COVID-19 resources

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Helping couples in the shadow of COVID‐19

Family Process

The pandemic caused by the SARS‐CoV‐2 virus (coronavirus) and the associated illness, COVID‐19, has caused a level of worldwide upheaval unlike any most people now living have seen in their lifetimes. This crisis affects people in their most important, committed, and intimate relationships. Although this crisis has damaged the health and well‐being of individuals, crushed economies, and led to an extensive period of uncertainty about the future, there may also be positive outcomes in the motivation people have to protect their relationships. This paper focuses on strategies that therapists and relationship educators can use to help couples preserve and protect their relationships during such a time. This paper describes four foundations of safety that allow relationships to thrive: physical, emotional, commitment, and community. This paper then highlight three keys from our body of work that can help guide individuals and couples in protecting their relationships on a day‐to‐day and moment‐to‐moment basis: (1) decide, don’t slide; (2) make it safe to connect; (3) do your part.

Last updated on hub: 14 October 2020

Developing a measure of the impact of COVID‐19 social distancing on household conflict and cohesion

Family Process

This report introduces the COVID‐19 Family Environment Scale (CHES), which aims to measure the impact of social distancing due to COVID‐19 on household conflict and cohesion. Existing measures do not capture household experiences relevant to the pandemic, in which families are largely confined to their homes while sharing a life‐threatening situation. Using best practice guidelines, this study developed a pool of items and revised them with review by a panel of experts, and cognitive interviewing with community respondents. This study administered the CHES by online survey to 3,965 adults. The CHES consists of 15 items for each of two subscales, household conflict (α = .847) and household cohesion (α = .887). Exploratory factor analysis yielded two factors, corresponding to the intended conflict and cohesion items, which accounted for 29% of variance. Confirmatory factor analysis partially supported the 2‐factor model (RMSEA = .057; CFI = .729, TLI = .708, and SRMR = .098). The CHES also contains 25 optional items to describe respondent and household characteristics, and household‐level COVID‐19 exposure. The CHES, publicly available at https://elcentro.sonhs.miami.edu/research/measures-library/covid-19/index.html, provides a tool for measuring the impact of the COVID‐19 pandemic on important determinants of resilience in the face of major stressful events. Further work is needed to address the factor structure and establish validity of the CHES.

Last updated on hub: 14 October 2020

COVID‐19 pandemic: applying a multisystemic lens

Family Process

The COVID‐19 pandemic has a pervasive effect on all aspects of family life. We can distinguish the collective societal and community effects of the global pandemic and the risk and disease impact for individuals and families. This paper draws on Rolland’s Family Systems‐Illness (FSI) model to describe some of the unique challenges through a multisystemic lens. Highlighting the pattern of psychosocial issues of COVID‐19 over time, discussion emphasizes the evolving interplay of larger systems public health pandemic challenges and mitigation strategies with individual and family processes. The paper addresses issues of coping with myriad Covid‐19 uncertainties in the initial crisis wave and evolving phases of the pandemic in the context of individual and family development, pre‐existing illness or disability, and racial and socio‐economic disparities. The discussion offers recommendations for timely family oriented consultation and psychoeducation, and for healthcare clinician self‐care.

Last updated on hub: 14 October 2020

Clinical supervision of couple and family therapy during COVID‐19

Family Process

This paper addresses the need for a swift transition from in‐person clinical supervision to telesupervision during the time of the COVID‐19 global pandemic. Five specific areas will be discussed in the effort to enhance the quality of clinical supervision provided to couple and family therapists in training at this time including the following: (1) COVID‐19 and the structural changes and technological adaptation of supervision; (2) culturally and contextually sensitive guidelines for clinical supervision during COVID‐19; (3) the supervisee’s competence and the clinical supervisory process; (4) the new set of boundaries and the supervisory role; (5) and the supervisory alliance and supervisees’ vulnerabilities in the face of COVID‐19.

Last updated on hub: 14 October 2020

Behind the (virtual) mirror: online live supervision in couple and family therapy

Family Process

Online therapy and supervision, a rapidly rising practice in couple and family therapy, has been the subject of a growing body of literature. From its early days, family therapy training has included live supervision, which has typically been conducted by a supervisor and a team of trainees situated on the other side of a one‐way mirror. With the outbreak of the COVID‐19 global pandemic, the staff of supervisors at the Barcai Institute in Tel Aviv, Israel were compelled to find solutions to continue meeting with clients and to provide supervision for family therapy trainees. To this end, they have shifted their live supervision courses (“practicums”) to the virtual arena, adapting the popular application “Zoom” into what they call “PractiZoom.” Based on over 100 PractiZoom sessions conducted between March and May 2020, involving 14 supervisors and 28 therapists‐in‐training and their clients, the article reflects on this pioneering online practicum for the online live supervision of therapists with geographically distributed participants. This article outlines the operational methods and adaptations for conducting live behind‐the‐mirror supervision online. Following a short theoretical background, the process of online live supervision is outlined, and any reflections and those of the trainees on the challenges and possibilities it poses are discussed, and offer a number of preliminary conclusions and recommendations.

Last updated on hub: 14 October 2020

Rituals in the time of COVID‐19: imagination, responsiveness, and the human spirit

Family Process

Following the format put forth by Imber‐Black and Roberts, this paper examines daily rituals, family traditions, holidays, and life cycle rituals during the pandemic of COVID‐19. Marked by symbols capable of carrying multiple meanings, symbolic actions, special time and special place, and newly invented and adapted rituals are illustrated through stories of couples, families, and communities.

Last updated on hub: 14 October 2020

Expanding possibilities: flexibility and solidarity with under‐resourced immigrant families during the COVID‐19 pandemic

Family Process

The novel coronavirus has added new anxieties and forms of grieving to the myriad practical and emotional burdens already present in the lives of underserved and uninsured immigrant families and communities. This article relates to experiences since the COVID‐19 crisis to the lessons that have be learned over time as mental health professionals working with families in no‐cost, student‐managed community comprehensive health clinics in academic‐community partnerships. This paper compares and contrast the learnings of flexibility of time, space, procedures, or attendance acquired in this clinical community setting during regular times, with the new challenges families and therapists face, and the adaptations needed to continue to work with our clients in culturally responsive and empowering ways during the COVID‐19 pandemic. This paper describes families, students, professionals, promotoras (community links), and IT support staff joining together in solidarity as the creative problem solvers of new possibilities when families do not have access to Wi‐Fi, smartphones, or computers, or suffer overcrowding and lack of privacy. This paper also describes many anxieties related to economic insecurity or fear of facing death alone, but also how to visualize expanding possibilities in styles of parenting or types of emotional support among family members as elements of hope that may endure beyond these unprecedented tragic times of loss and uncertainty.

Last updated on hub: 14 October 2020

COVID‐19 interconnectedness: health inequity, the climate crisis, and collective trauma

Family Process

The COVID‐19 pandemic brings to the forefront the complex interconnected dilemmas of globalization, health equity, economic security, environmental justice, and collective trauma, severely impacting the marginalized and people of color in the United States. This lack of access to and the quality of healthcare, affordable housing, and lack of financial resources also continue to have a more significant impact on documented and undocumented immigrants. This paper aims at examining these critical issues and developing a framework for family therapists to address these challenges by focusing on four interrelated dimensions: cultural values, social determinants of health, collective trauma, and the ethical and moral responsibility of family therapists. Given the fact that family therapists may unwittingly function as the best ally of an economic and political system that perpetuates institutionalized racism and class discrimination, we need to utilize a set of principles, values, and practices that are not just palliative or after the fact but bring forth into the psychotherapeutic and policy work a politics of care. Therefore, a strong call to promote and advocate for the broader continuum of health and critical thinking preparing professionals to meet the challenges of health equity, as well as economic and environmental justice, is needed. The issues discussed in this paper are specific to the United States despite their relevance to family therapy as a field. We are mindful not to generalize the United States' reality to the rest of the world, recognizing that issues discussed in this paper could potentially contribute to international discourse.

Last updated on hub: 14 October 2020

Effect of the covid‐19 pandemic on the mental health of carers of people with intellectual disabilities

Journal of Applied Research in Intellectual Disabilities

Introduction: The measures implemented to manage the COVID‐19 pandemic have been shown to impair mental health. This problem is likely to be exacerbated for carers. Method: Informal carers (mainly parents) of children and adults with intellectual disabilities, and a comparison group of parents of children without disabilities, completed an online questionnaire. Almost all the data were collected while strict lockdown conditions were in place. Results: Relative to carers of children without intellectual disability, carers of both children and adults with intellectual disability had significantly greater levels of a wish fulfilment coping style, defeat/entrapment, anxiety, and depression. Differences were 2‐3 times greater than reported in earlier pre‐pandemic studies. Positive correlations were found between objective stress scores and all mental health outcomes. Conclusions: Despite their greater mental health needs, carers of those with intellectual disability received less social support from a variety of sources. We consider the policy implications of these findings.

Last updated on hub: 14 October 2020

Upholding rights and valuing voices: advocacy principles for coronavirus and beyond

National Development Team for Inclusion

These operating principles seek to make sure that people who use social care and health services during and beyond the Covid-19 pandemic are heard and listened to, recognising the essential role of advocacy in supporting people. The coronavirus pandemic has shone a light on and exacerbated inequalities – effective advocacy is ever more important as a tool to make sure that people’s voices are heard, inequality is addressed, and rights are respected. These principles supplement the advocacy charter but do not seek to duplicate or replace it. They sit between the high-level principles of the charter and more detailed guidance and practice requirements (including the Advocacy Code of Practice). The principles are: 1. Make sure that people are heard, and their rights are respected; 2. Communicate effectively and safely meet with people in person; 3. Make sure that people can access advocacy; 4. Take positive anti-discrimination action; 5. Work together to promote systemic change.

Last updated on hub: 13 October 2020