Free therapy delivers emotional support. COVID-19, racial injustice inspire college clinic to serve community
“You didn’t do the dishes,” a woman complains to her partner upon arriving home, exhausted, after a long day as an essential worker caring for COVID-19 patients. “Now I have to do them so I have room to fix dinner.”
“I worked remotely and did school work with the kids all day,” her partner complains back.
The argument escalates. He does the dishes; she insists it doesn’t count. In her mind, he should have known what it meant to her.
He feels unappreciated. The dishes were minor compared to what he did do. The stress is just too much.
The college’s Couple and Family Therapy Clinic helped many such struggling couples and families in scenarios like this during June, July and August. Faculty and student therapists responded to the intense emotional pressure caused by the issues of the time by offering free, solution-focused, one-at-a-time sessions, 60-90 minutes each, via telehealth.
Five-hundred hours of complimentary sessions were provided to individuals, couples and families during that time, and services will continue through December at rates based on income and what clients can afford. “We were honored to provide therapy in a very accessible format to many who were struggling during this time,” said Margaret “Charlie” Knerr, clinical assistant professor and clinic director. “Clients were able to call and be seen usually within a week.”
Suzanne Bartle-Haring, who works with many such couples, said conflicts can build during stressful times. “It’s about connections,” said the professor and director of the college’s academic Couple and Family Therapy Program. “In some way, they’re disillusioned about their partner. From an outside perspective, what looks trivial is actually full of symbolism of what’s missing between them.”
When her partner didn’t do the dishes, it triggered the woman’s fear. She’s wondering, “Are you going to be there when I need you?”
The more needs go unfulfilled, no matter how small, and aren’t discussed, the more hurt and animosity build. Under growing strain from events such as financial uncertainty, health concerns, racial injustice and more, people can feel lost. Desperate.
The May COVID National Tracking Survey showed that only 14% of American adults say they’re happy, a five-decade low.
“One-at-a-time sessions can be incredibly helpful to clients in their hour of need,” said Knerr. “The field has 25 years of research on this modality. If you catch clients at the right moment, a trained therapist can provide a different way of looking at the situation, affirm strengths and give them what they need to help make a shift. Often, it doesn’t take signing up for ongoing therapy. One session can make a pivotal difference.”
Creating a united front against COVID-19
To handle the emotional onslaught, the clinic helps people explore their connections, which builds emotional support.
“We have this myth in society that when you get together with the right person, they should know you so well, you don’t have to ask for what you want,” Bartle-Haring said. “I’ve had clients trying to guess what their partners wanted, but they never, ever verbalized it.”
Appreciating each other out loud makes relationships more stable and satisfying, she said. “The hard work of communication is essential in a relationship. It doesn’t matter if you have to ask for what you need.”
Asking can be tricky, though. Instead of focusing on emotions and saying, “I want this,” or “I feel that,” Knerr recommends a how-do-we-build-this-together collaborative process. “As therapists, we try to help our clients solve the problem, not fix each other,” she said. “It’s asking, ‘How can we co-exist during this pandemic?’ ‘How can we manage the children and get our work done?’ ‘What do we want our romantic life to look like?'”
Kaitlyn Ludwig, a first-year master’s trainee from Cincinnati, considers clients experts about their own lives. “Every person is unique, so I like them to tell me their stories,” she said. Then she suggests approaches to address their issues.
Some couples tell her they find it hard to be together 24/7 and still be truly present for each other. She asks them to consider specific activities to reconnect. “I put the idea in their heads, but I don’t give specific advice,” she said.
Preventing domestic violence
When the stress of sheltering in place intensified, the clinic started to get calls about domestic violence.
Bartle-Haring stresses that domestic violence is not perpetrated by males only. Nor is it confined to heterosexual relationships.
In Franklin County Municipal Court, the number of domestic violence cases filed in June 2020 was up 31% compared to June 2019.
“In my experience working with men in batterer treatment programs, they often report growing up in a home with domestic violence,” said Kris Snyder, a licensed therapist earning independent licensure through the clinic. “If a man wasn’t taught how to resolve conflict in intimate relationships, he may turn to how his father related to mom. Was it to strike out and become physical? To use coercion and threats? Isolation?”
In such situations, Snyder often uses kinship to uncover family patterns. “I draw a genogram with them — it’s a nonthreatening picture of three generations — and we track cycles of prison, violence, mental health, smoking, substance abuse,” he said. “If your grandfather, aunt, uncle and father did it, it’s coming right down the pike to you.”
Snyder’s motto is, if you can name it, you can tame it. He teaches that hitting your partner as a solution to their interrupting or yelling is domestic violence. Alternatives exist. “The key is helping people identify unhealthy and unproductive behavior,” he said. “Once they understand, the goal is to help them with resources to develop and maintain healthy relationships.”
Snyder encourages talk about solutions rather than problems. “Some people don’t have the skills to navigate,” he said. “They feel powerless, so they shut down. It helps to have a script.”
It’s asking, ‘How can we co-exist during this pandemic? How can we manage the children and get our work done? What do we want our romantic life to look like? It’s much more of a how-do-we-build-this together, collaborative process.”Margaret ‘Charlie’ Knerr
Clinical Assistant Professor
He tells them it’s not about the goals, but the process. “You can’t cut down a tree with a baseball bat. You need to sharpen your saw,” he said. If a client comes in feeling like a zero, he asks them, “What would it take to get to a one? It’s the small victories that give us confidence.”
Sometimes clients are too stressed or fatigued to work the strategies, Snyder said, so he and the other therapists make referrals to medical doctors when needed.
He also teaches mindfulness and gratitude to change perspectives. “You can’t be complaining and be in a state of gratitude at the same time,” he said. “I ask them to name five things they’re grateful for. It’s the small, consistent steps that keep us motivated.”
Handling family conflict in a stressful time
During the racial justice protests, Knerr said many families experienced intergenerational conflict.
“Parents come in with their high schooler who wants to go to protest,” she said as an example. “Mom wants her daughter to have a voice and participate, to go with friends. Dad says she’s not old enough to vote and doesn’t really know what she thinks. He’s worried about her face being on social media, about COVID-19, about violence.”
First, the therapists always listen and validate the experience. Knerr helps the parents get on the same page. Then she encourages families to communicate with the teen openly in real and meaningful ways, to discuss values they share, to ask questions of each other and really listen.
The goal is for everyone to feel connected and heard. Then they can begin to solve problems together.
She tells the young person, “When you want to do something, figure out what part will worry your parents. See what solutions you can present to calm their worries.” Knerr said. “Instead of being in the middle of a protest, could you be on the side with a sign? Could you wear a mask so you’re physically safe and also not identified on social media?”
Knerr reminds families that they have been solving problems for years. The convergence of the pandemic and protests has made life feel out of control. “We’re training families to slow down. We call them back to the skills they know, have them articulate them, then use them. Not everyone is 100% happy, but they’re happier.”
Knerr also suggests young people seek common ground with those who went through the Civil Rights era. “If the younger generation also can give voice to their grandparent’s generation, it’s a fascinating conversation,” she said, “because those two are speaking the same language in some ways.”
Finding community in a time of isolation and fear
Kira Hayes, also a licensed therapist earning her independent practice license, partnered with Ellison Luthy, a PhD student therapist, to respond to the chaos by starting two free support groups. One was for sexual and gender minorities to find community. The other was for parents of LGBTQ+ adolescents or young adults to process their experiences in a safe and accepting environment.
Many in the LGBTQ+ community support Black Lives Matter, Hayes said, because they, too, know what it is to be marginalized.
“It’s very difficult to find (a mental health practitioner) with significant training and specialization in working with (the LGBTQ+) population in general, let alone for relationship and family therapy,” said Hayes, who is multiracial but aware that passing for white gives her privilege. “That’s why I make it known in my practice that I’m a queer-friendly and queer-identifying therapist. I want to be part of changing that.”
In the bi-weekly June and July sessions for individuals and couples, Hayes and Luthy provided psychoeducation during the first half. In the second half, everyone shared experiences and support.
“Minority stress was a main theme,” Hayes said. “Some people who had to move home because their college closed were back ‘in the closet.’ They’re feeling trapped, which is super challenging to navigate.”
Hayes and Luthy described healthy coping skills, ways to counteract feelings of isolation and ways to show self-compassion. During discussion, those at various stages of coming out shared and offered insights.
Hayes and Luthy plan to incorporate changes recommended by the participants, then restart the groups in October.
Supporting the protests and protesters
Several of the student therapists have taken part in the protests, including Hayes. As a speaker at local events, she addressed disparities in access to mental health care for minorities.
Hayes also has been a street medic volunteer with Frontline, an organization providing emergency emotional support to individuals in need or in crisis at a protest.
Despite the hurt and lack of change for minorities, she sees the protests as having a uniting effect as the queer community joins with people of color to demand change.
“There’s a lot of shared and parallel experiences there,” she said. “Putting our energy toward something positive, toward action for something people believe in, is really helpful to mental health, is empowering. It’s where my heart is.”