What we can do to ease the burden of the pandemic as helping professionals.

The global pandemic has come with many lessons and has exposed many areas of unpreparedness within systems and the helping professions. Working through my internship during the pandemic has exposed me to the great deal of distress and frustration struggling with impossible seeming situations. My student peers and professionals alike reflect a heartbreaking strain, as the agencies they work for and systems designed to help our clients and vulnerable populations fall short, become inadequate, or worryingly might contribute to psychological harm, amid social distancing and confinement restrictions.

Over the year, I have heard stories and experiences about many of these struggles. One classmate interning at a domestic violence shelter for example, shared her experience about the distress of their client population. This is a population transitioning from the trauma of violent, controlling, abusive relationships now stuck in the predicament of a similar feeling situation. Their activity and mobility are restricted, they are confined to their rooms. Normal operations and interventions in an environment designed to empower and start the healing process have been disrupted. Clients, as well as emphasizing Social Workers and Therapists feel frustrated, stuck and powerless.

In agencies and institutions across the country, problems and concerns seem everywhere. And the question on everyone’s mind as helping professionals seems to be “Amid these restrictions, what can we pragmatically do or be doing to better serve our clients?”. This is a particular area of research I have been doing with my internship and the purpose of this article is to share and explore some initial key points and insights that help answer this question.

The frameworks and method of intervention in the helping professions as the general rule are client centered. Focusing on the individual we seek to empower them. Using a “person in environment” model with a client agency cultivation centered approach makes a great deal of sense for intervention design. Even when focusing on the macro level, I believe it’s fair to say the “environment” is primarily focused on through the context of the individual themselves.

There is nothing wrong with these models or way of thinking and working with clients. A mountain of evidence based practice and research supports the efficacy of this approach. My argument here is not against this practice, merely that this perspective and approach leaves our field limited in tools to address the challenges of long term macro level crisis like the pandemic presents. An empowerment, personal agency centered approach becomes impotent in the face of global restrictions and universal crisis.

While we can advocate for better self care practices; a clients agency is still held hostage by policy and restrictions. No amount of individual motivation is going to alter the physical reality and constraints of the situation. Placing such a high amount of expectation and accountability on the individual, as we would normally do in solving problems and improving a client’s existence simply is not enough in this situation.

When we invert our way of thinking from a client focused one to a more environmentally focused one, a great deal of tools and evidence to base our practice presents itself. Rather than trying to fix our clients by default, we need to intervene in the real problem, the environment itself. Or more precisely the environment they occupy, one that in many settings we are responsible and have control over.

Environmental Psychology can loosely be described as the study of transactions between individuals and their physical settings. Or more importantly for our utility, the perspective of “environment in person” over the “person in environment” framework. This inverted perspective offers some new angles and tracts to help solve; or at least ease the problems agencies and clients are facing. I present my initial findings researching interventions for these problems from an environmental sciences perspective.

Confinement and mental health.

There is a long standing correlation of negative mental health outcomes and a loss of mobility and independence (Haney 2003, Metzner & Fellner, 2013). While prisons are studied as closed systems and are ideal institutions to research for these effects, these mechanisms extend into other settings and contexts for other confined populations of concern. Such as nursing homes, shelters, and the enforcement of policy that increases control over the mobility and independence of populations under their care.

Therefore any intervention aimed to minimize the negative effects of these policies must also consider or be rooted in addressing core factors/issues confinement presents. The perceived lack of freedom and frustration clients face in these systems is compounded by a lack of mobility and independence. So intervention should be focused in the spirit of increasing freedom of mobility and autonomy within confinement as much as possible. Policies should be of benefit to client populations if they are formed with 3 key sensitivities in mind.

• Minimizing restrictions on mobility as much as possible.
• Maximizing client’s autonomy and ability to make choices.
• Limiting the perception/experience of being overly controlled by institutional systems and authority.

The Impact of the environment on psychology.

Physical environment has a profound impact on our mental state. Something as simple as lighting for example, and its positive and negative effects is so important an entire issue of The Journal of Environmental Psychology is dedicated to its impact on our psychology (Veitch, De Kort, 2014). We also can be informed by and utilize research directed at easing environmental stressors in the design of hospitals and similar institutions (Ulrich, Bogren, Gardiner, Lundin, 2018). What follows is a list of recommendations for deliberate modification of the environment to intentionally ease environmental stressors inspired by these works.

• Maximize natural light sources. Studies show bright, full spectrum natural light is psychologically beneficial. While dim, poor or fluorescent lighting creates a detrimental environment for those exposed to it for extended periods of time.

• Reducing crowding stress is beneficial. Which on the surface seems like not an issue given social distancing mandates, could also be deceptive. While people may be further apart, the space they take up has increased by 6 feet. Making navigating a room with even a few people feel as hazardous and awkward as navigating a crowded room. Changes that facilitate the flow of human traffic and make navigation easier to negotiate will hypothetically quell the stress of uncertainty when traveling through these spaces.
• Accommodating or creating room for occupants to privatize space, or seek privacy. People need to be able to feel they can retreat and be alone when they need to be.

• Avoiding fixed seating in communal spaces may also be of benefit, as this allows users to customize space to their needs. Be it communication while respecting the social distancing gap, or simply to make best use of space as a whole to work within the situation and accommodate others effectively. This empowers a sense of control over ones environment and ability to manage their situation and accommodate those around them.
• Limiting exposure to uncontrollable, loud, or unpredictable noise or the amount of it in spaces.
• Exposure to nature and daylight. This can take the form of open windows, gardens and living house plants And fish tanks, sculptures and art that depict or impress a theme of nature. All are found to be significantly successful stress reducing therapeutic environmental hacks.

• The use of clean, white spaces is promoted. An easy and cheap hack that will provide a large impact is fresh white paint in some of the more worn areas clients and staff alike may occupy for example.

It is my hope these suggestions encourage looking at these problems in a different way. When asking ourselves the question “What can we do to help this situation?”, it may be prudent to take our cue from the millions of Americans who have flocked to hardware and home improvement stores like Lowes, and Home Depot over the course of the pandemic. In researching how the environment impacts psychology I theorize that this boom in home improvement activity is about more than people simply finding themselves with the time to do home improvement projects. And that people instinctively are modifying their physical environments to cope and ease stressors. As helping professionals it may be time we take our cue from this trend and do often cheap and simple modifications to our clients and work spaces as well; while using environmental psychology as our guide.

References

Haney, C. (2003). Mental health issues in long-term solitary and “supermax” confinement. Crime Delinquency 49, 124–156. doi: 10.1177/0011128702239239

Metzner, J. L., and Fellner, J. (2013). Solitary confinement and mental illness in US prisons: a challenge for medical ethics. Health Hum. Rights Chang. World 316–323.

Ulrich, R., Bogren, L., Gardiner, S., & Lundin, S. (2018, May 21). Psychiatric ward design can reduce aggressive behavior. Retrieved January 12, 2021, from https://www.sciencedirect.com/science/article/pii/S0272494418303955?via%3Dihub

Veitch, J. A. Ed., . De Kort Y. A, Ed. (2014). Light, lighting, and human behaviour (1149866228 864657655 ). Journal of Environmental Psychology, 39(September), 1–108. doi:https://www.sciencedirect.com/journal/journal-of-environmental-psychology/vol/39