Well Clinic started a free 8-week therapy program.
In response to COVID-19, the March 27th, 2020 Coronavirus Aid, Relief and Economic Security Act (CARES) provided funding to mental health organizations across the country through PPP grants. After securing funding, Well Clinic started a free 8-week therapy program for lower income folks and people who are struggling in general that could benefit from talking to someone for 8 weeks.
Well Clinic had the opportunity to provide 1,621 free therapy sessions in an economically unstable time to those in need of mental health support.
To get the word out, Well Clinic used social media and promotion through clinician networks to provide these free therapy sessions.
In June 2020, the PPP Flexibility Act was passed, giving recipients more time to use these funds and more flexibility in their allocation. This allowed for any clients currently receiving our services to have access to twice as many free sessions. Instead of 8 sessions, they could receive 16, which many clinicians and clients reported felt much more helpful, with most clients staying on for all 16 sessions.
Our free program extended from the end of May through October of 2020. Many of the clinicians matched with free therapy clients, with clinicians seeing an average of 2-5 clients through the program.
As this pandemic continues to impact many economically and folks continue to experience mental health distress over the consequences of this global disaster, it feels important to reflect on the success of this program and help promote greater access to mental health care, regardless of financial ability.
Pandemic Stressors in the Therapy Room
In speaking with several of our clinicians who worked with clients through the PPP program, clinicians reported top stressors as financial/economic, listing job loss or unemployment as a main reason for seeking therapy. For those with financial security, this fact is a stark reminder of the toll that financial insecurity takes on our minds and bodies.
Former LMFT, Patty Murray, noted the prevalence of relationship issues: “The stress of the outside world impacted intimate (romantic and familial) relationships as everyone was emotionally under-resourced and living in close proximity.”
Well Clinic clinicians noticed this as well, as Lilly Servera, LCSW, described: “Both family and partner relationships were impacted across clients. With folks living closer to family members, without space from loved ones to care for themselves, or stepping into new caregiving roles, this felt extra challenging.
In regular times, it wouldn’t feel so pressured. With so many layers of stress and anxiety in close quarters, this is a lot to deal with for any person.” On the flip side, others reported distressing loneliness around lack of community and physical isolation.
Many clients seeking therapy reported stress around uncertainty in general: around lack of familiar routine, finding a job, political leadership, and not knowing how long these “life-altering restrictions” will last.
Alongside uncertainty, Patty noted that fears of contracting COVID-19 or a loved one becoming ill were prevalent. This dovetails with research from the CDC as well as NIH, as well as personal experiences of many in the Well community.
In a Census Bureau study, researchers found that “compared to U.S. adults in 2019, U.S. adults in April and May 2020 were more than three times as likely to screen positive for depressive disorders, anxiety disorders, or one or both, with more than one out of three screening positive for one or both.” The spike in anxiety distress has been reported as even more paramount for those ages 18-24.
Both Servera and Vanessa Brown, LMFT, stated that specific stressors around racial trauma were impactful for clients. Servera observed: “The pandemic exacerbated racial trauma for some of my folks, where they had less space and boundaries with family for instance.
In a family unit, everyone was processing racial trauma in different ways. Alongside COVID-19 surges, the BLM resurgence last summer aligned with the timing of our program.”
Hope and Resilience in the Therapy Room
Despite the immense amount of pain, anxiety, loss and trauma during this time, clinicians reported high levels of resilience in folks receiving services. Brown noted that clients, overall, “were kind, compassionate and always looking forward, moving forward and working on improving themselves.”
With only 8-16 sessions, working with mental distress around complex trauma and suicidality can feel daunting for both the client and clinician. As Servera noted, “It was difficult to create that space knowing that time was limited. With all of these factors, I felt like more time would have been better to further process such complex and intertwined trauma.”
Even so, clinicians reported that many clients showed up with concrete goals and motivation to utilize their time in therapy.
Murray stated, “Due to the limited time, clients appeared much more eager to ‘do the work’ — they were consistent in attendance and maintained a relative focus on the key presenting issues, so things felt slightly more focused.”
Brown reported a sense of empowerment doing work with folks “with a positive response to therapy, ending with many clients feeling more resourced. Folks were accepting of self-care plans and open to taking on and trying new things like mindfulness and meditation.”
Murray experienced clients with “a great willingness and pursuit of prioritizing their mental health through getting support from the clinician as well as other built-in supports like friends and family.”
Clinician Feedback and Future Plans for Action
Overall, clinicians reported “a high sense of gratitude” from those receiving services.
Murray shared that sentiments from clients like: “I feel so grateful to have been part of this program, especially at this time in my life and during the pandemic”. The majority of Murray’s clients went on to continue treatment at sliding scale clinics, as they were eager to continue with therapy.
Lucy Moore, LMFT, had clients who reported feeling supported by having a time and “place” to be caring for themselves during a time they primarily cared for others.
With the state of mental health care in this country, many folks with low income find themselves on long waitlists for affordable therapy or unable to obtain services that attend to their specific needs.
As our clinic works to diversify on all levels, this program provided a chance to reach out to people beyond the immediate communities able to pay out of pocket for services.
Brown stated, “This has been an opportunity to provide services to people in low income groups felt much more freeing. I felt really empowered to do good work with them. In this private practice setting, it felt really refreshing to work with people with specific goals. Many folks had a positive response to therapy and some continued after the program.”
With a collective sense of gratitude from clinicians participating in the program alongside their clients, there is hope that Well Clinic can continue to offer these services beyond COVID-19 and provide more opportunities for access to care.
At the moment, we continue to offer sliding scale and pro bono services based on clinician availability. Schedule a free consult to learn more.
About the Author
Lucy Moore is a Licensed Marriage and Family Therapist (LMFT) at Well Clinic in San Francisco. In her words, “I am here to help you build on your strengths, cultivate resilience, and provide tools for communication and conflict resolution.”
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