The date is March 2020, the country begins to shut down and we are told to stay at home and immediately take a training to become certified to provide telehealth services. With most of my caseload being children, my first thought was, there is no way this is going to work; however, I also told myself that this will probably just be short-term (boy was I wrong). My second thought was, I have no idea how to provide telehealth. Fast forward to today, April 2021, and most of us are still providing telehealth.
Within that year, I was furloughed to part-time work; however, expected to take on more clients, expected to keep a child on the screen for 53 minutes, hold everyone else’s panic, depression, financial insecurities, and struggles of their altered perspective of the world, all while experiencing those same challenges myself. The only difference is that I had to “pretend” I was okay and stable. Truth is, I was not okay and my life was far from stable.
How was I supposed to be “fully present” in my sessions when I was exhausted, depressed, anxious, and constantly thinking about my own financial struggles and the mere dangers of simply going to the grocery store?
Days pass, weeks, months, and then a year and we are still doing telehealth. Although, at first, management was sympathetic to the change, that sympathy appeared to slowly drift from their consciousness. There was this underlying feeling of, “you’ve been doing this a year now, you should know what you’re doing.” Well contrary to this assumption, therapists are silently screaming, “NO WE DON’T” and “WE ARE TIRED.” Just because we were forced into this modality and had to do it for the past year, does not mean we know how to do it or feel good about our work.
We are exhausted, drained, questioning our career choices, losing motivation; however, still expected to meet a certain productivity while keeping a smile on our faces. We can all try and hide behind those smiles, but the bags under our eyes scream we are struggling mentally, physically, and emotionally. So, what do we do? Who do we turn to? Our own therapist? Sure, we could do that, but we know all too well they are struggling themselves. We are stuck, we are tired, and we are struggling too.
Therapists Struggle Too 
I could not possibly agree more. The pressure to act composed, not to mention the covert assumption that we are capable of providing both reflective perspective on these issues while also traversing the same emotional terrain has been exhausting, and at times, unmanageable. I also have found that managing the aspects of telehealth associated with the pandemic, in conjunction with addressing massive social change and political chaos has also confounded abilities to cope and manage our emotions during this time.
I find that the need to feel connected to others is greater than ever. Connected to other therapists, connected to our friends and family, and even connected to ourselves. This has been a year of confusion and discontent, and truly fragmentation in so many ways. I hope that we are all able to navigate it to find the value that has been available to us through the chaos, as change frequently requires chaotic predecessors. However, that is the therapist in me talking, and being intimately involved in that chaos just plain sucks sometimes.
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I second so much of this. I work with adults and generally the how of telehealth has smoothed out, though. The demand to do more outreach, see more patients, serve more is overwhelming, though. When we bring it up to management we are told our caseloads aren’t high enough to feel tired. We are heavily discouraged from using our time off for more than a day or two at a time. We’re told to find CEUs or (for unlicensed folks like me) professional development opportunities that are either 3-7 AM (this does happen often in our time zone) or in the evenings to not interfere with patient care 8-5. I’ve had two friends die since the holidays and each time I felt pressure to take no time or less than a day off. Now covid cases are rising in my area and management says we are going back to in-person by the fall. There’s talk of switching sooner. I’m drained and scared of going back to in person.
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I am glad this post was validating for you, however, I am sorry that you are experiencing this! What we do is hard and unfortunately upper management values quantity over quality while disregarding the well-being of the therapist.
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