Treating Trauma in a “Zoom” World: Is it even possible?

You might wonder if it is possible to treat post-traumatic stress disorder (PTSD) during a COVID-19 pandemic crisis, but this is the situation that therapists and clients find themselves. Can we find a way to maintain effective treatment through the use of modern technology? Is it possible to treat trauma with this “new world” approach to mental health?

Since the beginning of this year (2020), countries worldwide have worked to protect vulnerable populations from the virus COVID-19. The primary strategies used to prevent the spread of the virus is social distancing and self-imposed quarantine. While this has been effective in reducing the pandemic’s physical effects, it hasn’t protected us from the psychological effects of this unprecedented life-situation. We see an increase in fear, anger, anxiety, panic, helplessness, and burnout in both children and adults. As a therapist working remotely with people dealing with stress and trauma, I have seen several extreme reactions of hallucinations and delusions due to the isolation and continual digestion of negative news media. 

A Healthline.com survey of what COVID-19 is doing to our mental health gives a somber picture: increased worry and insecurity over finances, higher than normal depression and anxiety, prevalent feelings of sadness, and being “on edge,” and an alarming rise in suicides. In America, Federal dollars are being released to increase mental health services nationwide to stem this rising tide of trauma without fully knowing the long-term effects of trauma. 

Therapists, just like the general population, use social distancing and remote work to keep themselves, their families, and their clients safe. Therapists are “front-line responders” and considered “essential workers,” but not all therapists choose to be exposed to 30-40 people a week who might have the COVID virus. Many of them, like myself, have family members who have compromised immune systems and considered to be at-risk. Working from an office and seeing individuals, face-to-face is not an option. Therefore, therapists and clients have to seek alternatives that can be equally beneficial to both. 

The European Journal of Psychotraumatology studied the Telehealth models for post-traumatic stress disorder using cognitive therapy and found that clients rated it as very successful in managing their symptoms. High patient satisfaction ratings were given for both video conferencing and phone call sessions. In the later technology, the only nonverbal communication was the tone of voice, and yet it still benefited clients. 

The journal defines Post-traumatic stress disorder by “a sense of serious current threat, which has two sources: the nature of the trauma memory and excessive negative appraisals.” Traumatized individuals frequently have intrusive, negative thoughts about traumatic experiences and continue to see the world with a negative lens. They have a feeling of hopelessness about their future and easily triggered by daily events. 

Professional organizations are rising to the challenge and providing education and support to remote mental health workers on the unique delivery of mental health through technology. Guidelines have been created by the American Psychological Society, International Society of Traumatic Stress Studies, and the National Institute of Health and Clinical Excellence, specifically targeting PTSD. Governing boards for various mental health professionals are also outlining specific legal and ethical requirements for safe, trustworthy online therapy. 

According to the Psychotraumatology journal article, Telehealth’s use led to “improvements in PTSD symptoms, disability, depression, anxiety, and quality of life, and over 70% of patients recovered from PTSD (meaning they no longer met diagnostic criteria). The Journal of Family Process has reported several articles on the effectiveness of Telehealth with children, adults, couples, and families.

Therapists, offline and online, can provide education and support to (1) reduce negative reactivity in thoughts and emotions, (2) build more effective coping skills, and (3) deepen the quality of life and relationships.

These three areas are healing strategies outlined in my trauma-informed training and therapy. 

The foundation for PTSD work, in face-to-face or video conferencing, is to establish a sense of safety from which to utilize these healing strategies. The client has to trust the therapist, believing he can offer some hope, create an atmosphere of security, and witness the traumatic hurt for PTSD individuals. Empathy isn’t confined to the physical space of the therapist’s office. It can exist in the relational space online as well. Facial expressions on video, tone of voice, empathic responses, and supportive comments assist the connection despite distances.

Finding a private place to have a conversation is one real-world challenge of online work. Privacy can be increased by changing locations (some of my clients go inside cars, relocating to other rooms in the house, or going outside), using headphones, and letting family members know that they can’t be disturbed hour or so. Additionally, therapists can also learn about resources in the client’s living area if referrals are needed. Homework assignments can also be used between sessions and discussed online for adolescents and adults. Parents can participate online with young children, and family members can “zoom” in from different locations at an agreed-upon time. And lastly, follow up with secure emails and text messaging can further increase the outcome of this digital therapeutic medium for PTSD. 

If you are looking for a trauma therapist or someone to help you or a family member with anxiety, contact Ron Huxley today at RonHuxley.com

Be sure to take advantage of our free online resources for families during the COVID-19 Pandemic at FamilyHealer.tv

References: https://www.healthline.com/health-news/what-covid-19-is-doing-to-our-mental-health

https://www.tandfonline.com/doi/full/10.1080/20008198.2020.1785818

https://www.apa.org/practice/guidelines/telepsychology

https://www.ptsd.va.gov/professional/treat/txessentials/telemental_health.asp

Telehealth for Trauma: An effective treatment strategy

According to the National Center for Post-traumatic Stress Disorder, Telehealth or TeleMental Health services are an effective treatment strategy for trauma. Telehealth uses information technology, such as email, phone calls, FaceTime video, and Secure Online Video to conduct therapy services. This technology allows a therapist and a client to engage in real-time two-way interaction. Services that can be provided via Telehealth include assessments, individual and group therapy, psychoeducational interventions, and general therapeutic interactions.

Traditionally, mental health services are engaged in face-to-face, office visits. Just because this is traditional, doesn’t mean that is is more effective. There are times when face-to-face visits are preferred due to lack of adequate technology, challenges with privacy at home, or personal limitations of the client in using technology. In all other situations, TeleHealth is a unique service that provides several benefits, including:

  1. Savings in time and money,
  2. Overcome geographic distance for rural populations,
  3. Increased access to care for individuals with mobility issues (lack of transportation),
  4. Flexibility of appointment times (e.g., out of town for work, babysitting concerns, or other restriction on clients availability like a lunch hour, etc.),
  5. Promotion of physical health by avoiding spreading a contagious illness (COVID-19 or general sickness, like a cold).

Telehealth is not new. It has been used for six decades, in the medical field, and is now being adopted by TeleMental Health as a flexible option for individuals. It is not a “lesser” alternative to mental health care. Outcome research has proven it to be very effective in many areas of mental health issues, like anxiety, depression, and trauma. It also offers convenient support for many general concerns, such as parenting education, life transitions, spiritual direction, and more.

A recent article from the Washington Post points out how global pandemics, like the COVID-19 virus, have shifted the landscape of mental health services through the use of technology allowing more people to attend to their mental health needs. Therapists and individuals may be just blocks away from one another geographically, but medical issues isolate and create an insurmountable “distance” between them. The use of Telehealth or TeleMental Health eliminates geographic and social distance.

The reality is that people around the world are suffering and in need of mental health treatment, education, and support. Children and adults who have experienced trauma cannot wait for medical cures or be punished for lack of mental health access. Telehealth/TeleMental Health is a powerful tool to bring immediate hope and healing.

Learn how to use TeleHealth with Ron Huxley by clicking here!

Read about our security measures and informed consent for Telehealth services here!

SOURCES:

https://www.ptsd.va.gov/professional/treat/txessentials/telemental_health.asp https://www.apa.org/pubs/journals/releases/ser-a0034963.pdf https://www.washingtonpost.com/opinions/2020/03/23/coronavirus-is-mental-health-emergency-too-we-must-remove-barriers-care/?fbclid=IwAR3JK9PIihf_5_nbwbPtgtC1coPpflzmWnAPEDE5FL5kgjsvCnUix_N74aY