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Christine Forte Mar 18, 2020

Counseling in a Time of Covid-19

We are living in extraordinary times. For the first time in modern history our world is experiencing a global pandemic and all that it implies for changes in our way of life. How drastic it will be is not yet known.

As counselors we cannot predict exactly what will happen, nor is it our job to advise clients about the virus itself. During these tumultuous time, however, what we can help with is the fear and anxiety that surrounds the uncertainty. In our work, we are all very familiar with the concept that living in distress is neither healthy nor desirable for our clients and so it’s part of our duty as therapist to do what we can to help in reducing our clients’ fears.

To broaden our perspective, we can keep in mind that even as we are experiencing unprecedented measures being taken to protect our societies; adversity and insecurity are not new elements to human life. They are always present in a multitude of diverse ways, its just that right now they are louder.

Everything you know as counselors still applies. Through your education, experience and continued training you are well equipped to help your clients through this crisis. But given that our own anxiety levels during this time may be high, it might be useful to feel that you have a few additional strategies in your toolbox, and have thought through some the special considerations impacting clients’ lives right now.

Last fall I repatriated to the US after ten years living and working in Shanghai, China. As I was in private practice there, I have continued seeing many of my clients online, and even added some new ones in other parts of China and Korea. All of them have been impacted since January by the virus, either from living in cities where movement outside their homes is greatly restricted or from being displaced in other countries due to limitations on travel. While a couple months of treating people directly impacted by this pandemic certainly does not make me an expert, it is my hope that I can share what I have learned so far with counselors in the US, particularly as our communities are now much more directly impacted.

Through a series of posts I would like to provide resources and open a dialogue that goes beyond psychological first aid. For while it is a useful strategy in disaster mental health care, what we are currently faced with is a situation that will require recovery measured in months, rather than in days or weeks. The repercussions of this virus will not just have health impacts, but there will also be impacts in terms of grief and loss for our clients, as well as economic, employment and education impacts. We may even have clients who face displacement internationally or changes in their family situations. We, as counselors, need to be prepared to help with this recovery, even as we ourselves are impacted.

Some stress is normal and important in life. The hormone cortisol, when released in small amounts as it is when we experience normal amounts of stress, actually keeps our body and organs energized. It can help to motivate us to get things done or protect ourselves as needed. However, when it goes too far, stress becomes toxic and can result in pervasive anxiety and panic on the psychological level, and can also physically take a toll on the body. In the next two posts I plan to address both cognitive strategies for reducing stress and then emotional ones for addressing deeper seated fears. I’ll then examine some of the special considerations around isolation and loneliness, counselor self-care, expectations in terms of practice management, in addition to other topics.

This is just the tip of the iceberg in the conversation about psychological coping during this time. As I write this, I’m aware of my own fear that my posts will be criticized for being incomplete. And this would be true – I’m only at the introduction now! But it also occurs to me that in a way my own apprehension about these posts is representative of greater fears at the moment – that efforts which we make to prevent the spread of the virus and protect our families and communities will be insufficient, and later criticized as such. For they likely will be.

An epidemiologist that I heard interviewed on NPR described how most disease prevention is viewed as alarmist, until things reach a certain epidemic tipping point, and then the previous efforts made are criticized as being inadequate. And so as with everything in life, we must seek balance, striving to do our best, while simultaneously working on making peace with the fact that it will always be imperfect.

I would encourage readers to reach out to me to participate in this blog if there are things you’d like to see included here, either resources you’ve found helpful or challenges you’ve faced during this time. Collaboration and mutual support are such important parts of what we do even as we are experiencing greater physical distance from each other.

Throughout this conversation, and the epidemic in general, I believe that we as counselors can carry with us always the beacon of hope. In the last couple of days, I have seen my beloved city of Shanghai emerge after the lockdown, changed, a bit slowed down, but nonetheless taking steps forward. I am moved to see the optimism of the people there even as they still take important precautions. It shows us that there is life after Covid-19, and also reminds us of the importance of our interconnection as a global community to inspire and cheer one another on. 

Christine Forte is a counselor working in private practice online with the globally mobile community. She has recently repatriated to the US with her family after ten years of living and working in Shanghai, China. You can contact her at Christine(at) or read more about her practice at

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