ABC Model Covid-19

            THE ABCDE MODEL

How to manage stress and anxiety about corona virus

Normalize feelings of stress and anxiety   We should discuss with patients that all of us can expect to feel some stress and concern about the corona virus situation and the uncertainty surrounding it. Accept that there is STIGMA with those who contract it. Always “normalise” this and encourage accepting it rather than trying to deny it. The situation is definitely stressful for all of us and we should acknowledge this with our patients.   Encourage patients to maintain their daily routine as much as possible   This is a standard recommendation for stressful times and applies to the corona virus situation as well. It’s probably not helpful to spend all day talking about the corona virus or watching news about it. We should encourage patients to maintain as many of their normal activities as possible. For example, if they can’t go to the gym, they should exercise at home. If they are visiting friends and family less often, they should call some of their friends and family every day.   Implement Cognitive Behavioural Therapy   Follow the simple an effective ABCDE methodology with your clients to address the anxiety and stress they are experiencing.   Make time for fun and relaxation   Each person has something they do for fun and relaxation that works for them. In this crisis we should encourage our patients to fall back on things that have worked for them in the past. This may be watching a movie or show, listening to music, cooking and so on.   Talk to their children about it as well   Parents should realize that during times of stress, children are more attached to their parents and demand more attention, and this is normal (World Health Organization, 2020). Just like other issues we should recommend that parents should discuss the issues related to corona virus- including the specific child’s questions and concerns- instead of avoiding the topic.  

ABCDE- ADVERSITY, BELIEFS, CONSEQUENCES, DISPUTE, EFFECT OROUTCOME

ADVERSITY

COVID-19 is the event that triggers this

BELIEFS

What are your thoughts around Corona virus? Is it out of control? Chaos? Is it spreading rapidly? Does everyone who is infected die from it? Will I definitely get it?

CONSEQUENCES

Introspect and begin to understand your thoughts and beliefs around COVID- 19 and how they are impacting your daily life. What results from these thoughts- anxiety, stress, sleeplessness, anger, helplessness? Are you tired, worn-out, getting physically sick and putting your health at risk?

Ask yourself-

  1. Are these thoughts useful to you?
  2. Is it beneficial to have these thoughts?

DISPUTE

If the consequences of your thinking are useful to you and serve a constructive purpose, then keep these thoughts and move on.

If the consequences of your thinking are negative and not constructive, then dispute your beliefs.

How to dispute your thinking- ask yourself:

  1. Evidence- what evidence is there that my thoughts are accurate?
  2. Alternatives- are there alternatives that could be substituted
  3. De- Catastrophize- Some of our clients may engage in “catastrophizing” about corona virus. Some of them may overestimate both their chances of them getting the infection and of serious consequences from it. On the other hand, they may underestimate their ability to take precautions and to deal with.
  4. How much control do you really have? – To limit anxiety, we should encourage our patients to focus on what they can do to reduce the risk to themselves and their families. So, it may be helpful to ask what measure they are taking to mitigate the risk. This may reinforce to patients that they are doing all the right things that are being recommended by infectious disease experts.

EFFECT OR OUTCOME

Energized with reduced anxiety

Face to Face Sessions

There are many simple steps you can take based on existing advice, such as:

  • Practice social distancing. Keep at least one metre away from clients (ideally two metres for extended periods, i.e. over 10 minutes). Avoid hand-shaking or other physical contact.
  • Wash your hands thoroughly before and after each client.
  • Regularly disinfect door handles, hand-rests of chairs, computers, laptops, phones, writing implements etc. between clients.
  • Make sure tissues are available to clients (if they weren’t already) so they can practice the mantra “catch it, bin it, kill it”. Pre-divide tissues into batches so that you can provide clients with their own portion- don’t have one central box of tissues that could become contaminated.
  • If you provide a bin for tissues, make sure it is emptied between clients and use appropriate measures to prevent yourself from coming in contact with the contents- or ask clients to take their tissues home and dispose of themselves.
  • Air out the consulting room where possible by opening windows etc.
  • Use your judgement; if you have any doubts about your own health or that of your client, take the appropriate steps. This may include self-isolation, sign-posting clients to resources and notifying other individuals who may have been in contact with (or who may be affected).