Sound Health Counseling – Laura Tauzin – York, PA

Kim is a nurse. She has been working 24-hour shifts working on a COVID floor in a local hospital. They are currently short-staffed due to the illness. She is physically and emotionally exhausted due to prolonged stress from treating COVID patients. She fears getting it herself and bringing it home to
her young children. Due to the pace and stress, she has reported she feels less empathy recently towards her patients, and at home, she reports she is less understanding of her children’s daily experiences after working a full shift.

According to Psychology Today, people whose professions lead to prolonged exposure to other people’s trauma can be vulnerable to compassion fatigue. They can experience acute symptoms that put their physical and mental health at risk, making them wary of giving and caring.
Symptoms of compassion fatigue can include:

• Exhaustion
• Disrupted sleep
• Anxiety
• Headaches
• Stomach upset
• Irritability
• Numbness
• A decreased sense of purpose
• Emotional disconnection
• Self-contempt
• Difficulties with personal relationships.

Other factors can include:
Poor self-care, previous unresolved trauma, Inability or refusal to control work stressors, and a lack of satisfaction for the work.
When a person is continuously exposed to other people’s traumatic experiences through witnessing and/or hearing others’ stories, vicarious trauma can be experienced.

According to Lynn Wonders, a play therapy supervisor, prevention of compassion fatigue begins with the ABC’s: Awareness, Balance, and Connections.

Awareness:

1. Identify events or situations that cause you to experience an unusually strong reaction.
2. Recognize your limits, boundaries, what you can personally handle. Know yourself.
3. Are you taking care of yourself?

Balance:

1. Practice excellent self-care (exercise, eat healthily, get enough sleep, practice mindfulness, etc).
2. Nurture yourself. Put activities in your schedule that are sources of pleasure, joy, and diversion
3. Take mini-escapes from your work.
4. Challenge negativity. Find meaning and gratitude in the work you do.
5. Organize your time to concentrate on vital tasks.
6. Ask for help.

Connections:

1. Talk out your stress with someone else.
2. Build a positive support system.
3. Interact with your pet. Petting your animal reduces stress.

If you find yourself experiencing compassion fatigue, know that you are not alone. Refer to the blog Burn Out? and Avoiding Burn Out for tips on avoiding burnout. Give me a call at SHCS for more information.

Millions of students are learning remotely during this pandemic, including my own. It is a phenomenon that has required teachers, students, and parents to stretch in new ways and embrace technology like never before. Not only are their challenges in just staying connected, but engaging with students differently, keeping them working and learning, and also meeting their unique learning needs. It’s no simple task.

According to Attitudemag.com, the right technology paired with the right teaching methods can help your child become a better student all around. Software or apps that address your child’s specific learning style can help your child achieve his full potential.
Learning strategies may include:

• Audiobooks or text to speech software
• Adjust the appearance of text to provide guides for visual tracking and to remove distractions(i.e. changing the font, size, spacing, or colors in a text)
• Use highlighters and sticky notes to mark up print
• Use graphic organizers to organize writing tasks
• Use spell-check tools to create positive writing experiences
• Create PDF annotation handouts for students to enter responses
• Reduce the amount of material needed to be copied; Take a screenshot of the assignment on
• the board; record audio of the class and synchronize with hand-written or typed notes
• Reduce distractions or change the environment; Allow for white noise or music if needed;
• incorporate physical movement into daily tasks with fidget toys, wiggle cushions, or sit/stand
• desk
• Create a place for everything to organize daily workflow
• Use visual task timers to assist with time management

For specific apps and software recommendations for your child, see the following link: https://www.additudemag.com/category/parenting-adhd-kids/school-learning/
If you have additional questions on how learning needs and ADHD go hand in hand, give me a call at SHCS.

Ashley has trouble staying on task.  She forgets to raise her hand and calls out in class.  She’d much rather be daydreaming then do math.  Her hand writing is sloppy and she has trouble finishing what she starts.  

Damien is uncomfortable in social settings.  He is easily embarrassed by being called on and fears he will say something wrong.  He copes by shutting down, hiding his face, and not talking to anyone outside of his home.  

Michael has difficulty following directions.  He talks incessantly about Minecraft.  He struggles with reading.  He does not adjust well to change and struggles with transitions.  When overwhelmed with his work he yells, tantrums, and elopes.  

Three very different children, with a range of needs.  Ashley has ADHD, an educational disability.  Her fine motor skills are weak and she has poor executive functioning skills which impact her ability to effectively plan, organize, and complete her work.  Damien has social anxiety and selective mutism.  He is comfortable at home, but not outside it.  Teachers will need to understand how to effectively communicate with him during times of high anxiety.  Michael has autism and a learning disability in reading.  He also escalates when frustrated and tries to avoid his work.  If you can identify with any one of these children, you may have a child that may qualify for special services at school.

Did you know the school can offer tools or accommodations to lessen or compensate for your child’s needs at school?  Your child may have important legal rights to receive assistance at school, under federal and state law

www.ed.gov/index.jhtml and https://www.education.pa.gov/Pages/default.aspx.  The two keys federal laws are the Individuals with Disabilities Education Improvement Act and Section 504 of the federal Rehabilitation Act of 1973.  

Whether your child qualifies for assistance depends on the nature of your child’s disability and the kind of assistance he or she needs.  How do I determine if my child needs assistance?  According to Jeffrey Bernstein, psychologist, and author of 10 Days to Less Distracted Child:

1. Talk to your child.  Find out what your child likes and dislikes about school and what kind of frustrations he or she is experiencing.
2. Meet with your child’s team to communicate your concerns.  Listen to their feedback and see if changes can be made to the existing program in place.
3. Take good data and keep all paperwork.  Do not be afraid to question things.
4. Stay level-headed.  Be calm, firm, and non-controlling.
5. If the situation does not improve, and academic or behavior struggles continue to affect education, you can request educational testing to rule out any additional learning or mental health concerns that may be impacting school.

Believe it or not parents, you are the expert on your child.  You are their best advocate when it comes to education, communicating concerns, improving learning, and maximizing your child’s success at school.  Working effectively with teachers and being cooperative, courteous, and responsive with the school will bring you the best chance of being heard when addressing your child’s needs.  

If you’d like to talk further about how to be an advocate for your child, contact met at SHCS.

Your child may be asking, “When are we going back to school?  Will we be able to ride the bus?  When can I see my friends again? Will school be in-person or on-line?  I have a 504 or an IEP.  How will I get the help I need?”

These are not easy questions to answer.  School districts are hard at work putting together risk management plans, surveying parents, and developing educational frameworks to meet this expectation.  Other parents may choose alternative options such as home or cyber school to eliminate the need for exposure to the virus at school altogether.

No one knows for sure how schools will look in August/September, however there are some possibilities being talked about to ensure students receive a quality education whether in-person or on-line.  Students will need to work differently and families will need to be flexible.

However, for working parents, already juggling the demands of a job, and in many cases of whom are not teachers, the mention of continued online school places additional stress on families.  Not to mention the real possibility of illness and spread still lingering in the air as the idea of returning to school commences. 

With such uncertainty, parents can develop a plan, script, or story for their child on what they do know.  For example:

• School resumes in the fall.  
• We will still have classes.  
• We will still work with teachers.  
• We will still have homework.  
• School may look different than last year.  We might need to go in-person a few days or we might need to continue to do school at home on line.   
• Perhaps your child will still ride the bus, or your child will be dropped off.  
• There will still be routines, chores, family time, and rewards/incentives.
• We will still connect with friends (whether in person or online).

You can remember to remind your child of times he or she handled change and expectations well.  Build on your child’s strengths during this time.  Also remember that during this pandemic, it is okay to reassure your child about school, fears, and uncertainties associated with it.

For further support with the school transition, you can check out  Blog#6 – Creating a Cheerful Back to School Mindset

You can also contact me at SHCS.

Drew works 24 hour shifts.  When he does get off work his mind races.  Forget about sleep.  That remains disrupted.  On his mind are the unfinished work tasks that didn’t get done, again.  And the argument with his coworker over something trivial.  He can’t even remember what he was so mad about.  His relationship with his wife is strained and his children feel he does not make time for them.  He can’t remember the last time he had a vacation.  Sound familiar?

In the last blog, I addressed the warning signs and causes of burnout.  Today, let’s review the consequences of burnout and how to best avoid it.  

Consequences of Burnout 

• Loss of productivity
• Reduced creativity
• Excuses for missed days of work
• Poor well-being
• Impacts to relationships with family and friends

Long-Term strategies to Avoid Burnout

• Re-discover your purpose (how does your work impact others?)
• Do a task analysis (what is expected of you and what isn’t?)
• Practice small acts of kindness to others
• Manage your time effectively.  Create a priority list, to do list, action plan, and a goal.
• Exercise regularly
• Get a good night’s sleep
• Manage your stress.  Meditate, breathe deeply, relax, think positively.

For additional resources check outhttps://www.mindtools.com/pages/article/avoiding-burnout.htm

If you are unsure how to repurpose your life, establish boundaries for a better work-life balance, or need support to manage life stress, contact me at SHCS.

Are you feeling tired?  Looking forward to the weekend and it’s only Monday?  Pessimistic about your work or find it to be meaningless?  Have you snapped at others because there never seems to be enough time in the day to get things done?  Are you overly committed to your job?  Is your job mundane or stressful and no matter how hard you try you feel you cannot change the environment?  If so, you have probably experienced burnout.  

According to Ayala Pines and Elliot Aronson burnout is a state of physical, emotional, and mental exhaustion caused by long-term involvement in an emotionally-demanding situation (a cause, way of life, or relationship) https://www.mindtools.com/pages/article/avoiding-burnout.htm

Signs of burnout include:

1. Having a negative and critical attitude at work.
2. Dreading going into work, and wanting to leave once you’re there.
3. Having low energy, and little interest at work.
4. Having trouble sleeping.
5. Being absent from work a lot.
6. Having feelings of emptiness.
7. Experiencing physical complaints such as headaches, illness, or backache.
8. Being irritated easily by team members or clients.
9. Having thoughts that your work doesn’t have meaning or make a difference.
10. Pulling away emotionally from your colleagues or clients.
11. Feeling that your work and contribution goes unrecognized.
12. Blaming others for your mistakes.
13. You’re thinking of quitting work, or changing roles.

Causes of Burnout

• Lack of autonomy
• Feels as if there is never enough time to complete tasks
• Your values don’t align with the organization
• Having unclear goals or job expectations.
• Working in a dysfunctional team or organization.
• Experiencing an excessive workload.
• Having little or no support from your boss or organization.
• Lacking recognition for your work.
• Having monotonous or low-stimulation work.

There are numerous consequences of burnout, however change is possible.  If you recognize that you are experiencing burnout, are unsure of the next steps, and you desire to put your life back on project status.  Give me a call at SHCS.

Taking time to regroup, to relax, and rest is necessary for our health, our sanity, and for our families to reconnect with one another.  

Choosing whether or not to travel during the pandemic is another matter.  For some of you, this may not alter your choices.  Perhaps you already had a vacation planned and are determined to take it no matter what.  Or perhaps you are uncertain about travel and feel staying home is a safer option.  Or perhaps you are just returning to work after being shut down for so long and are unable to take a vacation this summer.  

Whatever your situation there are some things you can do to feel refreshed and prepared amidst the uncertainty of our present circumstances.

1. Be prepared.  Make sure safety measure are in place wherever you go (wipes, hand sanitizer, face masks, social distancing)

1. Plan ahead.  Is COVID spreading in my community?  Is it spreading at my destination?  Would you have to quarantine yourself for 14 days upon arriving? What are the state and local requirements of where I would like to go?  https://www.msn.com/en-us/news/us/should-you-travel-this-summer-here-e2-80-99s-a-guide-to-flying-road-trips-and-other-vacation-concerns-amid-the-coronavirus-pandemic/ar-BB15T2YA
2. Consider less populated sites like visiting a lake or the mountains.
3. Go on a road trip in your own car.

Staying home? https://clark.com/travel/staycation-ideas/

• Read a good book.
• Take time to enjoy the little things around you.
• Explore nature.  Hike, bike, visit a state park.
• Play board games or put a puzzle together.
• Camp in the back yard.
• Unplug
• Rest, relax, and enjoy!

Taking time for yourself whether away or at home helps you to reset.  Everyone needs a break.  If you are finding it hard to relax, need assistance setting boundaries between work and home, contact me at SHCS.

If you live in PA, then you are aware of the different phases of reopening affecting our state.  York County recently became green in June.  What does this mean?  

Green is not an all clear as some would like to believe.  The virus is still among us, live and well.  Businesses are allowed to open under CDC guidelines to start up the economy again, but with mask-wearing and social-distancing still being reinforced.  

And since pandemics have been recorded in human history, we can expect it will hang around for 18-36 months.  Daunting right?  It would take a lot of people to become infected to make it safe for humans to return to life as we knew it before the coronavirus began.

I cannot tell you how many folks I have seen in my area that are not taking these precautions seriously.  Some are choosing to not to socially distance, nor wear masks at all.  I have seen this in grocery stores, home stores, and in small shops.  

At SHCS we take your health risks and our own seriously and respectfully.  Here is what you can expect if you would choose to return to an in-person visit:

• Telehealth is recommended whenever possible for sessions, meetings, and groups.  Appointment days and times will remain the same.  Operating hours will remain unchanged.  
• In-person visits are not recommended, however, they may occur on a case by case basis for persons that are unable to access and or struggling with telehealth, or for mental health emergencies.  Please note the following:
  • A COVID19 signed informed consent form will be required.
  • The waiting room will remain closed.  This means that your therapist would meet you at your car for an in-person visit.
  • If inside, a mask is required, along with a temperature check at the door.  Clients will be asked to wash their hands before the session, and again after the session if materials were handled.  Social distancing will remain in place 6-feet apart between client and therapist.  
  • If a session is held outside (weather permitting), privacy cannot be completely guaranteed, however, you will not need a mask as long as social distancing is practiced. (Two outdoor spaces are underway.)
  • Limits to certain therapy materials will continue in the office due to cleaning and disinfecting required between visits.  Play items will continue to be cleaned routinely and instruments wiped down.  Toys used by a client will not return to the shelf or shared by another client until it has been disinfected.  We ask that clients who play with toys/instruments use hand sanitizer before/after any play activity and any time they touch their faces during play.  If hand sanitizer is not available, the client will be prompted to wash their hands with soap and water.  Temporarily we are also going to suspend the use of puppets and soft toys at this time.  
  • Please note for music therapy clients, that singing cannot take place during an in-person visit due to CDC guidelines. Telehealth is recommended if singing is especially necessary for your child.  However, if outside (weather permitting), singing could take place if social distancing is practiced.  
  • Should a COVID19 exposure take place, the building will be thoroughly cleaned. Clients that have been to the building during the timeframe of exposure will be notified.  Temperatures of therapists and co-workers will continue to be taken before entering the building and sent home if 100.4 or higher.  If sick, we will follow the CDC recommendation on home isolation.  Clients will be contacted if their therapist is unable to keep appointments due to illness.  

With the increasing uncertainty and growing number of infected individuals around the world, I encourage you to take responsibility for yourself and your family.  It’s important to take a proactive approach to minimize exposure.

• If you have recently been to any airport or traveled to any state by car with a stay-at-home order, please wait 14 days before coming in for an in-person appointment.  Use telehealth whenever possible.  
• If you’re exhibiting symptoms of respiratory illness, I urge you to stay home, take care of yourself, and seek medical help when appropriate.
• Please refer to the CDC website for additional information https://www.cdc.gov/, and maintain awareness by checking the official communications from our state https://www.pa.gov/ and the World Health Organization.

If you have any questions, feel free to reach out to me at SHCS.  Stay safe and be well!

Collectively, our hearts are heavy for all those affected throughout the world, in our own country, and neighborhoods as a result of the coronavirus.  Tragedy on this scale can be difficult for those directly and indirectly affected by the virus.  Whether you have loved ones affected by it, have a personal connection to someone affected by it, or have engaged through news reports by the media, there is a chance you are dealing with stress, anxiety, and emotional strain.

An important part of coping is accepting and providing support when needed.  According to Dr. Jennifer Gentile of Amwell, everyone experiences stress differently and that may be reflected in a variety of emotions, actions, and expressions.  There is no right or wrong way to react to the news of a frightening event, such as the coronavirus.  She describes that responses to traumatic events may include a combination of the following: https://amwell.com/cm/blog/how-to-cope-and-heal-in-the-wake-of-tragedy/

• Disbelief and shock
• Hypervigilance and fear about the future
• Intense feeling of anger and irritability
• Sadness and depression
• Apathy, emotional numbness, or denial
• Nightmares and recurring thoughts about the event
• Difficulty sleeping or falling asleep
• Increased physical complaints related to headaches, stomach cramps, back pain, rapid heart rate, nausea, and fatigue

She goes on to say that grieving is important in the days following a traumatic event, or prolonged one, such as the pandemic.  Seeking assistance from a health care provider after experiencing a trauma is a reasonable response and helps prevent long-lasting effects, such as Acute Stress Disorder, PTSD, and depression.

There is no right answer or time limit for the grieving process, but if it interferes with daily life, if you start to abuse substances, or have thoughts of death or suicide, it’s time to talk to a professional or go to your nearest emergency room.  Contact me at SHCS.

In my last blog, I mentioned ways to help show compassion and care for our health care providers.  I wanted to elaborate this week on our licensed mental health providers.  Please keep counselors, social workers, and other behavioral health providers in your thoughts and prayers as well.  

The mental health needs of our communities are increasing and changing during this crisis.  The demand for therapy is high and providers are often at full capacity.

Further, while many insurance plans are covering behavioral health services in some manner, others are not.  Many providers are offering reduced rates and sliding scales to accommodate folks during this crisis.

Telemental health platforms are also making it possible to check-in with clients, assess their risk and safety, and continue to work towards stability.  Many providers are offering shorter sessions via telehealth, allowing them to see more people.

To complicate things, some insurance companies are requiring specific platforms to gain services, making it difficult for clients to stay with their current mental health provider.  The disadvantage of these specific platforms is that some are already full and are no longer accepting new providers.  Clients may be forced to change therapists, amidst a national crisis, which can cause harm to them, depending on their situations and unique mental health needs.  

While other insurance plans have expanded their coverage, it is important to stay informed.  Some plans are waiving copays and deductibles while others are collecting copays.  Some companies are reimbursing significantly less for telehealth sessions as well as requiring shorter-length sessions, despite similar quality as face-to-face visits.

Some clients have opted out of services altogether until the crisis is overdue to changing financial circumstances.

Whatever your situation, be an advocate for yourself.  If your insurance plan allows for outpatient visits, but not tele-behavioral health visits, talk to your HR rep, senator or congressman. 

• Senator Pat Tooney (855)552-1831
  https://www.toomey.senate.gov/?p=contact

• Senator Bob Casey (717)-231-7540
  https://www.casey.senate.gov/contact/

• Congressman Scott Perry (202)-225-5836
  https://perry.house.gov/contact/

Continue to seek help if you need it.   Contact me at SHCS with any questions, referral needs, or services.