The global coronavirus pandemic has left no part of our world or experience untouched. For those of us treating young people with trauma disorders, however, it is clear that these vulnerable individuals, many with PTSD or acute stress disorder, are uniquely impacted by the disruptions, uncertainties, stresses and triggers of this time. While all crises can be difficult, the social distancing measures, shelter-in-place orders and omniscience of the COVID-19 pandemic make the impact of this crisis unprecedented in scope.
We spoke with Dr. Amanda Fialk, Partner and Chief of Clinical Services at The Dorm about the challenges being faced for young people with trauma and how we have adapted treatment to meet their needs. This is what she had to say.
Treating Trauma During a Global Pandemic: What We’re Seeing on The Front Lines
New Challenges For Therapeutic Recovery
- Exposure therapy is often used in the treatment of traumatic disorders but this clinical approach involves helping an individual face the trauma, triggers, and bad memories in a safe environment. In the coronavirus treatment landscape, this is no longer very easy. Creating a “safe” environment for exposure therapy (both physically and emotionally) is difficult and requires a lot of adaptation and trust.
- Avoidance is a defining presentation for individuals suffering from trauma, but facing the memories and learning to cope with them in positive and healthy ways can help the healing process. Unfortunately, avoidance of social situations, people, places and things is the expectation right now as part of essential efforts to keep our communities safe.
The Impact of Losing Day-To-Day Connection
- Victims of childhood abuse, interpersonal violence, or trauma at the hands of a trusted family/significant relationship often struggle with trust, connection, attachment, and forming supportive relationships. Nevertheless, these supportive relationships and connections can be a vital part of healing and recovery.
- Former day-to-day interactions (i.e. going to the coffee shop or saying hello to a neighbor) were opportunities for low-stakes connections which could be soothing and healing. Today, these forms of interaction are more challenging than ever due to social distancing practices and intensified fear.
The Pandemic As a Trigger
- For weeks now, we have seen the pandemic experience become a trigger in its own right. COVID-19 represents an “invisible enemy” that is potentially life-threatening and which is impeding one’s ability to make basic decisions about one’s own life such as where and when to go outside and how to interact. This can be very triggering and retraumatizing for an individual with a trauma diagnosis.
- Some of these triggers are so intense that they have led to flashbacks in clients; the re-experiencing of previous traumatic experiences as if they were actually happening at the moment.
Profound Levels of Fear and Uncertainty
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- What makes the COVID-19 pandemic different from the other widespread crises we have collectively experienced such as Hurricane Katrina or 9/11, is that there is no foreseeable endpoint. Feeling out of control and uncertain about the future can compound feelings of trauma.
- To add to this, while many young people are experiencing anxiety, depression, anger, or sadness, when you add in uncertainty around schooling, employment, health concerns (for oneself or one’s loved ones, etc.) with no traditional outlet or ritual for coming together to heal, grieve or mourn, the risks for trauma and retraumatization is heightened.
- All of this is exacerbated for any front-line workers who face a life-or-death decision each time they go to work and face a virus that they still know little about. These individuals tend to work long hours only to worry about their own health and that of their family. In the aftermath of this pandemic, these individuals will need extensive support.
Treating Trauma at The Dorm: How We Have Adapted During COVID-19
Providing Consistent Clinical Care: Only The Medium of Delivery Changed
- At the Dorm, we already had a robust treatment approach to caring for young people with trauma. None of that changed once we started to provide treatment virtually, simply the medium.
- This has meant that any client we support who may be struggling with trauma is able to access a consistent level of treatment include EMDR during one-on-one therapy, and our twice-weekly “Seeking Safety” process/support group just as they would before COVID-19.
Additional Clinical Check-ins
- We now provide morning and evening clinical check-ins and daily accountability checks with our clients to help provide an extra level of support and sense of safety during this uncertain time.
Increased Self-care & Wellness Services
- At The Dorm, a holistic approach is central to our treatment philosophy. Since COVID-19, we have increased the frequency of self-care and wellness services and, in particular, anything that involves movement or opportunities to cultivate mindfulness skills.
- These activities are important tools for coping, healing and self-care, but also for creating natural breaks from staring at a screen all day.
Maintaining A Strong Community
- At the heart of The Dorm is the strength of our community. Not only do we now offer our community clubhouse online, we have also increased the number of social groups we offer (including on the weekends), introduced virtual community challenges (like following 7 days of gratitude), and virtual volunteer opportunities.
