COVID-19 challenges counselors to treat children, paves long, difficult road ahead

Adam Carter
Adam Carter

COVID-19 changed abruptly from just a concerning topic in the news to a crushing force that isolated and locked down schools, communities and economies.

The pandemic continues to claim a heartbreaking inventory of victims, from small businesses and gainful employment to human lives, while it creates sometimes unanswerable questions.

For parents and mental health professionals, one of those challenges involves children.

“Most of our children are not necessarily experiencing the loss of human life, but it’s this loss of predictability and normalcy that is often considered disenfranchising,” says Adam Carter, an assistant professor in the Department of Counseling and Higher Education with a research interest in preschool grief reactions.

“We have well-meaning adults in children’s lives who are telling them, ‘At least they’re not sick.’ ‘At least they don’t know anyone who’s gotten sick and died.’ ‘At least they’re healthy,’ ” he adds. “Amongst all those ‘at-leasts,’ what we’ve done is completely minimize the fact that, one day, these children had access to their friends and freedom to navigate the world as they wanted, and the next day, that was physically cut off from them.”

Young children and adolescents feel this loss in different ways, Carter says.

High school seniors, he says, watched their spring sports seasons, proms, graduation ceremonies and other rites of passage vanish. “These students have been working toward these for 18 years,” he says, “and now they’re gone or drastically different.”

Little ones, meanwhile, are grieving the disappearance of the daily routine provided by school and teachers.

“For some children, this was only stability that they had in their lives,” Carter says. “The only predictability was, ‘I have to go to school, and these people are going to take care of me, and when I come home, it may not be as predictable.’ That’s a huge loss.”

Keeping families together around the clock, whether for shelter-in-place orders, unemployment or both, poses its own challenges.

Carter, a husband and father of three, is seeing that in his own home as it transformed into “remote” offices and classrooms. “Two adults and three children, working all the time, is taxing on our relationship,” he says, “and we like each other!”

The coordinator of NIU’s Trauma-Informed Counseling graduate certificate program believes that the road ahead is a long one.

“My guess, and this is the guess of many mental health professionals, is that we’re going to see the ramifications of this ripple for years. We really are. The grief that is there won’t, in my opinion, necessarily be acknowledged as grief until much later,” Carter says.

“We probably now more than ever have demonstrated to children that it’s very hard for us as adults to keep them safe, which is the foundation of adult-child relationships to which we’ve committed,” he says. “It’s our responsibility to keep you safe and, now, keeping you safe means you don’t get to leave the house. Or if you do get to leave the house, you’re wearing a mask. And if you are leaving the house, it has to be essential.”

Parents naturally serve as the role model for their children in nearly every aspect of life, he adds, regardless if they know how to do so appropriately.

Grieving is included in that unspoken compact.

“In the best of circumstances, we say the way you prepare children for funerals and for the beginning of their mourning process is by answering questions,” Carter says. “Well, children are asking questions right now that adults can’t answer, and that puts children on edge, which then has the potential to complicate their grief even further.”

He has good advice for parents who are struggling: “Be present, answer questions, focus on safety and provide options.”

Adults should clearly state to children the ways in which they are protecting them, he says, and should frame their statements with the reasons behind those actions. This is why we wear masks. This is why I don’t let you to the grocery store with me. We’re keeping you safe and keeping other safe.

Meanwhile, he adds, parents can model healthy behaviors by turning them into choices “so they don’t feel powerless in this time. Where do you want to wash your hands? The kitchen or the bathroom? Do you want to use the green hand soap – or the pink hand soap?

Despite the best efforts of parents, Carter says, it’s expected that some children will allow their emotions or behaviors to boil over and limit them from living the lives they want.

Some will seek control. Some will unravel into tantrums. Those are common, he says.

But when children hurt themselves, or threaten to harm themselves or others, it’s time to seek professional help, he says.

Fortunately, counselors are up for those calls, even as they manage their own stress levels caused by COVID-19 – and those who are struggling to cope understand that they can take breaks from work, Carter says, or find “a sense of grace” within the community of care among other counselors and first-responders.

“We do have some training in being able to compartmentalize these things, but our training doesn’t dehumanize us. Counselor-educators right now are stressing the importance of self-care, both to our clients and also to our counseling students,” Carter says.

“It’s a very stressful time, and we’re having to relearn how to take care of ourselves on top of learning how to support others who are experiencing this trauma and tragedy along with us,” he says. “When this is over, we’re still going to see these things occur, and counselors are going to be the new frontline folks once we have the virus itself under control.”

Are professors of counseling already incorporating COVID-19 into their curriculum? That’s not a good idea yet, Carter cautions.

“I’m not a huge fan of basing pedagogy in the trauma. The world is still on fire for most of our students,” he says. “Returning to some sense of normalcy is necessary before we’re then able to learn life lessons. Right now, our students really are in survival mode. They’re not in thriving mode, and thriving mode is where learning takes place.”

He does believe that COVID-19 will inspire faculty to place a greater emphasis on telehealth practices, something NIU started this spring.

Finally, Carter is encouraged to see counselors “falling back” to the fundamental practices of humanistic relationships and person-centered approaches that he teaches: How are YOU doing? How are things going with YOU right now? Let’s talk about that. Let’s process that.

“The students who I supervise who are professionals in the field right now are not seeing a dip in no-shows. Their show rate has actually increased since moving to tele-mental health,” he says.

Why?

“I can share things with you in my house that I many not feel comfortable sharing in your office, and we have a generation of folks right now who are very comfortable communicating this way and do not see it as a less-than means of communication,” Carter says. “As counselors start to embrace that, we’re seeing our quality of counseling increase because we’re going back to our roots.”

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