COVID-19 feminist framework and biopsychosocial-spiritual perspective for social workers and mental health practitioners to manage violence, abuse, and trauma against children, women, BIPOC, and LGBTQIA+ during and post-COVID-19

Abstract

This article explains the integrated implementation of a COVID-19 Feminist Framework (CFF) and biopsychosocial-spiritual perspective (BPSS-P) on the inclusive equitability of social service providers, practitioners, and policy-developers on global platforms. Mechanisms of CFF and BPSS-P entail the process to address/mitigate institutional inequities, mental health issues, violation of human rights, race/sex/gender-based violence, abuse, and trauma amid COVID-19. This discourse is about raising consciousness, collective liberation, wellbeing, and equality for women, children, BIPOC, LGBTQIA+, and gender-diverse people. This article further discusses social workers and mental health practitioners’ uniqueness for short-term and long-term support for emotional, cognitive-behavioral, and psychosocial repercussions on the individual and community levels.

Introduction

The COVID-19 (Coronavirus Disease 2019) outbreak has brought many systems to the brink of collapse – political, social, educational, socioeconomic, environment/climate, and healthcare. Human rights and their fundamental principles including universality, inalienability, interdependence, indivisibility, equality, non-discrimination, non-derogation, and accountability are unwarranted in the response to COVID-19 alongside collective rights of indigenous people, racial and ethnic minorities, migrants, displaced and refugees, labor rights, elderly, people with disability, BIPOC, LGBTQIA+ (lesbian, gay, bisexual, transgender, queer and/or questioning, intersex, and asexual and/or ally), people living in low socioeconomic conditions, and people who are in detention, incarcerated, and institutionalized. How the pandemic is defined, what is expected from individuals, communities, the state, and civil society to meet those challenges, and what future population will emerge all seem far from certain. The following sections discuss the impact of COVID-19 on vulnerable groups; proposes a framework to manage that impact via the biopsychosocial-spiritual perspective (BPSS-P) to integrate that framework; fear factors behind perpetuation and vulnerability; and social workers and mental health practitioners’ uniqueness in managing the said issues.

Differential impacts of COVID-19 operate on intersectional gradients possibly resulting from marginalization, which reflects historic inequalities and differential risks that should be at the front and center while addressing radicalized, marginalized, and vulnerable people. Marginalized groups are being disproportionately affected by COVID-19 – intensified burdens of care with amplified violence against minorities. This is striking as approaches to manage the pandemic have relied profoundly on an extended role of care and unpaid work – all manifested areas in feminist philosophy and activism (Mukhtar, 2021a). COVID-19 seems to have paved the way further for an intensification of xenophobic, anti-feminist, neoliberal, and authoritarian-populist politics.

Natural disasters and public health crises have racial and gendered dimensions that have been overlooked by socio-politico-economic domains and sustainable development goals demonstrated across disciplines. There is a paucity of rigorous studies on the estimated increase in reporting of violence against women and children (VAW/C) during and post-pandemics/epidemics; however, media reports and anecdotal evidence are widespread. For instance, the collateral damage during the Ebola outbreak of the ‘epidemic’ of ‘rape, sexual assault and violence against women and girls’ remained undocumented (Yasmin, 2016). Ebola in Africa resulted in severe and long-term gendered impacts for many young girls and women: girls dropped out of schools, teenage-pregnancy rates increased, domestic and sexual violence was exacerbated, women’s reproductive health was jeopardized, and the mortality rate increased due to obstetric complications (Lewis, 2020; Marindo, 2017). The Zika epidemic in Latin America worsened gender issues with a lack of reproductive rights for women amid the crisis (Velez and Diniz, 2016). In the current COVID-19 pandemic, there are reports from Australia, Brazil, Pakistan, India, China, and the United States that suggest an increase in VAW/C. In China, police stations filed a total of 162 case reports of intimate partner violence (IPV) and gender-based violence in February 2020, which is three times higher than that in February 2019 (Wanqing, 2020). Globally, one in three women has experienced some form of violence by an intimate partner in their lifetime (Devries et al., 2013). The most common form of violence against women is domestic violence; the more specifically perpetuated domestic violence is IPV and the most common perpetrators are male intimate partners (Heise and Ellsberg, 1999; Kaur and Garg, 2008). In the European countries, 19.3 percent of women have experienced IPV in their lifetime (Devries et al., 2013). IPV can be physical, sexual, emotional, coercive and controlling behavior, and economic and financial control that has long-term impacts on physiological and psychosocial health (Campbell, 2002; Muelleman et al., 1998).

There are also profound consequences for children who witness IPV, with a higher rate of emotional-behavioral problems and increased likelihood that they will either experience or perpetrate IPV as adults (Capaldi et al., 2012; Gibbs et al., 2020). Since the COVID-19 pandemic, health emergencies, and quarantine periods, 15 million cases of gender-based violence for every 3 months of lockdown are expected (UNFPA, 2020). The reasons for increased VAW/C during COVID-19 could be broadly threefold: (1) COVID-19-related restrictions seem to be associated with negative emotions (frustration, aggression), problematic coping strategies (alcohol consumption as coping mechanism for boredom), and mental health concerns (increased stress); (2) quarantine restrictions lead to increased exposure to perpetrators, decreased social support, and facilitates perpetuators’ tactics of isolation and control; and (3) the COVID-19 pandemic leads to more financial distress, which is associated with increased likelihood of IPV (Capaldi et al., 2012; Schneider et al., 2016). Although the global legal framework declares equality and safety, deep-rooted discrimination and gendered power imbalance have been exacerbated. Cultural constructs of femininity and masculinity in the context of COVID-19 are reflected through non-institutionalized and non-assumed gender by challenging hegemonic masculinity (by endorsing re-embodied masculinity) and resisting emphasized femininity (by endorsing non-conformist femininity).

COVID-19-related lockdowns have landed women where they are defined by the ‘traditional’ responsibilities which have reinforced the deeply rooted gender disparities and the vulnerability of women’s nascent gender identity. Some of the undocumented issues that women have faced during this pandemic include violence, mobility, reproductive health, issues of pregnancy and maternity, economic dependence, girls’ education, and women workers’ rights. A lack of already existing bodily autonomy and reproductive choice coupled with restricted mobility leaves women vulnerable to unwanted pregnancies (unwanted sex and transactional sex) and complications, especially for younger women and child brides. China is expected to witness the birth of 13.5 million babies since COVID-19; India takes the lead with 20.1 million pregnancies after the virus outbreak and an estimated 116 million babies will be born in India after COVID-19; while Pakistan stands at 4 million, Nigeria at 6.4 million, and Indonesia at 4 million statistical data according to the UNICEF (2020) report. One in three women of reproductive age have experienced physical and sexual IPV and more than a third of female homicides are due to IPV (Devries et al., 2013; Stockl et al., 2013).

Women, children, sexual, and gender minorities (LGBTQIA+), ethnic minorities (BIPOC [Black, Indigenous, and people of color]), and gender-diverse people have been disproportionately impacted by the pandemic outbreak as COVID-19 has become a crisis for feminism. Marginalized groups including minorities and people of color are particularly vulnerable during the pandemic due to stigma, discrimination, and racial socioeconomic injustices (Mukhtar, 2020a; Vigo et al., 2020). Ethnic group minorities are at even greater risk of complications due to unreachable healthcare systems (Mitja et al., 2020) and thus the need for social workers to strengthen their work on anti-oppressive frameworks, equal human rights, and social work advocacy to emancipate individuals from oppression and social injustices manifested by COVID-19 is critical. Underlying structural racism and injustice will exacerbate difficulties for these groups (Dyer, 2020; Mukhtar, 2020b) and thus a call for action for feminism. Feminism is about raising consciousness, freedom, collective liberation, bodily autonomy, equality, and giving every person the freedom to make choices to promote a sense of greater control over their own lives. The gendered dimension of this crisis applies at the workplace, public places, and within homes where the gendered division of unpaid care labor is still demonstrable disproportionality around the globe. Apart from the disproportionate division of home-labor and precarious working conditions (safety violations without proper personal safety equipment), there the risk of surging pandemic-related abuse, violence, and trauma perpetuated against women by abusive intimate partners and family members. Women carry a different kind of COVID-19-related burden, from childcare and elderly care to household work, as inequities disproportionately impact their wellbeing during lockdowns. VAW/C is growing with increased domestic violence, overtaxed health services, the overlooking of women’s sexual and reproductive health services and prenatal and postnatal care, compromised economic resilience, and exacerbated gender inequities. In this time of crisis, existing inequality and inequity are already seeing an emergent need to address gender-based issues, feminist perspectives, and mental health concerns. Feminism during and post-COVID-19 will need advocacy, organized efforts, robust programs, support and networks, safety and security, and solidarity for all women not just in times of crisis but beyond that as well.

COVID-19 Feminist Framework

The COVID-19 health crisis has far-reaching impacts on basic human rights, healthcare, psychosocial functioning, mobility patterns, workplace flow, public security, and gender-responsive operationalization. Amplified humanitarian care, social, health, economic, and political discourse has barely laid the structural injustices and inequalities that are deeply ingrained across societies and systems and that have been feeding on exploited women’s rights. Furthermore, exclusion, stigmatization, marginalization, hate speech, xenophobia, racism, sexism, and prejudice could be intersecting responses of inequities-interlinked multilayered crises within systems.

Studies (Mukhtar and Rana, 2020; Rana et al., 2020) so far have predicted a surge in psychosocial problems, including interpersonal violence, posttraumatic stress symptoms, boredom, ambivalence, addiction, medical mistrust, inclination toward conspiracy theories, and misinfodemics (rumors, conspiracy theories, myths, superstitions, misinformation, disinformation, and false information) and other mental health concerns (Mukhtar, 2021b). Drawing on the author’s research, experience, and practice at shelter homes for women and children and counseling-psychotherapeutic services, a framework is delineated below that incorporates strategic and premeditated perspective/resources and could become a blueprint for a wide range of intersectional feminist-informed pandemic responses for researchers, health practitioners, social service providers, and decision-makers.

The COVID-19 Feminist Framework (CFF) analysis is the systematic empirical inquiry of biopsychosocial relations to adjust the cognitive-behavioral and mental health inclusive response to address the inequities during and post COVID-19. The mechanism of CFF entails the process to address and mitigate gendered/racial inequities; violation of human rights, education, health, and labor force participation; time use and mobility; financial empowerment; and gender-based violence during and post COVID-19. The CFF includes the following:

• Ensuring basic human rights;

• Awareness of risk, recognition, access, and reporting of violation of basic human rights;

• Sexual and reproductive rights;

• Access to help, healthcare, information, and technology;

• Sex-disaggregated epidemiological mortality and morbidity data and statistics of COVID-19;

• Mitigate stereotyped xenophobic stigmatization of marginalized communities;

• Identify, question, and challenge gender-based roles at home or at work;

• Re/distribute unpaid domestic and care work and proportionate needs and priorities for caring of sick at informal and formal setups;

• Social and cultural factors in pandemic outbreak;

• Restrained gendered-based violence, abuse, and trauma;

• Equitable gender-neutral decision-making and policy development (regardless of age, race, ethnicity, economic status, geographical status, religion, migration status, sex, gender, sexual orientation, gender identity, and others); power; and political dynamics (roles, responsibilities, and opportunities);

• Implement gender-friendly strategies at individual and collective levels.

Social workers and mental health practitioners in both developmental and clinical practices could advocate against stigma and discrimination. Furthermore, this calls for strong antiracism laws implemented through the responsiveness of law enforcers and efficacy of the criminal justice systems. The professions of social work and mental health advance the values of human dignity and individual uniqueness together with positive regard. Mental health social workers are advocates who can work toward better living conditions of marginalized groups (McLaughlin, 2009). Social service providers in the hospital setting could participate in policies that address equal access to health services and oppose inhumane practices that worsen health inequalities.

The gender–race-sensitive framework recognizing work outside of paid employment should be developed with a feminist perspective. The impact of the pandemic on marginalized groups will be drastic, since quarantine and social distancing will be challenging while living with perpetrators and abusive partners. Efforts to mitigate IPV, male violence against women, domestic and sexual violence, violence against children, abuse, trauma, and other forms of disparities should be prioritized. It is difficult to overstate the scale of coronavirus-related problems, especially for those who are subjected to abuse, violence, and trauma of all kinds. The pandemic crisis cannot be used as an excuse to limit equal rights, women’s reproductive healthcare, maternal and child health, economic empowerment, unpaid labor, women’s educational and career prospects, and expanded choice. Global crisis, economic instability, civil unrest, and pandemic disaster provide the enabling environment that may exacerbate or spark diverse forms of violence, especially violence incited by race and gender. There are some pathways that are linked with multiple forms of violence and abuse proposed by CFF:

• (a) Quarantine and social isolation;

• (b) Economic instability and low socioeconomic status;

• (c) Impact on mental health;

• (d) Disasters, violent conflicts, pandemic-related uncertainty;

• (e) Decreased health service availability;

• (f) Multiple sources and forms of violence;

• (g) Inability of abuse victims to escape perpetrators and their exposure to violence and coercion in response efforts.

Understanding the framework of racial and gender equality: the underlying predisposing, precipitating, perpetuating, and protective mechanisms; the magnitude of the problems; and intervention-response action, is important to mitigate the adverse impacts of COVID-19 on equality and equity. Mental health practitioners (advocates) and social service providers could initiate awareness campaigns, hotlines, crisis centers, shelters, and legal aid and engage men and boys to challenge underlying patriarchal power inequalities, stereotyped attitudes, gender-based societal norms, and the community accountability approach. Community social workers and mental health practitioners could provide interventions for helping and educating people to cope with psychological distress (Mukhtar and Mahmood, 2018). The most likely effective measures taken to reduce the impact of violence, abuse, and trauma among individuals and communities are to start a campaign, create online support, create more funding for alternative accommodation and support for victims, and use of a code word.

BPSS-P

The BPSS-P in this framework could be highly applicable in social work and other social sciences. This perspective is specifically connected to social work because the profession is inherently concerned with an individual (biological, spiritual, and psychological factors) in the social (environmental) perspective. Dynamic interpersonal, physiological, and psychological systems interact with the contextual factors to shape an individual over their life span (Harkness, 2011; Lehman et al., 2017).

The anxiety of contracting and susceptibility is not only related to coronavirus but also with the embrace of false claims and hostile attitudes toward others, which in turn amplify fear and anxiety. The availability bias only accentuates self-perpetuating critical thinking and decision-making and as a result people interpret events in a threatening way. Emotions could also impair the perception of assessing risk and since knowledge of COVID-19 is still evolving, so uncertainty and unpredictability could be attributed to perceived external locus of control (Mukhtar, 2020c). Corona-related anxiety could be a product of miscalibrated emotion and misinformation.

Our brains are hardwired to automatic, unconscious survival responses to threats through fight, flight, fright, or freeze. This phenomenon explains mass panic attacks during public gatherings where fear that is triggered from unverified sources of terror ends in tragedies. In addition to information about socially transferred fear, information about safety and tolerance should be delivered. During stress, details and nuances are hard to process and partial or misinformation could increase uncertainty while uncertainty augments fear and anxiety. In the end, no one can control every single risk in life and live a meaningful, reasonable, and productive life simultaneously.

The psychosocial-spiritual impact of the COVID-19 pandemic is mediated by people’s perceptions. COVID-19 has witnessed two seemingly prevalent psychological factors: avoidance or worry. For instance, in the case of denial and avoidance possibly due to the fear of quarantine, people are resisting; and people who are worried and anxious misinterpret their bodily sensations as symptoms of novel coronavirus. Many factors contribute to the mental health, wellbeing, resilience, coping, psychological and social wellness, psychosocial functioning, and quality of life, including the unpredictability of this illness, lockdown measures, interpersonal issues, social dysfunctioning, emotional and behavioral issues, psychological problems, previously existing mental health issues, or proneness to getting affected with traumatic events have perpetuated predisposing and precipitating mental health factors (Rana et al., 2020). Psychological vulnerability and individual differences such as intolerance of uncertainty, chronic anxiety, and perceived vulnerability to disease play a crucial role in corona-related anxiety (Mukhtar and Mukhtar, 2020; Rana et al., 2021). Similarly, misconceptions, misinformation, and popular rhetoric about COVID-19 have been shown to incite fears, phobias, and violence. In this particular scenario, intervention for assessment and management of these aspects will be substantial.

The COVID-19 pandemic provides the opportunity to rethink social policies and health systems to approach vulnerable groups by adoption of BPSS-P planning, and thus increasing facilitation and diminishing barriers. To achieve the sustainable development goals and equity in access, a holistic approach is the key factor for global improvement. The pandemic provides opportunities to adopt a holistic perspective by investing in preventing inequities, promoting health literacy, and ensuring well-funded health and social protection systems. Therefore, fostering resilience, solidarity, and wellbeing of the whole society will be ensured.

Coronavirus versus fear of coronavirus

It can spread from one person to another, is contagious, independent of physical contact, and extremely dangerous – is the fear of it. COVID-19 has also witnessed the upsurge of fear and panic as the byproduct of unpredictability and uncertainty. Despite the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), and National Institutes of Health’s (NIH) information packages, people are drawn toward misinfodemics out of mistrust in the legitimized health systems, further inciting anxiety, fear, and violence. Regardless of all these repercussions, the lack of sensitization and awareness toward information in the general public is insubstantial. In this scenario, mental health practitioners and social service providers can play a significant role toward individuals, families, and communities. The impact lies in the magnitude, adversity, severity, intensity, novelty, and uncertainty of such scale, which has shaken the individual and collective sense of safety, security, stability, and solidarity.

As COVID-19 proliferates, two phenomena are largely at play: there is a pandemic of coronavirus and then there is a pandemic of the fear of coronavirus, which incites prejudice and violence. The media have exposed the attacks against Asians sparked by xenophobic stereotypes subsequently spreading panic and fear. Adding to the fuel are Internet conspiracy theories driven by personal or politically twisted motives bent on perpetuating misinformation and misconceptions (Mukhtar, 2021b). Fashioning conspiracy theories is a function of unsupported inexplicable sets of stories that provide a tentative personal opinion presented as factual reasoning.

Internalizing problems: ‘Am I immune to coronavirus?’

Many communities and cultures concoct their own sense of explanation of the events, like specific practices prevent ‘evil’, some food items cure diseases, reading certain words avert the sickness and the very notion that certain people are exempted from contracting coronavirus (‘we are immune to coronavirus’). Science, however, is a systematic enterprise of testable (consistent and repeated), rational (logical proof and positive evidence) and factual (completely substantiated) explanation of events. Everything beyond the premise of science falls under the category of ‘non-science’. These conspiracy stories are contradicting, orchestrated/ostentatious, negative, scandalous, perjured, insinuated, random, and euphemistic. Partiality toward these stories lies in the illusion of certainty, wishful thinking, and unquestionable conformity of norms. It poses difficulty in spotting misinformation online because of un-invested time to fact-check and actively seeking information that validates preexisting beliefs and elicits strong emotions. The psychological states triggered by rapid, unanticipated, and frightening experiences can often lead to clouded judgment by bias, prejudice, discrimination, irrational attitudes, stigma, and marginalization ascribing to the cause of the problem.

Externalizing problems: ‘You made me sick’

In the wake of COVID-19, numerous reports of stereotyped xenophobia directed toward the Chinese are astonishing; for instance, closing of Chinese restaurants, laid-off Chinese employees, and Chinese people barred from restaurants and cruise ships (Aguilera, 2020; Evelyn, 2020). A prime example could be the racialized rhetoric of COVID-19 as the Chinese Virus or Wuhan Virus or Kung-Flu, which incited mass-level discrimination, harassment, and violence against Asians. Many US respondents (32%) in a poll blamed the Chinese government for COVID-19 (Taylor and Asmundson, 2020). This infection-related social-identity xenophobia appears to be an unfortunately common response in previous pandemics/epidemics as well.

Social workers and mental health practitioners’ uniqueness

Social workers and mental health practitioners are uniquely equipped with knowledge, expertise, practice, eclectic perspective, integrative approach, cross-cultural framework, action research, and theory-practice brought together in a client-focused approach. For instance, humanistic psychologists believe that everyone has an innate capacity to grow emotionally and psychologically toward self-actualization and personal fulfillment. One of the branches of psychology is counseling psychology, which is a health service provider specialty in professional psychology that focuses on assessing, analyzing, and managing how people function and addresses the emotional, mental, psychological, social, work, academic, and physical health concerns at different stages in the lives of individuals, families, groups, and organizations to improve their sense of wellbeing, alleviate feelings of distress, and resolve crisis (Mukhtar, 2020b); for instance, assessment, management, and prevention in counseling and psychotherapy for crisis intervention, disaster, and trauma management; training programs/workshops to educate and inform people about mental health, personal and interpersonal functioning, school, family, relationships, and workplace issues; consultation with organizations; and psychometrics (Table 1).

Table 1.

Social workers and mental health practitioners’ blueprint of strategies for mental health planning.

	Short-term strategies	Long-term strategies
Psychological impact	Monitoring and reporting of mental health issues; reassure mental health help-seeking behaviors	Normalizing and sensitization; ascertain psychosocial consequences on wellbeing
Holistic mental health	Manage psychological, physical, and organizational factors; educate behavioral modification	Protect mental wellbeing and promote positive emotions; optimize community collaboration
Vulnerable groups	Identify outreach methods and community support; identify gaps in rapid intervention; facilitate personal growth	Approaches on prevention and treatment of mental health symptoms; facilitate self-compassion
Adherence to lifestyle change, mental wellbeing	Holistic empowerment of community; optimize behavior change; track perceptions and public responses	Enable communities to psychological preparedness for future crisis; understand facilitators and barriers in providing mental health services

The counseling psychotherapeutic approach of mental health practitioners lies in the belief that a problem is not caused by life events but how people experience and perceive them. This experience and perception in turn affect the emotions and feelings directed inwards and influence self-constructs and wellbeing. Therefore, social service providers and health practitioners’ approach to counseling encourages clients to learn to understand their responses toward their life events (which leads to psychological discomfort) and aims for clients to explore their own thoughts and feelings and to work out their own unique solutions by learning self-acceptance to both negative and positive aspects of character and personality. Given below are some of the possible interventions that social workers and healthcare practitioners can intermediate in.

Normalizing and sensitizing about psychological impact

COVID-19 as an extreme life stressor has been causing negative emotions and compromising on mental wellbeing – inducing the hopeless feeling that any effort aimed at constructive change is futile and the helpless notion that nothing more can be done to change the situation. In this particular case, the COVID-19 pandemic, likely cognitive biases are black-and-white thinking, jumping-to-conclusions, overgeneralization, minimization, magnification, personalization, abstraction, and catastrophization. It is hardly surprising that challenging situations induce states of hopelessness and helplessness and an individual might think that, ‘We are not going to survive coronavirus’ and ‘this is the end of the world’. Such negative thoughts, unhelpful behaviors, cognitive-dissonance eventually unsettle one’s peace of mind, so empowering coping skills would help in changing these thoughts and behaviors (Graham et al., 2016). Normalization and behavioral activation could challenge catastrophizing thoughts. In addition to modifying lifestyle change and stress management, mindfulness and acceptance, and commitment intervention can be used to help individuals and communities foster and cultivate resilience (Padesky and Mooney, 2012).

Normalizing and sensitizing are the objectives of this interventional phase. Educating and informing people about the normal common psychological reactions and stress responses (ranging from emotional to behavioral to psychosocial) that are a consequence to a traumatic event is a part of this phase. Common stress emotional responses such as irritability, anger, or frustration could be evident in children and adolescents. Other psychological stress responses like fear, anxiety, anger, stigma, marginalization, discrimination, and prejudice could be evident in the general population. An important aspect in this situation is to educate and inform people about the general measures of safeguarding mental health by counteracting mental health concerns.

Attunement, communication, involvement, and presence

Social service providers/mental health practitioners and clients must have a certain attunement that requires understanding of the needs-based and feelings-centered approaches immersed in the clients’ experience. Not merely an understanding, attunement is rather a kinesthetic and emotional sensing of the other person – knowing their experience by metaphorically being in their skin. Effective attunement basically requires that the practitioner remains aware of the boundary between client and practitioner and keeps the client aware as well.

The effective and timely communication of attunement validates the client’s needs and emotions and sets the foundation for building a therapeutic relationship. Attunement can be delivered and effectively heard by demonstration of what we say, such as ‘that must be hard’, ‘you seemed frightened’, or ‘you needed someone to be there with you’. As a matter of fact, it should be more frequently communicated by the practitioner’s facial expressions or body movements signaling to the client that his or her presence ‘exists’ and ‘matters’, also giving the message that it is perceived by the counseling psychologist to be significant, and that it makes an impact on the health practitioner and that the client has been heard as well.

Involvement begins with the practitioner’s commitment to the client’s wellbeing and a reverence for the client’s phenomenological experience. Full therapeutic contact becomes promising when the client experiences that the counseling psychologist respects the client’s needs, stays attuned to his or her feelings and needs, is sensitive to the age and stage of the client’s psychological functioning, and that the practitioner is interested in understanding the client’s understanding and frame of reference.

Presence is provided by the practitioner’s perseverance of empathic responses to both the verbal and nonverbal expressions of the client. It is ensured when the behavior and communication of the practitioner regards and emphasizes the client’s integrity. Presence includes the practitioner’s receptivity to the client’s needs, that is, being moved by the client’s unique and individual life and yet not to become angry, anxious, or depressed.

Attunement, communication, involvement, and presence are expressions of the practitioner’s availability, responsibility, and reliability–the application of the true spirit of psychological intervention.

Educating about lifestyle, behavioral modification, and social learning

The general public needs to be directed to credible sources of accurate information for better adherence to lockdown and frustration-tolerance. Limiting the exposure to social media and the spread of misinfodemics and disinformation to create panic is advisable. Constant exposure to the impacts of infectious diseases through media exposure to misinfodemics could create apprehensions of anyone being infected and a carrier of the disease, which could culminate in anxiety, anger, stigma, violence, and negative emotions toward others. Lifestyle, behavioral modification, and social learning are the key elements in this situation, which include hygiene, activity scheduling, introspection, mindfulness, meditation, painting, reading, playing, learning, dancing, gardening, and connecting with family to decrease stress. Mental health risk assessment and crisis management on individual and community levels and responses should be diligently implemented.

Promote community support and social facilitation

Social workers and mental health practitioners can play an integral role in optimizing the social-identity misconceptions (stigmatization, marginalization, stereotype, xenophobia, discrimination, prejudice, bias, and misplaced negative emotions and behavioral reactions) by collaborating with legitimized organizations to offer community support. Creating sensitization and altruistic cohesive mutual support for each individual in the community is one of the interventions that mental health practitioners and social workers can offer to distressed community members. Mental health practitioners’ unique approach to the BPSS-P and psychological crisis intervention approach to manage collective trauma and psychotherapeutic management provide the community with a sense of normalization and harmony. Cultivating resilience, altruism, prosocial behaviors, optimism, hope, and positive emotions to cope with the anxiety, loneliness, change in sleep or eating patterns, posttraumatic symptoms, emotional distress, and exacerbated physical and mental health will improve the quality of life and wellbeing. These approaches could provide a coping mechanism for victims or survivors and an outlet for violence perpetrators with an alternative perspective. Mental health practitioners could implement brief empirically evident public mental health interventions to build resilience at the individual and community levels (Rana et al., 2020). Mental health practitioners can offer support in the face of mutual trauma and collective psychological distress, help communities build resilience to cope with the crisis, to manage physical and mental wellbeing, and build strategies to prevent long-term mental health problems.

Facilitate personal growth and self-empathy

Various self-constructs from self-efficacy, self-esteem, self-confidence, self-concept, self-image, self-identity, self-awareness, self-knowledge, to self-conceptualization are the major factors impacted by traumatic events. The objective of mental health practitioners is to identify, ensure, and manage the discrepancy in achieving these constructs to facilitate personal growth. Self-reliance and self-sufficiency should be cultivated in the wake of mandatory social distancing and self-isolation to foster independence and individuality in the victims and survivors of violence, abuse, and trauma. This self-isolation provides the prospect of know-thyself, spending time with oneself, giving oneself the unconditional positive regard by self-reflection and self-understanding and self-acceptance. Self-constructs can be reinvigorated to convert loneliness into self-reflecting isolation, hopelessness into self-assuring optimism, anxiety into self-soothing excitement, fear into self-compassion, and hatred into self-kindred empathy.

Holistic empowerment of individuals and community

The mental health repercussions of coronavirus could have both short-term and long-term effects on individuals and communities. These effects could contribute to developing adjustment issues and acute/chronic posttraumatic symptoms stemming from perceived anxiety and fear. Reassuring the survivors of coronavirus illness (and related psychosocial consequences) including affected individuals, families, healthcare professionals, volunteers and social services personnel, and the general public about their mental health and physical health through holistic supportive interventions and management could facilitate adjustment, acceptance, and willingness to change. In this situation, constructive support, counseling, mental health interventions, and self-care could prevent impaired functioning and improve the quality of life.

Resilience, coping, wellbeing, and change

Resilience is an individual’s ability to recover readily from adversity and bounce back, and it is the community’s interactive and dynamic process of adapting and regulating in adversity. Proactively nurturing positive emotions in individuals and communities could stimulate resilience to foster collective change. Coping with mental and psychological problems is a paramount challenge in the wake of the COVID-19 pandemic. Resilience could build positive emotions, healthy behaviors, healthy positive aging, subjective quality of life, wellbeing (social wellbeing, emotional wellbeing, psychological wellbeing, spiritual wellbeing, and physical wellbeing), and life satisfaction. Short-term training in mindfulness improves markers of resilience, and a collective sense of empowerment and feeling of belonging promotes resilience (Oldfield et al., 2020). The development and implication of public health-level interventions will help individuals and communities build resilience in the face of one of the most challenging situations the world has ever witnessed.

Social service providers and mental health practitioners like counseling psychologists’ unique mental health perspective and psychological crisis intervention approach to manage collective trauma and psychotherapeutic management provide the community with a sense of normalization and harmony. Social service providers and mental health practitioners could implement time-sensitive empirically evident public mental health interventions to build resilience at the individual and community levels.

Conclusion

Governments, civil societies, community-based organizations, and global platforms should focus on (1) strengthening violence-related first response systems through mental health and legal counsel and (2) mental health help and other support systems during quarantine (Figure 1). Mental health and social service providers should be educated to identify traumatized individuals at risk of violence and abuse during the examination/interview and offer shelter and temporary residence for victims and survivors of abuse and violence. One of the most unfortunate consequences of the pandemic outbreak is the challenges in achieving equality – which is further divorced from the broader goals toward a fairer society. It is important to gather experiences of gender, sexual, ethnic, and other minorities as well to explicitly consider intersectional patterns of disadvantages and structural injustices. Gender equality and diversity initiatives should be about collaboration and working together to eliminate entrenched inequalities in societal systems. This article recommends creating ways and initiating feminist actions.

Figure 1.

Social workers and mental health practitioners’ approaches toward individuals and community outreach during and post-COVID-19 pandemic.

Social service providers and mental health practitioners could bring the attention of policymakers and governing bodies to introducing mental health services and psychological crisis interventions for individuals and the community in this crisis. Social service providers and mental health practitioners could address empirically evidence-based approaches of a biopsychosocial spiritual perspective. Healthcare teaching approaches (educational material, experts’ views, and user manuals) integrated with community-based interventions could be implemented to deal with COVID-19-related anxiety among individuals, patients, and their families; medical personnel; and the general public. Such interventions are not only important for COVID-19 but also for future epidemic or pandemic outbreaks, as crises past and present are proven to be the most important moments for change and growth.

Author biography

Sonia Mukhtar, certified in Integrative Counseling (United Kingdom) and Narrative Therapy (Australia), is a former visiting faculty at the University of Management and Technology, Lahore, Pakistan.