RESPONDINGTOAPANDEMIC:COVID-19ANDINTEGRATED

PRIMARYCARE

NancyB.Ruddy,Ph.D.

BarbaraWard-Zimmerman,Ph.D.

LearningObjectives

•  Followingthispresentation,participantswillbeableto:•  IdentifythreewaysintegratedbehavioralhealthproviderscanbeofassistanceregardingCOVID-19

•  ListthreestrategiestohelppeoplecopewithanxietyrelatedtoCOVID-19

•  ListthreestrategiestohelppeoplecopewithlifedisruptionsassociatedwithCOVID-19

BehavioralHealthRoleDuringaPandemic

•  SupportmedicalprovidersandotherteammembersastheycopewithCOVID-19

•  PromotehealthbehaviorchangetoenhancepreventionofCOVID-19transmission

•  ProvidedirectservicesandotherresourcestohelppatientscopewithCOVID-19relatedanxiety

•  ProvidedirectservicesandotherresourcestohelppatientscopewithlifedisruptionassociatedwithCOVID-19

PROVIDERFACINGINTERVENTIONSHelpthehelpers….

SupportingProviders

•  Acknowledgelegitimateconcernswhilesupportingasenseofagency

•  Facilitateadvocacytominimizerisktoprovidersandstaff

•  Provideresourcestofacilitatediscussionwithproviderandstafffamilies

•  Providestressmanagementresourcesandsupport

ResourcesforProviders

SleepApp:Freew/codeHEALTHCARE

Headspace.com/health-covid-19(needNPI#)

ThankstoJulieSchirmer,MSW,MaineMedicalCenter,PortlandME

Directservicesarechallengingtoaccess–evennotduringapandemic–opportunitytoembraceappsandalternativeformsofassistance!

Otherstrategies

•  “Happy(half)hour”–anyoneonstaffcantalktoyouviaZoom,alittlevirtualsupportgroup

•  Briefwebinarsthatoutlinecopingmechanisms

•  Staffactivitiestopromotewellness(briefbreathingbreaks,connectionpointsduringday,providingfoodandbriefbreaks)

•  Dailycommunicationstoinspireandsupport,focusongratitude

EnhancingEngagementinOnlineGroups(forprovidersandpatients)

•  Startmeetinginwaythathelpsparticipantsbeonemotional(ratherthanintellectual)planefrombeginning(e.g.,usearhetoricalquestion)

•  Includeanexperientialexercisemid-waythrough(e.g.,briefrelaxation)

•  Usequestionstoelicittheirwisdom,ratherthansendingmessagethatonlyprofessionalshaveanswers

•  Setasidetimefora“questionandanswer”format•  Usea“calltoaction”(e.g.,howcanyouapplythistoyourbiggest

copingchallenge…”)•  Allowtimefordiscussion•  Attheend,consolidateandsolidifylearning.

–  “Youlearned3skillstoday….”–  “Whichofthesecanyouuseforyourbiggestcopingchallenge?”–  “Wouldanyoneliketoshare?”

ThankstoBethDarnall,Ph.D.,StanfordUniversity

FamiliesofProviders

•  Explainingselfisolationtochildren– “Rightnow,I’mhelpingpeoplewhoaresickbecomehealthyagain.IneedtomakesureIdon’tmakeyousick,sowecan’thaveourbodiesbeclosetoeachotherrightnow.ButIamgoingtodomybesttobeavailabletoyou.Let’stalkaboutwayswecanfeelclosetoeachotherwithoutbeingrightnexttoeachother.”

– Shareideaswithcolleagues– Berealisticabouthow“available”youcanbe,givenphysicalandemotionalexhaustion

FamiliesofProviders

•  Dealingwithfearsforproviders’safety– CBTresourcesforanxietyworkforprovidersandfamilymemberstoo!

•  Partner/othersoverwhelmedwithnewnormal– Pullinsupportswherepossible– Acknowledgelimits,lowerstandards– Usevirtualsupports,espotherfamiliesofproviderswhounderstandspecificissues

PATIENTFACINGINTERVENTIONSProvidingdirectandindirectservices….

FacilitatingPatientBehaviorChangeforCOVID-19Prevention•  Atthispoint,notengaginginsocialdistancingisNOTlackofinformation•  Treatlikeanyotheradherenceissue–ASKWHY?

•  Receiptofnon-evidencebasedinformation•  PerceptionthatCOVID-19isnotrelevant•  Denial/selfperceptionofprotectedbyown“strength”

•  UseMI;isconcernforothersamotivator?•  Addresstheissues;recognizelimitations;acceptlackofpowerasprovider–can’tfixeverything!

TheAnxiousPatient

•  COVID-19feedsintoeveryfear,espforsomaticallyfocusedpatients

•  Helptobeinthe“now”ratherthaninthe“whatmightbe”– Grounding–  RelaxationTechniques–  Reduceexposuretonews/sensationalism–  Facilitateselfappraisalofeverydaysymptoms–  Ensuretheyknowwhentoreachoutforassistance–  Engagefamilyandothersupports

FACECOVID1•  F:Focusonwhat’sinyourcontrol•  A:Acknowledgethoughtsandfeelings•  C:Comebackintoyourbody•  E:Engageinwhatyou’redoing•  C:Committedaction•  O:Openingup•  V:Values•  I:Identifyresources•  D:Disinfectanddistance

Harris,R.(2020).FaceCOVID:HowtoresponseeffectivelytotheCoronaVirus.E-publication.https://drive.google.com/file/d/117HY4z4mY5izJpR44ejuZ8rhTyoWEGEG/view?fbclid=IwAR1r8TLlBm5ny7wXHrreEOp6GaCPpmDWJBOXVWH7b6JUICfV_5g6EGKP9YAAccessedMarch25,2020.

FamiliesandCOVID-19

•  Thevulnerablearemorevulnerable– Domesticviolence/childabusesituations– Foodinsecurity,financialperil

•  Normalizefrustrations,conflicts•  Encouragebreaksfromoneanother•  Pullinsupportsaspossible•  Helppeoplesetreasonableexpectationsforthemselves

WellnessforAll•  Sleephygiene•  Nutrition•  Connection•  Routine•  Exercise,ideallyoutdoorsw/socialdistancing•  Avoidinginformationoverload•  Takingbreaks•  Expectationsetting•  Beinginthe“now”

WorkingfromHome1

•  Minimizedistractions•  Setgoalsandboundaries•  Makeacommunicationplan•  Seeksocialconnection

Greenbaum,Z.(2020).Psychologistsadvicefornewlyremoteworkers.E-publication:https://www.apa.org/news/apa/2020/03/newly-remote-workersAccessedMarch25,2020

Staysafe,socialdistance,andtakecareofoneanother!

ResourcesforProviders•  UniversityofColoradoprovidesalistofresourcesforprovidersto

practiceself-careduringthistime•  Montefioreprovidesawebinaronhowtomanageanxietyrelated

toCOVID-19forproviders•  AmericanPsychologicalAssociationprovidesavarietyoflinksfor

healthcareprovidersaboutCOVID-19andhowtomanagestress•  TelepsychologyWikiversitypagefortipsandtricks•  IntensiveCareSocietyprovidesavarietyofresourcesforproviders

onhowtomanagetheirwellbeingduringthistime•  Children’sMercyprovidesinformationonmanagingEthicswhile

providingtelehealth

ResourcesforFamilies•  ChildStudyCenteratNYULangoneHealthprovidesan

educationalwebinarongeneralinformationaboutCOVID-19,strategiesonhowtotalktochildrenaboutCOVID-19,andhowtomanagesymptomsofchildrenwithdifferentdiagnoses(e.g.,ADHD-ODD)duringthistime

•  TheNationalAssociationofSchoolPsychologistsprovidestipsforparents/caregiversonhowtotalktochildrenCOVIDandhowtonavigateschoolchangesduringthistime

•  SAMHSAprovidestipsforcaregiversonhowtotalktochildrenanddifferentreactionsthatchildrenmayhaveandhowtomanagethesereactions

•  CenterforDiseaseControlprovidesgeneralprinciplesonhowtotalktochildrenaboutCOVID-19

ResourcesforFamilies•  NationalChildTraumaticStressNetworkprovidesparents/

caregiversinformationthattheyshouldknowaboutCOVID-19,howtopreparethefamilyforanoutbreak,copingwiththeoutbreak,andresourcesforadditionalsupport

•  CenterfortheStudyofTraumaticStressprovidesavarietyofresourcesforfamilies,providers,andleadersonhowtosupportthemselvesandothers

•  NPRprovidessomecomedicreliefandcreatedacomicforkidstounderstandmoreaboutCOVID-19

•  AssociationofPsychologistsinAcademicHealthCentersprovidesavarietyofresourcesforprovidersandfamilies

•  UNICEFprovidesideasforteachers/caregiversonhowtotalktochildrenatdifferentagelevelsaboutCOVID-19

ResourcesforFamilies•  NationwideChildren’sHospitalprovidescaregiverswithtipson

howtotalktochildrenaboutCOVID-19,howtostaymentallyhealthy,howtomanageindoorboredom,andavarietyofotherusefulideas

•  StorythatexplainsCOVID-19foryoungchildren•  TheNewYorkTimesprovidesinformationforcaregiversonhowto

talktotweenandteensaboutCOVID-19andmanaginganxietyrelatedtothepandemic

•  FreewifiavailablefromComcast•  SocialStoriesbyVerySpecialTales.comaboutCOVID-19•  KidsHealthbyNemourshassomestrategiesfortalkingtokids

aboutCOVID-19•  MindHearthasseveralgreatcolorbookingsformultiplelanguages

ResourcesforFamilies•  SesameStreetonhowtomanagefeelingsrelatedtoCOVID-19

•  TheAutismEducatorprovidesashortstoryaboutCOVID-19

•  IncludedinthisfolderareavarietyofCOVID-19PDFs

•  ChildMindInstituteprovidesinformationonhowtosupportteeangers/youngadultsduringCOVID-19crisis

•  ChildMindInstituteprovidesideastohelpchildrencopewithtraumaticevents

ResourcesforFamilies

•  EmergingMindsprovidesinformationonhowtosupportchildrenandyoungpeopleduringCOVID-19

•  CHADDprovidesresourcesforfamiliesonhowtoworkwithstudentswithADHDduringthistime

•  AmericanAcademyofPediatricsprovidesinformationforfamiliesaboutCOVID-19

•  ParentingforLifelongHealthprovidesresourcesforfamiliesonwhatCOVID-19isandhowtokeepfamiliesontrack

•  Nationwideinformationforfamilieswhoareundocumented

ResourcesforFamilies

•  NYULangoneprovidesaresourceforcaregiversonhowtomanageschoolconcernsduringthistime

•  DepartmentofEducationprovidesinformationforfamiliesaboutspecialeducationservicesduringthistimeoffofschool

•  TheSchoolDistrictofPhiladelphiaprovideslinksforcurriculum-basedassignmentsforallgradelevelstohelpcontinuelearningwhilechildrenareathome

•  KidsActivityBlogcompiledalistofeducationalcompanieswhoareprovingfreeresources