by
Joseph Peters
| Jan 20, 2022
Announcer:
Welcome to The Voice of Counseling presented by the American Counseling Association. This program is hosted by Dr. S Kent Butler. This week's episode is, Counseling Practice During Phases of a Pandemic Virus and features Dr. Mark Stebnicki.
Welcome to The Voice of Counseling from the American Counseling Association. I'm Dr. S Kent Butler and joining us today is Dr. Mark A Stebnicki. Counseling Practice During Phases of a Pandemic Virus is a new book that he has just put out. And we're going to discuss that today. Dr. Stebnicki is a professor at Emeritus and former coordinator of the Military and Trauma Counseling Certificate Program at East Carolina University. He developed the MTC certificate in 2015 and the Clinical Military Counseling Certificate Program in 2016, which is offered through the Telehealth Certificate Institute.
Dr. Stebnicki is an active practitioner, researcher, counselor, educator, trainer for over 35 years. So that's some great experience that's going to be coming to us, to share with us what he's been doing. The work that he's been doing within the psychosocial rehabilitation and mental health needs for adolescents and adults with trauma, chronic illness and disabilities. So joining us today, Dr. Stebnicki. How you doing today, Mark?
Hey, man. Thanks Kent for having me and I really appreciate the American Counseling Association offering me to come on your show. I mean, this is the pinnacle of my career. Seriously.
You've been doing some phenomenal work for 35 years. So why wouldn't we want to have you here?
Well, I'm only as good as my last presentation. That's about it. That's my philosophy.
Okay. Well, we're going to make this one a great one. So can you tell me a little bit about what motivated you to write this book, especially this time of the year? Especially, with this pandemic that we've been going through.
Yeah. Well, you gave my background there. So over 30 years, 35 years working with chronic illness, disability. And in the last 20 years, I specifically work with veterans, active duty service members, veterans with disabilities, military families. Kent, I've lived and worked in communities that were plagued by violence, by gun violence, workplace violence and those are person made disasters. And then, natural disasters. Such as earthquakes, hurricanes, floods, tornadoes. I had a colleague tell me once that, "Boy, I don't want to move to the town you're going to next."
Yeah. I was thinking that, it was following you around a little bit there. One of the great things that happens when these types of things happen is, it helps to trying to create who you become as a person and as a practitioner. So you were able to adapt to those things very easily.
Yeah. In March 1998, I was a member of the crisis response team for the Westside Middle School shootings in Jonesboro, Arkansas.
And it was an 11 and 13 year old shooter, that killed four students, a teacher and injured over 20 others. So I guess you can say 1998 began my ... I was working at Arkansas State University in the department of counseling and psychology at the time. I was just a natural go-to person to go out and do critical incidents, stress debriefing. The point being is that, these kind of life experiences, if you're resilient, bring some meaning and you find out others that could benefit from training like this. Counseling Practice During phases of Pandemic Virus is my 10th work. I think number eight was Disaster Mental Health Response. I just have a body of research, a body of practice. So what I did is, I put the old Disaster Mental Health hymnal on my bookshelf, and then I wrote a new anthem.
Describing the medical, physical, mental health care characteristics of this new disease that we have. And this is COVID-19, the viral pandemic that never sleeps. It's relentless, it never takes a day off.
The counseling profession as a whole, I feel needs to prepare for, prevent and treat disaster mental health because it looks differently than natural or person made disasters.
Can you tell me a little bit about your writing style? How did you get there? Your 10th work, so as a practitioner, who's writing and sharing this work with so many people out there who are doing the work in the field, what got you there and what's your joy and your love in terms of writing?
That's a good question. I had some really good mentors in my doc program for writing. And then Gerry Corey, Dr. Corey has been a mentor to me, in terms of inviting me on the book panels that he does at the annual conference.
After years of writing, you get to look at, I have a voice also. So here's what I'd like to say. You get a certain breadth and knowledge in a specific topic area. Then you take that and put it in your own voice. You can develop conceptual models, theoretical models that may be interesting for researchers somewhere down the road. It takes a while finding your voice. Textbooks don't give you that latitude, I think. Some of the books, like Clinical Military Counseling that I did with ACA last year, and then this year, Counseling Practice During Pandemic. Of course, it's research based. I've got a panel of eight experts that have looked at my pandemic risk and resiliency model. It's research based, but I wanted to use my own voice.
So my style of writing comes along with, I think practice and experience. I've had some mentors probably like you that are pure researchers and they're good. It's good mentors to have, but you also need to learn how to develop your own characteristic.
Yeah. And I think that's great. I mean, when you are able to kind of tap into who you are as a person and give from that perspective, because that's who we are as counselors in the long run is what we give of ourselves. And so why not use our own natural ability to kind of make that happen? Speaking of natural abilities and all those other things. So there's a multitude of natural and person made disasters that are out there. How do we kind of re conceptualize disaster response, especially as it relates to a viable pandemic?
Sure. So before you even start with a viable pandemic, you got to have some awareness, knowledge and skills of how to work with unique attributes of a natural disaster or person made disaster, or biological disaster and so forth here. Once you begin to recognize the unique medical, psychological, social emotional aspects of disaster. Then what you try to do is, look at, first of all, the literature on other pandemic viruses here. We in the US, haven't had that many pandemics, we've been lucky. We've got Zika virus. Of course, HIV started with the endemic or started as an epidemic, then went to a pandemic. So we have a number of examples. Some of the differences is, pandemics are an ongoing disaster. There's no beginning, there's no middle, there's no end.
So as we transition through that, I think what this book does is it talks about a model I developed, the adaptation and adjustment model. So it assists practitioners with identification, early intervention, triage, prevention, and preparation. That's a maybe popular phase, but what I did is, I plugged in natural elements of a pandemic virus, which is unrelenting. It never ends here. So what I look at is untreated, undertreated, unrecognized signs that's unique to this disaster. For instance, if you live in a small town and your job falls through, or factory shuts down or coal mining dries up. You're dealing with one geographic location, but with a pandemic, you're dealing with job loss all over the US.
That's what's unique about understanding the multitude of natural and person made disaster is also understanding the unique aspects of pandemic viruses here. We're fighting an unseen enemy. If you live in a hurricane prone area, tornadoes, you've got physical evidence of the disaster. Whereas pandemics, you can't see it unless you work in laboratory, where you can look at the virus under a microscope.
Let me ask you a question really quickly based on that. Today, I heard about someone who passed away, someone out in California who was unvaccinated. So that's the new thing now. So we've been going through this and it's been adapting, it's been changing. And we came into this not knowing. I mean, I didn't know anything about what a pandemic would do like this, and what it would actually kind of curtail into as it continued to evolve. So now, we have this virus who has all these variants that are coming out. We didn't know about that. How do we learn about that? What do we need to know about the fact that ... Like you just said, it's never ending. So are we to be kind of getting ourselves prepared for the fact that this is going to be another variant after another variant, after another variant? How do we come to grips with this?
So humankind has known viruses for centuries. So it's just part of being human and living on earth. And so viruses job in nature is to morph into something else, where they can live. Live on a host, either it's an animal host. It could jump to a human host. One of the things I emphasize in the book, is that there's no beginning, middle and end to viruses because they morph into other kind of diseases.
I'm not sure, if I'm answering your question, as we move along, you might understand.
I think you are in a sense because it just was not ... We got into this and it's like, "Oh, it's going to be a year. Oh, it'll be passed us in two years." And then we learn more and more and more. And now you're saying, that it's never ending that that brings a whole nother context to it. And I think you brought some reality to me, by saying things like HIV and aids and Ebola and other things that have come along that we see now are continuous almost like the flu that we have. We continually take the vaccine, so that people don't get the flu every year and things along those lines. So it kind of makes sense.
Cultures learn how to survive and adapt. And I really emphasize that in my book about adjustment to ... I use stage miles of adjustment to chronic illness and disability as an example to build into this pandemic adjustment is that, there's predictable stages that the literature and the research has shown. There's a lot of fear, anxiety, mood disorders, irrational behaviors that lead to harm to self and others.
We're sort of in a war torn area here, where we're fighting this unseen enemy here on the COVID battlefield. So cultures learn how to adapt. If you live on an archipelago, you worry about flooding, food insecurity, tornadoes, hurricanes. Well, not tornadoes, but hurricanes. If you're an immigrant refugee asylum seeker, you're worried about survival. So different cultures throughout history have learned how to survive and thrive at the same time. I think that's what we have to learn. It's hard to say where we're at in that cycle, because I'm not an epidemiologist, but what I do here is, new variants come out. We've got to have some hope from a psychological point of view because a vaccination was developed. So there will be an end at some point to the spread, the contagion itself, the viral load.
But from a psychological point of view, I talk about historical trauma. You think about, every trauma that comes along and it doesn't get recognized, so it becomes untreated, undertreated or unrecognized and you try to move on and try to get back the balance. Kent, we're all having a normal response to an abnormal event.
It's helpful to remember that, I think.
That's good to know. So we know that there are multiple medical, physical, and mental health conditions associated with disasters. So what are some of the differences that we see in the COVID disaster versus other disasters?
Sure. So other disasters, as I mentioned are very visible, other natural disasters are pretty visible. I mean, you're looking at hurricanes, floods, tornadoes, but for COVID, you think about all the deaths. What is there over 700,000, 825,000? I get the figure somewhere, but the significant amount of deaths that have surpassed Spanish flu deaths, Spanish flu in the US killed about 675,000. COVID's causality is much higher than that. There's multiple medical, physical conditions that are untreated, undertreated, unrecognized. The rebuilding process could take years because, when you think about the systems in the US, our health care system, our financial markets, manufacturing industry, for producing goods and services. Our social political system is under strain.
So every conceivable aspect of life on the globe and in our own little world has had to stand up to this viral contagion. And then you think you're safe and then it morphs into a mutant variant. So here's the thing Kent, is that virologists, epidemiologists understand this stuff. They know where it's going. They love exploring this. In counseling and psychology though, this is unexplored territory. I mean, we're just starting to see journal articles come out about the psychological impact.
Here's the thing that we're at a crossroads with here is that, we have a disease of unknown etiology here. We still don't know how COVID happened, except it can be explained by scientists, it wasn't developed in laboratory. It's a naturally occurring coronavirus and there's like 12,000 coronaviruses that have been identified. So luckily, most of them haven't been as lethal as COVID-19 and some of its mutant variance here.
And I think that's one of the things that a lot of people didn't really take into consideration. It took a while for people to kind of realize that, yes, this is the 19th iteration of this.
And that's a natural part of trying to adjust and adapt to any kind of disaster, whether it's a natural disaster or a person made disaster. We want things to get back to normal. I mean, we pray hard for the soul wounding, this trauma to end for some people. Here you have a disease of unknown etiology, it creates fear and panic. When's the next variance going to come up? How lethal is that? We do know that one of the most frequent symptoms in pandemics is fear and anxiety because you can't predict. But what we can do is, look at disease in how psychosocial adjustment to say cancer is to other life threatening illnesses. And we can predict, we can anticipate what some of those sticking points are going to be, red flags.
So as therapist, it's important to understand this new psychosocial adjustment to a pandemic virus here because, we can be prepared for it. And I just want to add one thing is that, five years ago, I think. We put together a panel of experts in the US. It contained the CDC, the NSA, the DOD and some other top experts. And the president wanted to determine what the next threat would be to American national security.
So what do you think number one was? Of course, terrorism. Homeland threats and all that You know what was way at the bottom of the list? A lethal virus, a deadly virus. Of course, the scientists were saying, "Hey, we got to put money into this. We got to prepare." And other people in the task force are like, "Hey, we don't have anything that's threatening right now. We're worried about Al-Qaeda or Isil." Anyway, the point being is that, there's multiple medical, physical, mental health conditions associated with disaster. Pandemics are unique because they're ongoing. What we do know, is that there's this adjustment that happens during any natural or person made disaster. But the problem with the pandemic is that, it's pervasive. It never sleeps.
It's always around us here. We need to be looking at ways of how to bounce back.
That ties into people's anxiety. Especially, for us as counselors. So you talk about phases of a pandemic. And can you kind of talk about what you're talking about there? What are you referring to when you say phases, and should we be really referring to what's happening now as a disaster?
Oh, it's definitely a disaster. When you look at the death, the mortality of the sickness and the unique losses. The loss of job, loss of childcare, schools shutting down. Parents having to leave their job to take care of sick family members. Yeah, it's a disaster. So what's new again, is that psychology and counseling quite doesn't understand this, but public health, traditional public health epidemiologists know. That's their field of specialty. They study pandemics, epidemics. So viruses and diseases are natural occurring events that turn into natural disasters, like I mentioned before. All have the potential to be public health crisis.
But when you look at disease like rabies. A vaccine was developed by Louis Pasteur, back in 1885. Rabies still exist today. A tetanus vaccine developed in 1927, the shots still available to reduce infection. Mumps, measles, rubella, it's disease with no cure. Shots were widely distributed around 1971, hepatitis A and B. The H1N1 flu. So these all have no cures, disease of no cures. We know what the etiology is, but we don't have a cure for it. We do have mitigation measures to stop the infectious spread. We got vaccines developed for that. Yes, COVID 19 is a disaster because it's a viral contagion. And epidemiologist look at this as it's an ... At best case scenario, COVID-19 will be an endemic disease. We got vaccines now and then boosters, maybe on a regular basis possibly.
Mark, that makes me think ... Very quickly.
That makes me think about the fact that there are people who don't want to take the vaccines, but people over time have adapted to taking vaccines. You named off of quite a few different things just now. What is it about the human psyche that causes people to not trust? Especially, when we're going through something as devastating is what's happening right now.
Sure. So I think we all have opinions on it, but I think we need to look at this holistically here. I mean, we're in unprecedented times in terms of our political environment. Vaccines, good virus hygiene has become a major political issue and this has never happened before. So things are changing politically that affect public health. When I grew up, my parents wanted to get me a polio shot. They didn't want to say, "Yeah, we're going to not give our son a shot." Because, whatever reason. Parents back then, wanted to get their kids vaccinated for mumps, rubella. You name it, all these diseases here. [crosstalk 00:23:42].
There was also a trust in the medical system for many people.
That's true. And so we look at that piece of it and we did trust the health care system, the medical system. Nobody questioned it here. In my opinion, one of the driving forces of the distrust of the medical system. So we can call that, personal distrust, religious distrust, whatever it is here. If you review some of the models in the books here, it talks about guidelines for phases to try to treat this soon to be hopefully, endemic disease, as opposed to pandemic disease here. I didn't title the book phases of COVID-19 virus on purpose. I titled it, Phases of a Pandemic Virus because it's not specific to COVID-19. Pandemics have occurred for centuries, as I mentioned before throughout human history. But I think now we're just being able to understand the medical, physical, psychological aspects, but counseling psychology is behind.
So they need, I think some models, some prompting, some additional research. Whereas, public health students and epidemiology they're at the epicenter of this disaster. Think about having a kid in a master's degree program in public health. How much motivation there is to go into the field. The same should be with the mental health professionals and all counseling professionals. Now is the time to make your decision to get into the field.
So let me ask you a question for students and people who are coming up behind you who see you as a role model in terms of your writing and the things that you are doing, the books that you had put forward. You've been building up to this over time. When did you start writing this book and how long did it take you to finish? It's a curious question I have.
Well, I started writing it in my head around 1998, as I mentioned before, with crisis come opportunities. Being on the crisis response team for Westside Middle School shooting. Then I moved to Greenville to work at ECU in 1999. And there was Hurricane Floyd. That was at the time the state's largest disaster. I started writing this book when it started impacting my life. Some of my own childhood experiences too, this session's not about me, but we all are driven to the field for multiple reasons.
I think I had this book within me and the seeds were planted with various experiences. And that may be important for people to understand, if you're attuned and you can take a look at what motivates you to join a health club for the year 2022. What motivates you to go on a diet, to have better thoughts? Once you plant those seeds, you think about stages of motivation, precontemplation, contemplation, and so forth here. Same with writing is that, you think about doing something and trying to improve the world, but at the same time it improves me too.
Wow. So that's really good to know. It's fascinating to hear you say that you started looking at this in 1998, because many people, because of the times would say, "Oh, March of 2020, I sat down and decided I would just crank this book out and have it done by August of 2020." Or something like that. You know what I mean? That's good to hear your process in doing that because I think that's what young writers need to understand too, who want to ...
Yeah. And then you got to have a vision, I think.
A vision is critical. Look at the Wright brothers, people thought they were crazy. They wanted to fly. They were bike mechanics, basically. They built bikes in Dayton, Ohio.
They go to thee Outer Banks in North Carolina, they failed many times crashing. You don't hear about the plane crashes, the failed experiments. You just hear about the first in flight. Martin Luther King is another example, he had a vision, a dream about civil rights. We still have to maintain that vision despite all the carnage around us, the damage. So having a vision, if you're a student, if you're a young writer. Having some vision is a good first place to begin to plant the seeds of, how can my unique voice be heard?
Nice, thank you for sharing that. It just popped up just now when you were saying that, and I'm just like, "Wow, when did this whole thing come about?" We're coming up on a break time here. And so I want to give you an opportunity, just really one last question, before we go to break. We hear people say a lot, we're all in this together. You hear it all the time. There are issues that are related to vulnerable populations, health disparities, and other social cultural factors that overlap all those types of things that come into effect. So what is unique here, while we're here in the midst of this pandemic?
Well, I don't mean to crush your spirit here, but we're not all in this together here, Kent. That statement implies that we all enjoy the same benefits, the same privileges, we're all the same socioeconomic status. We have access to good quality health care, jobs, civil rights, adequate support systems. Many Americans don't recognize the seriousness of this lethal virus here. I'd like to offer a reframe is that, we are all our own best support system. As we come together in this present moment, I think we can unite as communities in a region and that's hard to do.
You see the rise of white nationalism, racism, actions to overthrow the government. Then thrown on top of that, you have a pandemic virus that is making people sick and so forth. We're not all in this together, but we're all our own best support system here. I think that would be a good place to leave before [crosstalk 00:30:54].
Yeah. We can break it there and come back, and kind of touch base on some of that again. Well, thank you Mark. Again, this is The Voice of Counseling. I'm Dr. S Kent Butler, and we're going to take a quick break and we'll be back in a few minutes.
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Welcome back to The Voice of Counseling. I'm Dr. S Kent Butler, and we're here today with Dr. Mark Stebnicki. And we're going to just get into another part of his massive repertoire here. Can you tell me a little bit about the veteran and the military communities and how they've been impacted by this pandemic?
Sure. As you mentioned in the introduction, and as I mentioned also, I've worked with active duty service members, veterans, veterans with disabilities, military family members. I look at them as a vulnerable population, especially service members that are transitioning and reintegrating into civilian life. Military, they live together. They train up together. They deploy together. So they're a vulnerable population, because they can't socially isolate. It's critical that we have military members here. So since the beginning of COVID-19, the reporting period up to December 2021 last month. The DOD reported somewhere around 390,000 service members, family members, and civilian DOD contractors contracted COVID. And believe it or not, there are COVID deaths. In fact, there are about 632 casualties as a direct result of COVID here.
The interesting thing is that 97% of active duty personnel have been vaccinated against COVID. That's decent. But when we think about the military as an occupation, it's a high risk occupation anyway for medical, physical, and psychological injury. And then living in close quarters to one another, especially for those of you listening that have been in the Navy. Being on a Carnival cruise battleship, there's all kinds of flus that run through the ship here. Life and safety of others are dependent upon your quick and decisive actions as military service personnel.
So some of the principles that the military uses in their advanced training for leadership is risk management. They're looking at assessing hazards, while trying to maintain an operation tempo to mitigate risk. And we're talking about, engaging enemy combatants. So an endemic, or pandemic is pretty new for the military even. The pandemic is a national security threat. It is a natural disaster and without good performance measures and being able to have a strong, resilient fighting force of men and women. Then we're at risk, I think, as a nation. The military is very invested in trying to mitigate spread and contagious viruses such as COVID-19.
Well, how can counselors be supportive of military? We thank them for their service, but how can we ... Especially, those who may not necessarily gravitate towards us, how can we kind of be impactful there?
Well, first understanding military is a culture unto itself. I mean, you think about the demands of having to kill. The military brain is mapped differently. It's aggress, not stress. In civilian life, if a gun is pointed towards you, you're running away from gunfire. Military runs towards gunfire. So understanding the cultural aspects of the military, how the brain is wired, how it's such a unique occupation, and then, maybe cutting through some of the military myths. Stereotypes that we have. We think [crosstalk 00:35:44].
It's a concept of almost like the first responder too. You're running to this, you're going to the danger.
Yeah. Yeah. As professionals, we need to be able to establish a rapport before we even get to a working alliance with that military client, and then understanding that it's critical to establish and earn the circle of trust. Whether you're earning a circle of trust with a firefighter or a cook or a war fighter in the military, that's critical aspect. It's also helpful to understand today's military in the 21st century is different than your mother's or father's military. Generally, the stereotype of the military is it's a bunch of white hyper masculine males. There's 40% of the military now that makes up people of color, different racial ethnic groups. Women, women represent a higher percentage than any other time in history. There's like 18% of women in military.
Understanding the within cultural group differences is critical for establishing this rapport, earning the circle of trust with military clients and the unique occupational attributes. They're at high risk for a lot of medical, physical, psychological injury, while in service. But as they transition out, there's longterm disability that can occur as a result of their service.
Do you think there's differentiation between the military branches, as well on [crosstalk 00:37:29]?
Good point. People turn their head, when I say, six branches of the military. There used to be five branches. Now, we got Space Force. Right?
We got Army, Navy, Marines, Air Force, Coast Guard. Coast Guard since post 9/11 is now under the DOD, the branch of the military. Now, Space Force. So yeah, there are within group differences, we got ground forces. The Marines, the Army. So knowing the language a little a bit. We call it, fighting ground forces or combat zones, combat theater. IN the Navy, they'd call it combat space or the Air Force. There's just little nuances like that in terms of rituals, in terms of language, in terms of traditions between the Marines. The media tends to call everyone in the military, a soldier. Well, the soldier is related to the Army. Don't ever call a Marina soldier. They might get upset.
What would happen? I don't know.
I said, what would happen? I don't know what would happen.
Well, if you're in a therapeutic situation, all the service members I've had, are very polite. I haven't done that, but they wouldn't tell you that necessarily in the therapeutic situation, but it would certainly hinder rapport building, if we made some assumptions about a certain branch of the military. Yeah.
So do your homework is what you're saying, understand the different branches.
Take classes, take seminars regarding military as a culture and understanding the unique aspects of the military as an occupation, and then some of the unique medical, physical medical conditions that they have.
So speaking of that, with the military involved as well. Are there unique mental health conditions that counselors are seeing right now during this pandemic?
Yeah, as I mentioned in part one of our conversation is that, the research shows that fear, anxiety are the predominant features found in other countries, in terms of pandemics and epidemics here, because you don't know when the next wave of infection is coming. So you can imagine that's one of the most common fears here. In today's practice though, some of the more clinically significant symptoms are major depression, anxiety, post traumatic stress, substance use disorder. And then there's some level of suicidality.
I mean, think about losing everything, not only your health but your job and some of the other aspects. There's unique losses that are associated with the pandemic versus other types of natural disasters here. Kent, as I mentioned before, we're all having a normal response to abnormal events. So some of the unique mental health conditions are first, understanding that we're having normal reactions, but we have to ... As therapists, we have to understand the unique losses to family, friends, illnesses, jobs, career opportunities, educational opportunities. And then be able to determine what's healthy, normal behavior and what's unhealthy abnormal behavior. The book goes over that in detail. The pandemic risk and resiliency continuum that I keep talking about.
Does it talk a little bit about the ripple effect of it all? As I'm listening to you talk right now, yes, there's all these different things that are happening because our mental health conditions and things along those lines. But I started to recognize that it impacts, it impacts you physically, it impacts your job. Think about it, nobody thought that we would go back to school or not go to school or have to be remote and things along those lines. So there's an impact that goes way beyond just what somebody might be feeling because of the pandemic.
Yeah. Being that it's a pandemic, it affects everyone around you. It's not a geographic specific natural disaster, like a flood, hurricane, tornado or wildfire. So that's a thing that permeates our consciousness. You hear it in the news media, you talk to neighbors, you go to church and you see people wearing masks or you have online church. It's pervasive, chronic and persistent, not only disease but it permeates our mental health consciousness also.
Yeah. Do you see folks dealing with loss and grief differently now?
Loss and grief is kind of a complex topic to talk about, it's multidimensional. And the reason being, is that we all have our own level of resiliency in coping with losses and grief. Some people are pretty stoic, when they go to a funeral. They don't release emotion at all. Other cultures have parades. They celebrate the loss and all that. We sort of have to look at loss and grief individually. So this is the unique position that we're in as counselors is that, we do have to look at the own unique attributes of that individual. You can't make assumptions. There's a loss of ability to connect socially, which is difficult for people. Particularly, those that like to get out and have fun, do recreational activities. So that's a major loss for them. Then there's financial loss, job loss.
Just today, I saw on the news that Chicago public schools shut down again, they're going to go back to online education. As we were talking about this before Kent, there's this wave and phases, so we're not at the end. We're not at the middle. We have to ride this wave.
It's unknown, an unknown wave. Right?
Yeah. Yep. Yeah. The unknown wave.
Wow. Yeah. So you mentioned that we need to re-conceptualize disaster response. That counselors, they know, or how to kind of really deal with the pandemic virus to change the ways in which we facilitate therapeutic interactions with each other. So whether it's in the mental health field, in the schools, career counseling, all those different things. So how do we re-conceptualize?
Well, I think one way of understanding is that, wars, famine, infectious diseases have been around us since ancient times, biblical times. The leading cause of death is disease and disability in developing countries. So you think about undeveloped countries that don't have the medicine and the health care system and the public health care system. Their trauma is probably more significant than in the US here. I think it's helpful to understand Kent, this combination of this traumatic soul wounding that doesn't have a beginning, middle and end. These mutant variants can infect us at any time here. But you can't just be riding your life on that wave because you know where that is, that goes to helplessness and despair and depression.
I think I mentioned this before, cultures learn how to adapt and survive and thrive. And I think that's what's important about the counseling field is understanding the unique attributes of what a pandemic disease is. It's not a cancer, it's not heart disease, it's not a stroke and it's a unique type of natural disaster. So we can use some of the same counseling theories and approaches, but we have to look at through the pandemic lens. I think the book does a good job of indicating that. How to couch that in terms of the unique attributes, the mental, physical, medical problems.
How does the book kind of tie into helping counselors, help clients understand COVID and vaccines medically? What have you been adding to that part of your text that helps folks work with those different vulnerable populations?
Sure. I propose this adaptation adjustment model and what it does, it helps practitioners to identify, do early intervention, do triage, do prevention and preparation for pandemic viruses here. So it follows a lot of the same psychosocial adjustment models to chronic illness and disability. This AA model I call it, starts with the first wave of pandemic of virus. What you can expect. In the first wave, if you can think back to 2020. Say January, February of 2020. Nobody was really tuned in on a pandemic. My gosh, we were still in our lives and do what we normally do. That's typical first wave is, you might hear something. It doesn't affect my world.
In this adjustment model, then you look at the initial impact and all of a sudden you start hearing in the media all these deaths related to COVID. So there's the fear and anxiety. Some people respond with denial, some people respond with depression or anger and hostility. And that, my factory might shut down, so there's anger. Or, I might have to keep my kid at home from school. Who's going to watch him? So there's that phase. There's acknowledgement of a pandemic. And in the acknowledgement stage, it's saying that, "Okay, this is what I got to deal with now." You make adjustments to either survive our thrive, you make those choices here.
Basically, what this book does in helping counselors, it gives them a better understanding of various phases of the pandemic. How to anticipate and plan for different therapeutic interventions. In it in a lot of ways, this normalizes what a pandemic is about because we're all going through a normal response to an abnormal event. We will survive this. We will adapt, we will adjust. As counselors, we have to motivate our clients to do that.
That's very encouraging. Especially, given your background and knowing how these things have kind of evolved over time. We're coming up on the end of our time together. And I wanted to kind of put it back, to see if there's anything that you wanted to add or share that you think that our counselors need to know. What are your hopes that we are going to be moving forward towards? And I guess I'll ask it in this last question, how has COVID kind of changed or impacted the broader counseling profession from your perspective and what do we need to be able to do to move forward as we kind of tie it up today?
Yeah. Of course there's a lot of offices that are shut down because of COVID. So we've learned how to use tele behavioral health technology or tele-mental health.
And the medical profession has used this in rural health for probably the last 20 years. But counselors, this is new technology to counselors. There's classes you can take on how to establish form therapeutic relationships and do therapy through tele behavioral health. Everybody's adapting, the insurance companies, they got new CPT codes for tele behavioral health. It does start this domino effect of how we have to adjust here. New clients have emerged, I've read several articles that say, there's a significant amount of people who have never been seen for psychotherapy before, and they're in therapy. And they're taking anxiolytics or antidepressants.
That's telling me that, wow, we're acquiring new populations and individuals that have never been to therapy. That's an opportunity to help a wider range of individuals here. Yeah. Then the pandemics created unemployment, there's temporary loss or there's permanent loss of jobs. So we got people going through career transition, people that were bartenders, cooks, servers. They've had to morph their career into something different, because they'll never return back to something that's going to place their life at risk. Plus, maybe they didn't like that job to begin with. They realize that it might be helpful to go back to college. Career counselors have their work cut out for them in terms of job exploration, job development. [crosstalk 00:51:51].
Some serious soul searching for many of us in regards to that.
And then children, children and adolescents, when they're having to be relegated to academic performance standards at home.
School aged kids that have poor nutritional habits or food insecurity because their stay at home kids. We got a lot of work to do, a lot of new populations that we can be thankful about and to try to help. We have to consider the longterm impact of these collective trauma experiences of a pandemic and try to understand how these unique, extraordinary, stressful and traumatic events impact vulnerable populations. Just the regular populations that seek mental health services and so forth.
Well, Mark. You really opened my eyes to a lot of different things, especially with regards to the military. And I thank you for coming in and talking with us today. It's been a phenomenal opportunity to kind of hear from your perspective, especially your writing process. So I want to thank you for being a guest today.
Thank you, Kent. I really appreciate you having me and I appreciate ACA inviting me also.
Oh, it was a wonderful opportunity to get to know you better. So thank you so much. This is The Voice of Counseling. I'm Dr. S Kent Butler. We were here today with Dr. Mark Stebnicki, and we had a great time talking about, what we're going to be doing to get through this pandemic. So we'll see you next time.
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