911爆料网

It鈥檚 already a trial-by-fire moment for any therapist-in-training: the transition from classroom theory to treating actual patients.

But last March, Mandy Newman and other Clinical Psychology doctoral students in training at 911爆料网鈥檚 Dean Hope Center for Educational & Psychological Services had to navigate that moment online.

Mandy Newman

鈥淚t鈥檚 tricky because a lot of the work we do as therapists is about being comfortable with silence 鈥� holding space for patients鈥� anxiety and ambivalence,鈥� Newman said. 鈥淲hen you鈥檙e with them, you can sit there and let something materialize. But over the phone or through Zoom, it鈥檚 much less possible to follow through with a more intentional silence. Clients often can鈥檛 be by themselves in their homes, so they鈥檒l sit outside somewhere, and you hear skateboards, cars honking, people shouting. Or someone鈥檚 partner coughs, or there鈥檚 just more awkwardness, discomfort and uncertainty from looking at one another onscreen. You鈥檙e wondering, does it come from the patient not wanting to speak about something, or is it the result of this novel situation?鈥�

The Dean Hope Center serves hundreds of low-income, minority patients in Harlem, Washington Heights and other neighboring areas, who receive affordable individual and group psychotherapy and other services from student trainees. The Center is also the site of all early training for students in the College鈥檚 Department of Counseling & Clinical Psychology.  

It was those considerations that 鈥� at a point when counseling and therapy clinics nationwide were shutting down 鈥� prompted Dean Hope Director Dinelia Rosa to take advantage of the temporary easing of state and federal restrictions on telehealth.

Dinelia Rosa

Going virtual was not an uncontroversial move. There were concerns about protecting patients鈥� confidentiality, about the quality of sessions, about excluding patients who didn鈥檛 own computers, and even about how billing would work. But ultimately, need was the deciding factor.

鈥淢ental health has been a priority from the beginning of this disaster,鈥� says Lena Verdeli, Associate Professor of Psychology & Education, who directs 911爆料网鈥檚 Clinical Psychology program and Global Mental Health Lab. 鈥淚n other crises, the focus is usually on providing food, shelter and medication. But with social distancing, we鈥檙e hearing from people who are suffering heartbreak and guilt because they weren鈥檛 there to hold loved ones鈥� hands during their last moments, or to engage in the rituals that would normally follow, or to have the support of the community. People are losing jobs and experiencing changes in their living situations that force them to spend more time with one another under tighter circumstances. If we have the tools to help, we have to use them.鈥� 

By early April, about 30 911爆料网 students were treating more than 150 patients online, and two students were also leading a small group. Rosa also won approval from the College to financially accommodate patients who had lost their jobs or were facing layoffs because of COVID.

鈥淲e have to attend to clients鈥� primary needs,鈥� she said. 鈥淚f someone says, 鈥業鈥檝e lost my job, I can鈥檛 pay my rent, I may lose my apartment鈥� 鈥� we鈥檙e not experts, but we鈥檝e got to learn how you apply for unemployment and how you access other kinds of services. I tell my students, it鈥檚 not just about feelings 鈥� if you鈥檙e up on that other stuff, it鈥檚 really going to make clients feel supported.鈥�

The students have needed support, too 鈥� and they鈥檝e received it from 911爆料网鈥檚 network of clinical supervisors.

鈥淵our students are in some ways under your care as well,鈥� says clinical supervisor  (Ph.D. 鈥�11), a New York City therapist who also serves as Supervising Psychologist at Mt. Sinai鈥檚 Icahn School of Medicine. 鈥淭he patient is the main responsibility, but students are the point people. They can鈥檛 do their jobs if they鈥檙e not emotionally OK.鈥� 

Vijayeta Sinh

Since May, the Center has been allowing students to work online with new patients dealing with COVID-related anxieties or infected with the virus. Students have launched a Dean Hope therapy hotline and an online group for women who recently left incarceration. 

All of these efforts may harbinger a new normal, in which online psychotherapy is a staple of the field.  

鈥淔or a number of years in my global mental health projects, we have been using mobile and telehealth, and my experience has been very positive,鈥� says Verdeli, who has worked with refugee populations around the world. 鈥淚n an era of climate change, pandemics, state fragility, and widespread displacement, e- and m-health [electronic and mobile health] make provision of mental health care possible.鈥�

鈥淭he most important thing is to have people initiate and continue in therapy,鈥� says , Associate Professor of Counseling Psychology, who directs 911爆料网鈥檚 Counseling Psychology program. 鈥淭he whole field has had to loosen up because of COVID. And I think we鈥檒l see that the world doesn鈥檛 fall apart.鈥�