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May 20, 2020

Shifting the Focus from Treatment to Prevention

Crises such as the COVID-19 pandemic are often times for reflection. As counselors, we can think about how the profession is responding to this crisis. There has been a rush toward telemental health implementation to assist clients during this troubling time, but what about the prevention efforts of our profession?

In a Medscape article, George Lundberg says, “Clinical medicine at its base is ‘one patient, one physician, one moment, one decision.’ … [It] is largely diagnosis and treatment of diseases.” Public health efforts, however, are aimed at disease prevention, and they benefit the public at large.

Have we gotten lost in the clinical medical model (the diagnosis and treatment of the individual) in our counseling identity of prevention? In public health, we look at different outcomes — primary, secondary, and tertiary. As professional counselors, we generally work within the tertiary model, treating the disease that is evident via signs and symptoms. But we often desire to work upstream of the outcomes (e.g., anxiety, depression) and work in a primary model, attending to the risk factors and building upon strengths of a community/population before the disorder or disease is evident.

As a profession, we can offer “psychological first aid,” but this time is also ripe for attending to the potential future outcomes or the sequelae after COVID-19 has passed.

Is there a risk of a mental health crisis or pandemic in the near future? If so, what efforts can we can take as profession to prevent this outcome or, if it is too late, to develop population-based control efforts? What prevention actions can we take within our field? What partnerships can we begin to establish at the city, state, national, and international levels to develop community-based prevention efforts? Can we begin to develop “trauma toolkits” for those in the front lines? Can we begin to establish programs for children, older adults, and spouses who have experienced neglect or abuse during the shelter-in-place orders? What actions can we take today to ensure we won’t have that client in the future?

In public health, we are in the business of not having business. In the counseling profession, we also value prevention. So, let’s work toward that goal during this time of crisis.

Author and Guest Blogger: David E. Jones, EdD

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