Vaccine Information and Education Materials
CDC COVID-19 Vaccination Communication Toolkit:
CDC Materials for Distribution and Use
CT Allows Interstate Practice Through April 15, 2022 - Read More:
UPDATE: “On Wednesday, February 16, following the expiration of the Governor’s executive authority on February 15 the DPH Commissioner Manisha Juthani, M.D., issued a Commissioner Order allowing certain out-of-state licensed healthcare professionals to render temporary assistance in Connecticut within the scope of the profession for which they are licensed, certified or registered. The healthcare professionals covered under the Commissioner’s order include those licensed, certified or registered in medicine and surgery, nursing, respiratory care, psychology, marital and family therapy, clinical social work, master-level social work, and professional counseling. The order is in effect until April 15, 2022.” (This order does include telepsychology across state lines)
The Association of State and Provincial Psychology Board (ASPPB) compiled an update of state licensing changes in response to COVID-19 pandemic. https://www.asppb.net/page/covid19”
Effective Coping with COVID-19 According to Viktor E. Frankl and Paul T. P. Wong, is out now!
Insurance Information for Practitioners
Please see the following chart for information regarding insurance coverage for clinical services during the COVID-19 pandemic. This chart will be updated as new details become available (but at least monthly). Note that delivery of services via telehealth and waiver of patient cost-sharing (i.e. copays and coinsurance fees) remain authorized by many insurance companies, but policies are inconsistent across carriers and may vary within a carrier as a function of individual patients’ insurance coverage parameters. Capitol Consulting (CPA’s lobbyist team) is actively monitoring this situation and advocating for reauthorization and/or permanent implementation of these modifications to ensure continued access to care during and after the pandemic. Other practice-related issues that are being tracked include authorization of audio-only (i.e. telephone) appointments and parity of telehealth and in-person reimbursement rates.
On 22 Jan 20201, the US Dept. of Health and Human Services (HHS) informed governors that “the [nationwide COVID-19 Public Health Emergency (PHE)] will likely remain in place for the entirety of 2021, and when a decision is made to terminate the declaration or let it expire, HHS will provide states with 60 days’ notice prior to termination”. In particular, it was noted that PHE-related flexibility (e.g. for telehealth service delivery) has enhanced the accessibility and efficiency of healthcare. It is thus likely that the following information will be a relevant resource throughout the year.
For those who offer services via telehealth, CT Dept. of Social Service’s Medical Assistance Program recently issued a Provider Bulletin (2020-100, 20 Dec 2020; https://www.ctdssmap.com/CTPortal/Information/Get%20Download%20File/tabid/44/Default.aspx?Filename=pb20_100.pdf&URI=Bulletins/pb20_100.pdf) that revised the coding of place of service (POS) for Medicaid claims. Per that bulletin, “telemedicine claims should no longer be billed with POS 02…[instead] indicate the POS that best describes where the service would have been rendered if the service was performed in-person. All claims for services performed via telemedicine must continue to be billed with one of the following modifiers: ‘GT’ is used when the originating site of the member is located in a healthcare facility or office; or ’95’ is used when the member is located at home”. Please visit the above link for additional information from the Bulletin.
Volunteer Your Time
We know many psychologists want to volunteer their time and expertise. The State of Connecticut created a registry for all types of health care volunteers to help with the response effort. Psychologists interested in volunteering should visit CTResponds.ct.gov to register. To date, it is our understanding the State of CT is still focused on the medical response. We have not heard of any psychologists being called upon by the State to volunteer.
In the meantime, CPA is working closely with other CT organizations to find ways to support the mental health of those on the frontlines such as healthcare, funeral and supermarket workers among others. We will provide a list of psychologists who are willing to volunteer their services to organizations that employ or support these front line workers. Please sign up here: https://www.surveymonkey.com/r/KF3RY7K
CPA Colleagues: Please see the attached chart for the most up to date information regarding insurance coverage for telehealth. Please note, telehealth as a form of service will continue to be valid following the expiration of the public health crisis surrounding COVID-19. The expiration dates listed are connected to emergency policies put in place by the insurance companies due to rapid changes related to COVID-19. Policies set to expire include the following: waiving telehealth provider enrollment, inclusion of audio-only (telephone) in definition of telehealth, telehealth reimbursement parity with in person session rates, and insurance company cost-sharing (covering copays). CPA is actively advocating for the extension and/or permanent adoption of these policies.
CT Resource Connection: Community Services and Businesses for You and Your Family During the Coronavirus Pandemic
EDUCATION – Online coding classes for kids ages 7-12, Three months of free online music lessons, Free online platform to learn a foreign language, and more.
FITNESS – Free meditation, Weekly virtual classes on Facebook, Virtual workouts and social connection for people in recovery from substance use and alcohol addiction, and more.
HEALTHCARE – Private counseling practice offering virtual and in-person counseling and coaching services to adults and teens struggling with anxiety, depression, Providing continued rehabilitation and at home services to elderly and disabled individuals, Prepare for all medical emergencies by owning your own medical records, and more.
MUSEUMS, ZOOS, & AQUARIUMS – Free online IMAX movies, kids activities and animal coloring books, Virtual tour and downloadable immersive VR tour, Virtual tours of aircraft and hangers, and more.
GROCERY & NUTRITION – Delivering healthy meals right to your home, Offering online shopping, Offering a senior shopping hour from 9 a.m. – 10 a.m, and more.
KIDS’ CORNER – Daily programs on Facebook Live to teach children about different animals, Hands-on experiments to learn music, Improve your typing skills while competing in fast-paced races, and more.
AUTOMOTIVE – Online sales with curbside delivery available, Open for virtual sales with complimentary home or curbside delivery, Door to door sales and service available, and more.
HOME & GARDEN – Design consultants can help you make choices from home, Open 8:00 a.m. – 9 a.m. for seniors and those with impaired immunity, and more.
LEGAL FINANCE – Business being conducted by phone and email, Working remotely and available via phone, email and videoconferencing, and more.
FINANCE – Waiving member costs related to COVID-19, Online banking available, and more.
RETAIL – Donation centers remain open with a touch-less Drop & Go donation process.
RESTAURANTS TO GO – Restaurants offering take out and/or delivery service
BREWERIES – Breweries offering on location pick-up
Re-opening the State and Practices
Complied by CPA Lobbyists Capitol Consulting
February 5th, 2021
All the Governor’s Executive Orders (EOs) have been extended until April 20, 2021.
While this is confusing, the EO extends telehealth to that date ( despite the fact that the special session law sunsets as of March 15th— in this case, the EO trumps that law).
The EO with respect to CEUs, will also continue until April 20th.
The Legislature will, between now and April 20, 2021, review all of the EOs and determine which, if any, they will review and/ or choose to modify. In the alternative, the DPH may choose to modify some things as well, and that could happen between now and the end of the legislative session in June.
May 21st, E.O. No. 7RR
- Authority for DEEP to issue rental refunds: Authorizes the Department of Energy and Environmental Protection to reimburse funds that were collected from rent paid by any person for use of state park property, including for camping or any special event.
- Modification of age limit for early intervention coverage: Requires health insurance policies to continue providing coverage for birth to three programs after a child’s third birthday in the event that school closures may delay a child’s transition to other services for older children.
- Waiver of requirement for guest books at private clubs: Waives the statutory requirement that private clubs maintain guest books to reduce shared points of contact.
May 20th, E.O. No. 7QQ
- Modifications to permit the use of absentee ballots to reduce the risk of COVID-19 transmission during August 11, 2020 primary
- Clarification that orders by commissioners issued pursuant to the governor’s executive orders are not regulations
May 19th, 2020
DECD Phase One Re-Opening Guidelines
In addition to the new executive order, The Connecticut Department of Economic and Community Development (DECD) has issued its rules and certification requirements for the Phase One re-opening of businesses effective tomorrow, May 20th. Here is a link to those guidelines. It is also important to note that all businesses subject to these guidelines are required to self-certify prior to opening May 20th. That certification form can be accessed here.
May 19th, 2020 (cont.)
Online Guide to Support the Re-opening of Small Businesses
The State of Connecticut has also released an online guide to help small businesses comply with COVID-19 safety guidance and manage the broader reopening process. The Small Business Reopening Resource Guide can be accessed by clicking here.
It includes valuable information in the following areas: Financial Needs, Employee Training & Support, Physical Layout, Geographic List of Suppliers
May 18th, E.O. No. 7PP
- Reopening Phase 1: Repeals several previously enacted executive orders to allow for the safe reopening of certain sectors of the economy on May 20, including for the reopening of outdoor dining, offices, retail and malls, museums and zoos, and outdoor recreation businesses.
- Enforcement of sector rules governing the reopening of businesses: Modifies certain statues and regulations to permit the enforcement of sector rules as certain businesses reopen on May 20, including for local and district health directors and municipal chief executive officers
- Extension of prohibition on large gatherings to June 20, 2020: Extends the prohibition of large gatherings in Executive Order Nos. 7D and 7N through June 20, 2020.
- Extension of restrictions on off-track betting, indoor fitness, and movie theaters to June 20
- Further clarification of limits on restaurants, bars, and private clubs – mixed drinks permitted for takeout delivery: Allows for the sale of mixed drinks for takeout and delivery by various liquor permittees under certain conditions.
- Limitation on the operation of day camps: Prohibits day camps, which were not already operating as of May 5, 2020, from beginning operations for the season until June 22, 2020.
- Enhanced health procedures for all day camps: Requires day camps to comply with the limitations on child group sizes and enhanced health procedure requirements placed on child care programs by Executive Order No. 7Q, and by orders of the commissioner of the Office of Early Childhood.
- Cancellation of resident camp operations: Prohibits the operation of resident camps for the duration of the civil preparedness and public health emergency.
- Limitation on the operation of summer and educational programs operated by local or regional boards of education: Prohibits summer school programs from beginning prior to July 6, 2020, unless earlier extended, modified, or terminated by the governor. The commissioner of the Department of Education is required to issue guidance on the limited operation of summer school programs that are permitted to engage in-person classes after that date.
- Suspension or modification of regulatory requirements to protect public health and safety: Permits the commissioner of the Department of Education to temporarily waive, modify, or suspend any regulatory requirements as he deems necessary to reduce the spread of COVID-19 and protect the public health.
Letter From CPA President
March 13, 2020
As we closely follow the COVID-19 pandemic and the efforts and responses in CT and nationally, CPA is also partnering with APA to advocate with Medicare, Medicaid, and commercial payors. For those not on the CPA LISTERV, this correspondence includes some helpful information for all CT Psychologists.
Daily, the Centers for Disease Control reminds us that everyone has a role to play in getting ready and staying healthy.
- · For some accommodations suggested by the CDC to limit community spread, please visit https://www.cdc.gov/coronavirus/2019-ncov/community/index.html
- · APA prepared a helpful fact sheet for psychologists on “COVID-19 and psychology services: How to protect your patients and your practice” https://www.apaservices.org/practice/news/covid19-psychology-services-protection?_ga=2.107199495.441335256.1584148282-1523503172.1517028541
Social Distancing – It Works!
Dr. Chris Ruser, the Chief of Primary Care at VA Connecticut sent out this message to VA colleagues. During the 1918 Influenza Pandemic, the city of Philadelphia decided not to cancel their events, including a major parade. Whereas the sensible mid-western town of St. Louis took precautions by canceling large gatherings, closing schools, essentially all the social distancing we are currently attempting to create. Here’s how it turned out.
The fight isn’t over, and the disease will still spread, but working together we can flatten the curve and avoid overwhelming ourselves and our healthcare system. If you don’t believe it, read this article: https://www.theatlantic.com/family/archive/2020/03/coronavirus-what-does-social-distancing-mean/607927/
Let us all be part of the solution. Be safe and stay well.
Anne Klee, Ph.D.
Not yet a member? Join Us! https://www.connpsych.org/Join
Governor Lamont's Steps to Mitigate the Economic Effects of COVID-19
Posted Monday, March 16, 2020
In CT, Governor Lamont’s administration takes steps to mitigate the economic effects of COVID-19:
- The CT Department of Social Services expanded telemedicine coverage for those under HUSKY/Medicaid. We provide more information below.
- The CT State Department of Education received a waiver from the federal government allowing students who receive meals under the school lunch program to continue receiving those meals during school closures and consume them at home. They also removed the 180 day requirement for public school attendance.
- The CT Department of Labor announced modifications to unemployment insurance.
- The CT Department of Economic and Community Development is working with small businesses to assist with COVID-19 impact. If your practice falls in this category, you may be eligible for a small business loan.
- The CT Public Utilities Regulatory Authority ordered a moratorium on all utility shut-offs.
HIPAA Regulations Update
Posted Tuesday, March 17, 2020
US Dept of Health and Human Services Office for Civil Rights will exercise its enforcement discretion and will not impose penalties for noncompliance with the regulatory requirements under the HIPAA Rules against covered health care providers in connection with the good faith provision of telehealth during the COVID-19 nationwide public health emergency. This notification is effective immediately. See more:
- 3.17.20 COVID 19 CMS Telehealth Waiver FAQ Final.pdf
Letter From APA to Psychology Educators
Here’s a roundup of APA resources for students, faculty, psychologists, supervisors, trainees and high school teachers of psychology. Thought it might be easier to provide these quick links.
Please share with colleagues, post to other listservs and pass along to psychologists, postdocs, interns and students who are seeking information and guidance. Be sure to check the APA website weekly for updates and new resources.
Cathi Grus, PhD
Chief Education Officer
American Psychological Association
APA Commission on Accreditation COVID-19 updates
The Commission on Accreditation is having discussions to formulate guidance regarding accreditation and OPCA staff are working to communicate this guidance as it is formulated.
Addressing issues affecting graduate students, postdocs, interns and faculty with supervision and training responsibilities.
APA electronic resources available for distance learning
Free access to a variety of books and other academic materials offered during shut-down period.
APA offers free access to Publication Manual and other resources through May 25
To support academic libraries and their many patrons, we are providing temporary free access to the Publication Manual of the American Psychological Association (6th and 7th editions), the Concise Guide to APA Style, and more than 160 other books published by APA Books through VitalSource and RedShelf.
Advice for psychology supervisors and trainees on caring for patients during the COVID-19 crisis
As public health and education officials continue to monitor the spread of the coronavirus, here is advice for supervisors and trainees at psychology training programs on how to prepare for and adapt to fluctuating circumstances specific to patient care.
COVID-19 relevant free journal articles
This free collection includes relevant psychological research published across the APA Journals portfolio. We will update this collection on an ongoing basis.
Free CE series on telepsychology best practice
For a limited time, APA’S four-part Continuing Education in Psychology series “Telepsychology Best Practice 101” is available free of charge.
Psychology lesson plans made available to all teachers by APA
In response to the COVID-19 pandemic, APA Teachers of Psychology in Secondary Schools (TOPSS) has made psychology unit lessons available freely for the benefit all teachers.
Conducting research during the COVID-19 pandemic
Advice from psychological researchers on protecting participants, animals and research plans.
HUSKY for Telehealth
Compiled by Dr. Meghan Butler, CPA Secretary and CPA colleagues
Until we better contain COVID -19, many CT Psychologists are conducting phone and video sessions. This is th best way to keep your clients and you safe. During these current times, HUSKY (CT Medicaid) is reimbursing for Telehealth (based on our understanding a video platform is required to meet the standards for reimbursement at this time). HUSKY now has active codes to reimburse for these telemental health services. The CT Department of Social Services released two bulletins on Friday, March 13th and a FAQ sheet. Please review them for details.
- https://www.ctdssmap.com/CTPortal/Information/Get Download File/tabid/44/Default.aspx?Filename=pb20_09.pdf&URI=Bulletins/pb20_09.pdf
- https://www.ctdssmap.com/CTPortal/Information/Get Download File/tabid/44/Default.aspx?Filename=pb20_10.pdf&URI=Bulletins/pb20_10.pdf
For those who take private insurance, we encourage you to call each company to determine what telemedicine benefits the plan covers as they can vary from policy to policy. Please keep in mind that most insurance companies ask providers to complete and submit a checklist before granting them approval to provide telemental health services.
Please remember that when conducting telemental health services, you must use a HIPAA compliant platform and complete an additional consent form for telehealth services that must comply with state guidelines. If you would like recommendations for HIPAA-conforming telehealth platforms, Dr. Jared Skillings, Chief APA Practice Directorate recommends that you review APA’s free online article, “Comparing the Latest Telehealth Solutions.” The article reviews three popular telehealth platforms: Doxy.me, thera-link, and Zoom. They asked four practicing psychologists to rate and provide pro/con descriptions for each telehealth platform. Ratings are based on privacy/security, features, ease of use, functionality, and customer support. The psychologists and their practices are diverse in several ways, and their descriptions will help you decide which telehealth platform might best fit your practice.
The National Register is offering its members and those with Trust Insurance a free webinar on telepsychology and the coronavirus next Friday, March 20th at 2 pm EST featuring Dr. Mary Alvord. To find out more, please visit: https://www.nationalregister.org/education-training/webinars/coronavirus-webinar/
TeleMental Health Implementation Checklist for Private Practice
Courtesy of CPA Member Carrissa Phipps, Ph.D. of Small Victories Wellness Services, PLLC in Middletown, CT
☐ Specialized TMH Training
- Consider getting specialized training in the unique ethical and clinical considerations related to TMH services
- Person Centered Tech and the Zur Institute both offer certificates
☐ Get Credentialed with Insurance Companies
- Each insurance company has a unique process for being permitted to bill for TMH services
☐ Verify Insurance Billing Procedures
- Place of Service: 02 – Telehealth
- Modifier: GT or 95?
☐ Create a Unique Consent Form for TeleMental Health Services
- Required by the state of CT
- Must include limitations of TMH (i.e. security risk, technology failure)
- A chance to set client expectations (i.e. privacy, technology, safety)
☐ Develop Paperless Intake Process
- Do you utilize an EHR that has a secure client portal?
- If you plan to use email, do you have a Business Associate’s Agreement (BAA) with your email provider to comply with HIPAA?
- Email encryption services
☐ Develop Paperless Payment Process
- Many EHRs and credit card processors allow for the option to store a client’s credit card information
- Also create a Credit Card Authorization form for clients to sign if you plan to store credit card info (this form serves as the client’s signature for payment)
Informed Consent Checklist for Telephychological Services
Provided by the American Psychological Association. Feel free to use with your letterhead.
Prior to starting video-conferencing services, we discussed and agreed to the following:
- There are potential benefits and risks of video-conferencing (e.g. limits to patient confidentiality) that differ from in-person sessions.
- Confidentiality still applies for telepsychology services, and nobody will record the session without the permission from the others person(s).
- We agree to use the video-conferencing platform selected for our virtual sessions, and the psychologist will explain how to use it.
- You need to use a webcam or smartphone during the session.
- It is important to be in a quiet, private space that is free of distractions (including cell phone or other devices) during the session.
- It is important to use a secure internet connection rather than public/free Wi-Fi.
- It is important to be on time. If you need to cancel or change your tele-appointment, you must notify the psychologist in advance by phone or email.
- We need a back-up plan (e.g., phone number where you can be reached) to restart the session or to reschedule it, in the event of technical problems.
- We need a safety plan that includes at least one emergency contact and the closest ER to your location, in the event of a crisis situation.
- If you are not an adult, we need the permission of your parent or legal guardian (and their contact information) for you to participate in telepsychology sessions.
- You should confirm with your insurance company that the video sessions will be reimbursed; if they are not reimbursed, you are responsible for full payment.
- As your psychologist, I may determine that due to certain circumstances, telepsychology is no longer appropriate and that we should resume our sessions in-person.
Corona Virus And Xenophobia
Maysa Akbar, Ph.D., CPA, Diversity Representative
CPA strongly condemns discrimination towards Asian Americans due to misinformation circulating about the Corona virus. As psychologists, we must speak up when we hear stories like these and share the facts and science. New York State Psychology Association Colleagues Drs. Daniel Kaplin, Amina Mahmood and Jean Lau Chin graciously shared the following information with CPA.
On March 11th, the novel coronavirus (COVID-19) was declared a pandemic. As such, the World Health Organization has recognized that the virus has spread globally. Yet, some individuals continue to refer to it as the “Chinese Virus,” the “Wuhan Virus,” or a “Foreign Virus.” This has resulted in xenophobia towards members of Asian communities. Viruses do not claim a nationality or ethnicity.
Terminology such as the “Chinese flu,” has contributed to Chinese and Asian Americans becoming targets of physical and verbal attacks, xenophobia, and microaggressions. Some recent incidents that we are aware of include:
- A woman wearing a face mask was punched and kicked by a man who called her “diseased.” Excerpted from NBC News (February 5, 2020).
- Amy Wong Mok, the president of the Asian American Cultural Center, reported that an Asian American “just coughed a little bit because she was coming in from the cold air and then people left.” Mok noted that, “Just a small cough and the people just left, left her like the plague…At least they left. They didn’t attack her”… Excerpted from CBS News Austin (February 7, 2020).
- “A 16-year-old boy in California’s San Fernando Valley was physically attacked this week by bullies in his high school who accused him of having COVID-19 — simply because he is Asian American”… Excerpted from CBS News (February 14, 2020).
- A Facebook message encouraged people not to patron Asian businesses stating “We urge citizens to stay away from Chinese supermarkets, shops, fast food outlets, Restaurant and Business”… Excerpted from the Brooklyn Eagle (March 5, 2020)
- Emily Park, an animation fellow at Business Insider who’s Korean-American, was on the subway in Manhattan on Monday when she cleared her throat. A woman stared at her for several moments and then promptly got up and moved seats farther away. Excerpted from Business Insider (March 7, 2020).
- A woman was confronted on the subway by somebody yelling “Where is your corona mask you Asian b—h,” before punching the woman dislocating her jaw…Excerpted from the New York Post (March 10, 2020).
It is troubling that these incidents are occurring in 2020. Asians have been scapegoated and presented as a threat to the Western (White) world for centuries. The United States past has been guilty of xenophobia and violence against Asian Americans: the Chinese Massacre of 1871, the Chinese Exclusion Act (1882), and Executive Order 9066 (1942) that resulted in the mass incarceration and torture of Japanese individuals. More recently Executive Order 13769 (2017) banned the entry into the United States from several Muslim majority countries in West Asian, Central Asian and Northern African regions.
Below is a list of some landmark theories around stereotyping and prejudicial thoughts or behaviors that we may unintentionally be guilty of. Let’s become better informed about our own cognitions and responses, in order to interrupt xenophobic responses by those around us.
Cognitive Sources of Stereotyping and Prejudice:
- Categorization (Ostrum & Sedikides, 1992) – placing people into groups based on superficial characteristics, aids stereotyping.
- Vivid Cases (Hamilton & Rose, 1980) – over-generalizing because of strong memories.
- Just-World Phenomena (Carli et al., 1990) – belief that the world is just and therefore people get what they deserve and deserve what they get.
- Social and Emotional Sources of Stereotyping and Prejudice:
- Victim-Blaming (Januff-Bulman et al., 1985) – holding victims of crimes and other misfortunes responsible for what happened to them.
- Outgroup Bias (Tajfel, 1970, 1981; Tajfel & Billig, 1974) – negatively treating those perceived as different from one’s in-group.
- Scapegoating Bias (Miller & Bugelski, 1948) – finding “the other” to blame as an outlet for one’s anger or fear,
Some Resources to address those targeted as a function of COVID-19:
- New York University Center for the Study of Asian American Health. Resources including hospitals and social service agencies for Asian Americans. Retrieved here.
- Southern Poverty Law Center. Resource Document– Responding to Hate and Bias at School. This could be valuable for school psychologists and professors to increase dialogue around hate and bias. Retrieved here.
Media related to Coronavirus related anxiety, and Xenophobia:
- https://podcasts.apple.com/us/podcast/s3-bonus-episode-coping-with-coronavirus-anxiety/id1437754602?i=1000468208275 (The BreakDown with Dr. Earl)
- https://www.apa.org/research/action/speaking-of-psychology/coronavirus-anxiety (APA podcast and transcript)
- https://youtu.be/3yQj-Mscn7k (Ali Mattu, The Psych Show—Coronavirus Anxiety)
Talking to Children About COVID-19
Compiled by Jessica Guite, Ph.D., CPA Science Representative
Whether you are a provider who works with children and adolescents, a parent or just a caring adult, it is important to keep in mind how the COVID-19 pandemic and recommended approaches to mitigating its impact may be experienced by young people. Guidance from the National Association of School Psychologists (NASP) was recently shared by the West Hartford Public School system to families with very helpful information about how to talk about Coronavirus with children. Excerpts from the letter are included below, with additional information available at www.nasponline.org and www.nasn.org.
“Concern over this new virus can make children and families anxious. While we don’t know where and to what extent the disease may spread here in the United States, we do know that it is contagious, that the severity of illness can vary from individual to individual, and that there are steps we can take to prevent the spread of infection. Acknowledging some level of concern, without panicking, is appropriate and can result in taking actions that reduce the risk of illness. Helping children cope with anxiety requires providing accurate prevention information and facts without causing undue alarm. It is very important to remember that children look to adults for guidance on how to react to stressful events. If parents seem overly worried, children’s anxiety may rise. Parents should reassure children that health and school officials are working hard to ensure that people throughout the country stay healthy. However, children also need factual, age appropriate information about the potential seriousness of disease risk and concrete instruction about how to avoid infections and spread of disease. Teaching children positive preventive measures, talking with them about their fears, and giving them a sense of some control over their risk of infection can help reduce anxiety.”
Remain Calm and Reassuring
- Children will react to and follow your verbal and nonverbal reactions.
- What you say and do about COVID-19, current prevention efforts, and related events can either increase or decrease your children’s anxiety.
- If true, emphasize to your children that they and your family are fine.
- Remind them that you and the adults at their school are there to keep them safe and healthy.
- Let your children talk about their feelings and help reframe their concerns into the appropriate perspective.
Make Yourself Available
- Children may need extra attention from you and may want to talk about their concerns, fears, and questions.
- It is important that they know they have someone who will listen to them; make time for them.
- Tell them you love them and give them plenty of affection.
Avoid Excessive Blaming
- When tensions are high, sometimes we try to blame someone.
- It is important to avoid stereotyping any one group of people as responsible for the virus.
- Bullying or negative comments made toward others should be stopped and reported to the school.
- Be aware of any comments that other adults are having around your family. You may have to explain what comments mean if they are different than the values that you have at home.
Monitor Television Viewing and Social Media
- Limit television viewing or access to information on the Internet and through social media. Try to avoid watching or listening to information that might be upsetting when your children are present.
- Speak to your child about how many stories about COVID-19 on the Internet may be based on rumors and inaccurate information.
- Talk to your child about factual information of this disease—this can help reduce anxiety.
- Constantly watching updates on the status of COVID-19 can increase anxiety—avoid this.
- Be aware that developmentally inappropriate information (i.e., information designed for adults) can cause anxiety or confusion, particularly in young children.
- Engage your child in games or other interesting activities instead.
Maintain A Normal Routine to the Extent Possible
- Keep to a regular schedule, as this can be reassuring and promotes physical health.
- Encourage your children to keep up with their schoolwork and extracurricular activities, but don’t push them if they seem overwhelmed.
Be Honest and Accurate
- In the absence of factual information, children often imagine situations far worse than reality.
- Don’t ignore their concerns, but rather explain that at the present moment very few people in this country are sick with COVID-19.
- Children can be told this disease is thought to be spread between people who are in close contact with one another—when an infected person coughs or sneezes.
- It is also thought it can be spread when you touch an infected surface or object, which is why it is so important to protect yourself.
- For additional factual information contact your school nurse, ask your doctor, or check the https://www.cdc.gov/coronavirus/2019-ncov/index.html website.
Know the Symptoms of COVID-19
- The CDC believes these symptoms appear in a few days after being exposed to someone with the disease or as long as 14 days after exposure: o Fever o Cough o Shortness for breath
- For some people the symptoms are like having a cold; for others they are quite severe or even life threatening. In either case it is important to check with your child’s healthcare provider (or yours) and follow instructions about staying home or away from public spaces to prevent the spread of the virus.
Review and Model Basic Hygiene and Healthy Lifestyle Practices for Protection
- Encourage your child to practice every day good hygiene—simple steps to prevent spread of illness:
- Wash hands multiple times a day for at least 20 seconds (singing Twinkle, Twinkle Little Star slowly takes about 20 seconds).
- Cover their mouths with a tissue when they sneeze or cough and throw away the tissue immediately, or sneeze or cough into the bend of their elbow. Do not share food or drinks.
- Practice giving fist or elbow bumps instead of handshakes. Fewer germs are spread this way.
- Giving children guidance on what they can do to prevent infection gives them a greater sense of control over disease spread and will help to reduce their anxiety.
- Encourage your child to eat a balanced diet, get enough sleep, and exercise regularly; this will help them develop a strong immune system to fight off illness.
Take Time to Talk
You know your children best. Let their questions be your guide as to how much information to provide. However, don’t avoid giving them the information that health experts identify as critical to ensuring your children’s health. Be patient; children and youth do not always talk about their concerns readily. Watch for clues that they may want to talk, such as hovering around while you do the dishes or yard work. It is very typical for younger children to ask a few questions, return to playing, then come back to ask more questions. When sharing information, it is important make sure to provide facts without promoting a high level of stress, remind children that adults are working to address this concern, and give children actions they can take to protect themselves. Information is rapidly changing about this new virus—to have the most correct information stay informed by accessing https://www.cdc.gov/coronavirus/2019-ncov/index.html.
Keep Explanations Age Appropriate
- Early elementary school children need brief, simple information that should balance COVID-19 facts with appropriate reassurances that their schools and homes are safe and that adults are there to help keep them healthy and to take care of them if they do get sick. Give simple examples of the steps people take every day to stop germs and stay healthy, such as washing hands. Use language such as “adults are working hard to keep you safe.”
- Upper elementary and early middle school children will be more vocal in asking questions about whether they truly are safe and what will happen if COVID-19 comes to their school or community. They may need assistance separating reality from rumor and fantasy. Discuss efforts of school and community leaders to prevent germs from spreading.
- Upper middle school and high school students are able to discuss the issue in a more in-depth (adult-like) fashion and can be referred directly to appropriate sources of COVID-19 facts. Provide honest, accurate, and factual information about the current status of COVID-19. Having such knowledge can help them feel a sense of control.
Suggested Points to Emphasize When Talking to Children
- Adults at home and school are taking care of your health and safety. If you have concerns, please talk to an adult you trust.
- Not everyone will get the coronavirus (COVID-19) disease. School and health officials are being especially careful to make sure as few people as possible get sick.
- It is important that all students treat each other with respect and not jump to conclusions about who may or may not have COVID-19.
- There are things you can do to stay health and avoid spreading the disease:
- Avoid close contact with people who are sick.
- Stay home when you are sick.
- Cover your cough or sneeze into your elbow or a tissue, then throw the tissue in the trash.
- Avoid touching your eyes, nose, and mouth.
- Wash hands often with soap and water (20 seconds).
- If you don’t have soap, use hand sanitizer (60–95% alcohol based).
- Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
Self Care for Psychologists
- Stick to a routine: “I still pack my lunch every day and put on work clothes even if I’m not going into the office,” says Gebhardt. “Still doing those routines gives a sense of normalcy to the otherwise abnormal situation we’re in.”
- Create a Separate Workspace
- Exercise: “Ask your gym or yoga studio if they’re offering virtual sessions or look for workouts on YouTube. Even dancing to your favorite music in your living room can help.”
- Try Mindfulness: “You don’t have to have a full-scale meditation practice, says ACCA co-chair Judith Holder, PhD, who directs the Professional and Personal Development Program at Duke University. Instead, she suggests, try “micro” breaks. “When you’re going from patient to patient, take five or 10 minutes to hit the pause button, think about something enjoyable and breathe in and out,” says Holder.
- Seek Social Support
- Change the way you think about your work
Phasing Back Into Society
- Determine whether an in-person visit is necessary
- Review the physical and mental health risks
- Establish new rules for patients attending in-person sessions: “If you decide to see patients in person, it will be crucial to protect your practice through informed consent. APA has developed a customizable informed consent template for in-person sessions during the public health emergency.”
- Take steps to reduce the spread of COVID-19 in your office
- Implement policies that protect employees
Helpful Tips for Patients
With the spread of COVID-19 many suffer with fear and anxiety. Psychologists have so much to offer our patients and the public as practitioners, researchers, professors and administrators.
- Tips from SAMHSA for patients: https://store.samhsa.gov/product/Taking-Care-of-Your-Behavioral-Health-During-an-Infectious-Disease-Outbreak/sma14-4894
- Coping With Stress During Infectious Disease Outbreaks, https://store.samhsa.gov/product/Coping-with-Stress-During-Infectious-Disease-Outbreaks/sma14-4885
- Centers for Disease Control and Prevention, Coronavirus Disease 2019 (COVID-19), https://www.cdc.gov/coronavirus/2019-ncov/about/transmission.html
- Talking With Children: Tips for Caregivers, Parents, and Teachers During Infectious Disease Outbreaks, https://store.samhsa.gov/product/Talking-With-Children-Tips-for-Caregivers-Parents-and-Teachers-During-Infectious-Disease-Outbreaks/SMA14-4886
- Handwashing and Hand Sanitizer Use at Home, at Play, and Out and About, https://www.cdc.gov/handwashing/pdf/hand-sanitizer-factsheet.pdf
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