Mark A. Stebnicki - Counseling Practice During Phases of a Pandemic Virus

The pandemic risk and resiliency continuum (PRRC) theoretical model can be used for identification, early intervention, prevention, and preparation for therapeutic interventions with individuals and groups during phases of a pandemic virus. The model has practical applications within the psychology, counseling, disaster mental health, and allied helping professions. The PRRC model has been reviewed and critiqued by a panel of eight experts in disaster mental health response, epidemiology, medical and psychosocial aspects of illness and disability, and applied behavior science. A primary supposition is that individuals exhibit a range of mental, behavioral, and psychosocial responses and adaptations during pandemic disasters on a continuum from excellent to poor resiliency and from low to extreme risk. The PRRC model is divided into two separate models—risk and resiliency—measured on a continuum. Five-level scales of risk and resiliency are used, and each level encompasses the categories of mental, behavioral, psychosocial, and medical/physical health.

The first model of the PRRC model assesses resiliency factors during a pandemic virus and is rated on the following Resiliency scale:

At Level 5, the person has excellent mental, behavioral, and psychosocial health. The individual has a rational and healthy respect for the seriousness, lethality, and consequences of a pandemic virus. The individual presents no irrational fears or anxieties around a pandemic virus despite exposure to trigger events (e.g., media reporting of positive novel coronavirus [COVID-19] cases, COVID-related illnesses and deaths, school and workplace closures). Clinically significant psychological/emotional symptoms and conditions are dealt with in a therapeutically healthy and normal manner. Individuals at Level 5 are stress hardy. They have the innate ability to bounce back from adversity. They endorse public health principles, practices, guidelines, and government mandates associated with a pandemic disaster. They view good virus hygiene and adherence to public health guidelines as essential to the protection of themselves and others and get vaccinated, wear a mask, wash their hands, and keep a social distance. The person lives life with excellent balance, adaptation, and adjustment in relation to their changing pandemic environment. The individual responds empathically to the grief, loss, and extraordinary stressful and/or traumatic events associated with a pandemic virus. They balance the reality of a pandemic disaster with other life responsibilities and make choices to thrive, rather than just survive, during the pandemic disaster. The person’s overall mental and physical well-being is demonstrated by consistent attempts to achieve optimal levels of wellness and resiliency. The person finds existential meaning and solace regarding their life and others in their environment amid a pandemic disaster. The mental, behavioral, psychosocial, and medical/physical health of the individual at Level 5 is demonstrated by the following.

Person is extremely resilient, with a high degree of psychological adjustment in dealing with critical life events and major life stressors (e.g., job loss, the death of a family member, divorce, personal illness, injury, disease, disability). Person takes therapeutic responsibility for any mental health symptoms and conditions. They demonstrate positive optimism and an excellent balance of mood, emotion, affect, and rational thinking. Person can handle daily life stressors with excellent coping and resiliency skills. Person transitions exceedingly well through the phases of a pandemic disaster, cultivating new meaning, personal growth, hardiness, and self-care.

Person has a well-balanced life and maintains a healthy routine of virus-related hygiene habits following public health guidelines. Person has high regard for self and others concerning social distancing, stay-at-home orders, and other good virus hygiene. Person engages in regular exercise, has proper nutritional intake, demonstrates healthy patterns of sleep and rest, maintains virus-adjusted recreational activities, and exhibits excellent overall daily functioning. Person is perceived by self and others to be highly focused, motivated, and goal oriented. They are observed by others taking personal responsibility for living in positive optimism. Person is high in social-emotional intelligence, demonstrates excellent interpersonal communication skills, demonstrates empathetic concern for others, is action oriented, is a contributor, and has a collectivist ideology as opposed to a self-absorbed lifestyle.

Person has exemplary functioning in a wide range of life areas, such as academics, job, career, and economic stability. Person exhibits excellent social and familial connections. Person is self-motivated and highly engaged in clubs, organizations, religious/spiritual life, and recreational activities. Person has an excellent balance of home, work, academics, and social life. Person exhibits excellent adaptation and adjustment to a pandemic disaster despite any personal medical, physical, psychological, behavioral, financial, or occupational challenges or challenges with independent living, environmental functioning, and/or functional capacity.

Person is medically and functionally stable and can take care of any existing medical/physical health conditions. Regardless of illness, disease, or disability, Person takes personal responsibility for their medical, physical, behavioral, mental, and psychosocial health by using support systems, resources, and technology to live life in optimal wellness.

At Level 4, the person has very good mental, behavioral, and psychosocial health. The individual has a rational and healthy respect for the seriousness, lethality, and consequences of a pandemic virus. Although some individuals experience and react with irrational fear and anxiety to a pandemic virus, the person recognizes and applies strategies to limit their exposure to trigger events (e.g., media reporting of positive COVID-19 cases, COVID-related illnesses and deaths, school and workplace closures). Clinically significant psychological/ emotional symptoms and conditions are dealt with in a therapeutically healthy and normal manner. The individual exhibits stress-hardy behaviors, although it may take them longer to bounce back from adversity compared to individuals at Level 5. Individuals at Level 4 endorse public health principles, practices, guidelines, and government mandates associated with a pandemic disaster. They view good virus hygiene and adherence to public health guidelines as essential to the protection of themselves and others and get vaccinated. They frequently wear a mask, wash their hands, and keep a social distance, although they may take slightly more virus hygiene risks than Level 5 individuals. Individuals at Level 4 live life with excellent balance, adaptation, and adjustment in relation to their changing pandemic environment. The individual responds empathically to the grief, loss, and extraordinary stressful and/or traumatic events associated with a pandemic virus. They balance the reality of a pandemic disaster with other life responsibilities and make choices to thrive, rather than just survive, during the pandemic disaster. The person’s overall mental and physical well-being is demonstrated by consistent attempts to achieve optimal levels of wellness and resiliency, although not to the same degree as individuals functioning at Level 5. Persons at Level 4 find some existential meaning and solace regarding their life and others in their environment amid a pandemic disaster. Although adjustment and adaptation to the overall effects of a pandemic virus are not as seamless as in individuals at Level 5, Level 4 individuals recognize how to correct their path to overall health and well-being. The mental, behavioral, psychosocial, and medical/physical health of the individual at Level 4 is demonstrated by the following.