Cognitive behavioral therapy

Therapy in the Time of Covid-19

Mental Health Clinicians Should Embrace Uncertainty

Of course, self-disclosure should be used sparingly in therapy treatment. But this is a pandemic, people.

So psychologist Emily Mohr, Ph.D., might actually mention she’s feeling a little slower than usual during a morning virtual session with a patient. She might mention she stayed up past her 10 p.m. bedtime because it’s hard to turn off work when there’s no differentiation between work and home anymore.

“I actually think it helps that we’re all in the exact same situation,” said Mohr, regional director of integrated care at Norwood, Massachusetts-based Child and Family Psychological Services.

“It’s like, no,” she said, snapping her fingers during a Zoom interview from her guest- bedroom-turned-home office, “we’re all dealing with being stir crazy in our houses and how can we keep ourselves well.”

Having human conversations is just one way to cope with just how weird things have gotten since the global spread of COVID19 prompted the shutdown of schools and workplaces and forever changed the way we thought about toilet paper consumption.

Just when the pandemic will peak is still open to debate. Clinicians should acknowledge uncertainty in caring for their patients’ well-being, according to guidance from the Center for the Study of Traumatic Stress at the Uniformed Services University’s Department of Psychiatry in Bethesda, Maryland.

Even their own.

Embracing the Web

The pandemic has Ashley Flynn, M.A., a licensed mental health counselor and clinical director at the Boston Child Study Center, leading her first therapy group entirely on the web. During virtual staff meetings, the center’s close-knit staff has embraced an all-in-this- together attitude.

“We joked that none of us got the pandemic course in grad school,” Flynn said.

She has even admitted to those feelings with her group of college-aged clients, especially when she wasn’t sure why she couldn’t see all of them on her computer screen. “I was like, ‘hey guys, I have no idea how this is going to work right now and so we’re going to see how it goes!’”

Owning up to being out of your element but being willing to forge ahead is essential to adapting to challenges, Flynn said.

Coping with Loneliness

A big discussion topic with her clients is how to cope with feeling disconnected and lonely. Flynn has advised them to think incrementally about getting through the coming weeks because that’s how she herself has framed the future.

“If you’re thinking of ‘What am I going to do for the next six weeks, eight weeks?’ I think that feels really overwhelming,” Flynn said. “If you’re like, ‘what am I going to do for the next seven days?’ I’m like ‘me too and if you think of any good ideas, tell me.’”

Clinicians new to telehealth sessions may feel a loss of control. Yet virtual therapy actually offers them a more naturalistic view of what life and all its distractions is really like for clients, says Hart K. MacCardell, Psy.D., director of school consultation and training at the Boston Child Study Center.

She sees high-achieving parents suddenly thrust into the role of having to be a teacher and feeling overwhelmed.

“A general parenting principle that I’m always working on whether there’s a pandemic or not is putting your oxygen mask on first and recognizing it is okay to have limits.” MacCardell said.

She encourages the parents she coaches to take breaks and take them mindfully and model practicing self-care for kids.

MacCardell’s advice for her colleagues navigating the new normal of their profession is to remember their training. “Your skills will transfer more than you think they will.”

Mohr is embedded in primary care practices on the South Shore where she typically saw up to 40 adults a week ranging from their early 20s through 70s in 30-minute sessions.

Before the World Health Organization declared the pandemic on March 12, she and her team mostly treated patients for anxiety, depression, health psychology issues like insomnia, smoking cessation and weight management or adjustment to the stress of a major life event.

What did Mohr see in the weeks after the pandemic? Anxiety, depression, health psychology issues like insomnia, smoking cessation and weight management or adjustment to the stress of a major life event.

“It hasn’t changed at all,” Mohr said. “What I anticipate is right now is the quiet before not just the storm but the onslaught.”

As spring progresses, Mohr said she expects to see more people presenting with stress-related symptoms.



Therapy in the Time of Covid-19

Janine Weisman

Janine Weisman is a journalist based in Newport, Rhode Island who frequently writes about mental health. Find her on twitter @J9Weisman.


APA Reference
Weisman, J. (2020). Therapy in the Time of Covid-19. Psych Central. Retrieved on December 4, 2020, from


Scientifically Reviewed
Last updated: 12 May 2020
Last reviewed: By John M. Grohol, Psy.D. on 12 May 2020
Published on All rights reserved.