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Weitzman ECHO: Crisis Counseling & Caring for Your Staff & Yourself

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Weitzman ECHO: Crisis Counseling & Caring for Your Staff & Yourself

  1. 1. Weitzman ECHO on COVID-19 Crisis Counseling and Caring for Your Staff & Yourself April 15, 2020
  2. 2. CME Credit • Bridgeport Hospital Yale New Haven Health is accredited by the Connecticut State Medical Society to sponsor continuing medical education for physicians. The Bridgeport Hospital Yale New Haven Health designates this live activity for a maximum of one (1) AMA PRA Category 1 CreditsTM. Physicians should claim only credits commensurate with the extent of their participation in the various activities. • This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Bridgeport Hospital Yale New Haven Health and the Weitzman Institute. Bridgeport Hospital Yale New Haven Health is accredited by the Connecticut State Medical Society to provide continuing medical education for physicians. • The content of this activity is not related to products or services of an ACCME- defined commercial interest; therefore, no one in control of content has a relevant financial relationship to disclose and there is no potential for conflicts of interest.
  3. 3. Weitzman ECHO on COVID-19 A Primary Care Perspective cont’d Stephen J Scholand, MD Infectious Disease Consultant 15 April, 2020
  4. 4. Objectives - Update on epidemiology (2019-nCoV, SARS-CoV-2) - Review any good news? - Continue the good fight!
  5. 5. COVID-19 in the United States 589,048 cases 4/14/20 – up from 368,533 cases last week (4/7/20) - https://coronavirus.jhu.edu/map.html
  6. 6. Any good news? • Remdesivir data starting to appear – NEJM for severe patients (n= 53) • 68% improved oxygenation • 57% extubated • New York showing early signs of improvement
  7. 7. Health Care Workers = Heroes • These are trying times – Emotional and physical exhaustion • Patients and patient families – Dying alone • Support is appreciated!
  8. 8. Stay safe -- Stay up to date • https://www.cdc.gov/coronavirus/2019-ncov/index.html https://emergency.cdc.gov/coca/calls/2020/ • https://www.who.int/emergencies/diseases/novel- coronavirus-2019 • https://covidactnow.org/ • https://coronavirus.jhu.edu/map.html
  9. 9. Jessica Welt, PsyD Timothy Kearney, PhD Crisis Counseling and Caring for Your Staff & Yourself
  10. 10. • Global Pandemic vs. Past Potentially Traumatic Events • Impact of COVID-19: Population Exposure Model • Shelter-in-Place Orders • Individual Variables • Normal Reactions to Abnormal Circumstances • Emotional • Cognitive • Behavioral • Physiological/Physical Crisis Response in the Midst of a Potentially Traumatic Event
  11. 11. Maslow’s Hierarchy of Needs Source: Simply Psychology
  12. 12. Step 1: Assessing the Situation • Listen and ask questions • Define the problem • Determine what client needs to cope effectively with the crisis • Ensure client’s safety Elements of Crisis Counseling Step 2: Education • Psychoeducation about crisis reactions • Normalize reactions • Help client understand reactions are often temporary
  13. 13. Step 4: Developing Coping Skills • Explore different solutions to the problem • Identify potential triggers • Practice stress reduction techniques • Encourage positive thinking • Help devise plan to utilize strategies independently Elements of Crisis Counseling Step 3: Offering Support • Active listening • Provide acceptance and reassurance
  14. 14. • Structuring the session • Keep focus on the here and now • Set the frame with the first contact • Crisis Counseling DOs • Ask about status since last visit • Assess safety every session • Practice coping strategies • Plan for the time between visits • Crisis Counseling DON’Ts • Focus on the past/history • Attempt to resolve long-standing problems Strategies for a 20-minute Session
  15. 15. • Ongoing safety and risk assessment • Increased risk of domestic violence • Increased risk of child abuse • Increased risk of suicidality • Increased risk of substance abuse • Develop safety plans with limited resources available • Physical safety • Psychological safety COVID-19 Era Increased Risk Factors
  16. 16. Supporting Your Behavioral Health Team Provide necessary support to assist BH team members in their goal to provide compassionate, efficient, and effective care to clients in the midst of a pandemic while balancing their own needs and those of their families and love ones. Staff members move through phases:  Is my job secure?  How do I care for my current clients and surging demand?  I can do a sprint – wait, is it a marathon?  How much longer can I do this?  Burn out.
  17. 17. “secondary traumatic stress is emotional distress that results when an individual hears about first hand traumatic experiences of others”. NCTSN web page Secondary Traumatic Stress • Irritability • Hopelessness • Guilt • Inability to concentrate • Social withdrawal • Exhaustion • Physical ailments • Emotional detachment • Sleep problems • Intrusive thoughts • Decreased self care • Hyperaware • Lack of predictability • Sense of chaos • Loss of control • Heavy case load • “Dose exposure” • Feeling unprepared Indicators: Contributing factors:
  18. 18. Opportunities to Provide Support SAMHSA’s Trauma Informed Care: • Realize you don’t see what you don’t know is there • Recognize need in your own staff • Respond balancing the multiple imperatives you face Preventive: • Training • Good Mental Health habits • Up to date information In the moment: • Administrative Support • Clinical consultation (client services) • Listening to feedback (transparency) Restorative: • EAP and other resources • Boundary discussion • Acknowledge the tension • Future orientation
  19. 19. 19 Free COVID-19 eConsults • Web-based portal • Free to all Safety Net Primary Care Practices – FQHC, FQHC-look alike, Migrant Clinicians, Healthcare for the Homeless, Free Clinics • No Protected Health Information (PHI) • Consults Addressed by: – Infectious Disease Specialists – Public Health Nurses * This initiative is supported by
  20. 20. 20 * This initiative is supported by
  21. 21. Thank You! www.weitzmaninstitute.org/coronavirus

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