning coping tools before, they now have to learn new coping tools, or adapt the ones they have learned to their current situation.
For many, parenting while you are home without outside support is challenging at best, especially if you are also helping children with schooling, and possibly working. For children in two households, there are added concerns around visitation and custody.
Clients with marginalized identities have had increased challenges in accessing social supports and have experienced increased discrimination. The systems that contribute to inequity are amplified for them in many ways. For LGBTQ youth who are not supported by their family, peers might be their main support system. If they don’t have the same access to those supports, social isolation for them may mean they don’t have people supporting their identity. For trans folks there can be added challenges due to limitations in their access to gender affirming medical care as well.
There are financial stressors, medical stressors, emotional stressors, pretty much any kind of stressors you can imagine. There is also a lot of grief and loss associated with this pandemic, people are losing loved ones, jobs, social connections, and many other things. I think that our clients are amazingly resilient in countless ways, too many for me to mention, but this pandemic is certainly challenging that resiliency.
Have you seen any changes in the need or demand for counseling services?
I think the mental health and well-being of all of us is challenged during this time. We have continued to receive calls from people looking for services, although it has slowed down a bit. I do not think this is due to the lack of need for services however. I think that people might not know that services are available, or they may be nervous about starting telehealth services. Accessing mental health services in general already has a lot of stigma attached to it—it can be hard to take that step to reach out. Any additional barriers to accessing services are likely to decrease people accessing support. I anticipate that as this goes on, there will be a greater and greater need for mental health and substance abuse support, and there will be a lot to heal from.
What types of therapy are you currently offering?
We are offering mental health and substance use treatment and skill building, in English and in Spanish. We also offer psychiatry. This can be with an individual, with a partner, their family, or other people in their home. For our child clients, we are also offering a lot of services to support their caregivers. We are offering a variety of different types of therapy, pretty much all the ones we typically offer, but with adjustments for it to work with telehealth, including CBT and DBT, motivational interviewing, play therapy, IFS, and EMDR.
Are you currently taking clients? If so, how would potential clients connect with you?
Yes, we are taking new clients! Clients can call our office at 541-484-4428 and will be connected with our referral coordinator to get things started.
Is there anything else you’d like to add?
I would like to add how amazing the counseling program staff have been. They have blown me away with their flexibility, creativity and spirit. Most clinicians have adapted to telehealth, our business staff have had to adapt to all the changes, and have taken on new roles and responsibilities to support the program, and our clinicians in our residential programs are going in and continuing to provide support to their clients. It is a unique situation for our clinicians to be supporting our clients with stressors that they themselves are also experiencing, and they have been so committed to helping their clients and supporting one another. It is such a joy to work with all of them, these challenges have really shown their true and awesome colors.
If you would like to schedule a telehealth counseling appointment, call 541-484-4428. If you are in crisis, call our 24/7 hotline at 541-689-3111. Non-urgent questions about The Counseling Program or Looking Glass can be directed to administration@lookingglass.us