Floyd Else, MA, LMHC (ret.), NCC, MAC

Therapy During a Pandemic

Author: Floyd Else, MA, LMHC (ret.), NCC, MAC

Posted on August 03, 2020


Webmaster comment:  A few weeks ago, I had trouble sleeping.   With the stay-at-home orders from governors and the president, and the social-distancing movement saying to stay 6 feet apart, to avoid transmitting the virus, how was this affecting the current Licensed Counselors/Therapists and Social Workers in the Counseling Washington Counselor Directory? Are they able to serve clients?  How prepared for this are they?  Are they able to counsel remotely; are they able to accept credit cards?  Are clients still trying to contact them for help?

What about the graduate school Master’s Degree students in the various counseling related programs (is the school closed; are they having remote classes?).

Finally, what can I do to help everybody through this? Generally, I see my role as providing helpful information on my site. So what can I do to help serve my subscribers in this situation? (It was keeping me awake.)

It is good to recognize that we are all in this together.  We are all, counselors, clients, students, educational bodies, anxious about the future, and what’s coming next.  Is it going to get better or possibly worse?  And what about “flare-ups” when we let down our guard?  And what about the problem of asymptomatic virus carriers?

Experts are reminding us daily that “hand washing remains important, but to avoid getting sick, the public should focus on staying away from other people.”


(An aside): The local daily newspaper is my regular indulgence, a great source of in-depth information.  Local newspapers are also being hurt by the pandemic as it closes stores and restaurants and cuts off the paper’s source of advertising revenue.)  I recommend you subscribe to your local paper, and support the important investigators and reporters who provide the facts we need to know, in order to keep our democracy informed and functional.


So, to be of service to our counselors, my associate, Lisa, and I have been working behind the scenes to improve the Counseling Washington website and, better-than-ever, serve those of you who are currently doing on-line counseling, whatever platform you are using.  It’s not a quick process as it involves additional programming in our data base, and visible changes to our web pages.  

We plan to survey to all our counselors, to find how they are meeting the challenges of the new normal, and gathering the information together in an anonymous form to share with all our counselors.

It is important to realize that face-to-face counseling will be difficult for some time.  Even when the stay-at-home order is lifted, the on-going fear of infection will make people reluctant to sit in an office with a counselor.

As an example, let me share my recent experience of going to a physical therapist for treatment of an aching arm. 

Even though they told me they were wiping down the treatment bed, between uses, I never actually saw anyone in the office actually doing any wiping down of surfaces.  When I came into the office I often saw staff members congregating behind the intake desk.  After several treatments, I called the physical therapist to tell her that I was discontinuing treatment.  And I suggested to her that as soon as a client came into the office, one of the staff should get busy wiping down the next treatment bed to be used, even if it had already been disinfected-- just to reassure the client.

I share this story to emphasize that for some time, clients will still be leery of possible infection delivery of face-to-face counseling and the process will need to evolve slowly as the opportunities to face-to-face counseling increase.  

So how do you imagine face-to-face counseling in the future?  Your comments are invited below.


I urge you to read this article, The Risks, Know them, Avoid Them

As you read this report of medical research, try to imagine the perfect office setup that would make it safe to perform face-to-face counseling in the confined space of the counselors’ office.

It is my deeply held belief that even if and when there is a COVID-19 vaccination that will confer immunity to the recipient, it will continue to be a severe public health issue until we have vaccinated 60 to 90% of the population.  For years after, the virus will continue to be a seasonal illness and continue to kill people who become infected, just as the flu does every year. 

The confluence of so many co-existing disasters—Black Lives Matter protests, the political assaults on our democracy and the environment—the COVID-19 virus, wide-spread business and school closures, mass unemployment, overwhelming numbers of illnesses and Death.  All mingled in our collective memories, have fused to damage the national psyche and created a deep and abiding unconscious fear of infection.   

The perception of danger in face-to-face contact in confined areas with poor ventilation will continue to limit our work as mental health counselors.  The same problems--anxiety, depression, substance abuse, etc.--will continue to trouble our potential clients, but their unconscious fear of infection will keep many from visiting our offices.

For several years, I expect that people are going to be afraid to sit in an enclosed office with a counselor.  Both the client and the counselor are at risk of contracting the COVID-19 virus.   Risking not just Death, but possibly living for years with severe health conditions involving the lungs or other body organs. Testing alone is not enough to protect you or your clients.

Facetime conversation on mobile phones has become common and accepted.  Online counseling can help people with the usual mental health problems who are afraid to go to a counseling office and risk their health or that of other loved ones.

Recommended reading:

The Great Invader: How COVID Attacks Every Organ
By Neha Pathak, MD

Also, read Julie Holt’s article explaining she handles the problems of counseling Online (see link below "How can I do online mental health counseling").

Those Counselors who depend on providing therapy service to the public for a living must embrace online counseling for the present and for some time in the future.

Another announcement of interest:

Washington State starts  a new mental health support program

To help Washingtonians cope with the stress of the COVID-19 pandemic, the State Health Care Authority has instituted a new mental health support program know as "Washington Listens," It includes an anonymous phone line that will connect callers with support specialists and community resources for assistance in managing stress related to the pandemic.

"Washington Listens helps people cope and strengthen their resilience in these uncertain times," Sue Birch, director of the Washington State Health Care Authority, said Monday in a news release announcing the program's launch.

“It complements the state's behavioral health response services by proving an outlet for people who are not in crisis but need an outlet to manage stress.”

The support line can be reached by calling 1.833.681.0211 between the hours of 9 a.m. and 9 p.m. on weekdays and from 9 a.m. to 6 p.m. Saturdays and Sundays.

When you call, tell them you found the number on Counseling Washington (

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