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‘I feel like I need to be there’: How Philly therapists are coping with longer hours and same stressors as their clients

Therapists are seeing more demand for their services, but it's not always easy to create boundaries for themselves.

Noel Ramirez, a Philadelphia-based therapist, has created a home office for conducting therapy sessions.
Noel Ramirez, a Philadelphia-based therapist, has created a home office for conducting therapy sessions.Read moreCourtesy of Noel Ramirez

When the COVID-19 pandemic hit Pennsylvania in March, psychologist Kyle Holsinger closed his office in Media and was unsure of when he would be back. At home, Holsinger, the clinical and executive director of Delaware County Professional Services, set up a makeshift office in his basement to see patients through teletherapy.

“I can stay in there for hours,” he said. “It can lead to some frustration and isolation, but I’m working on those boundaries and setting a routine that includes getting regular sleep and hygiene, not just working in pajamas.”

Like Holsinger, most therapists based in the Philadelphia area have had to set up home offices and quickly adopt teletherapy during a time of increased demand in mental-health services as people struggle to cope with stress from the pandemic and civil unrest spurred by the death of George Floyd.

The changes have left therapists scrambling to adapt to longer hours, set dividers between work and home life, and find space to process their own feelings about what’s happening in a healthy way.

“It’s a challenge to set aside clients’ issues [at home],” Holsinger said. “I’m coping and dealing with it in a very overt way, like setting aside time that is for self-care and personal life. People who get into this line of work tend to struggle with that.”

For Noel Ramirez, a therapist who works at a federally qualified health center and saw clients at the William Way LGBT Community Center in Center City, moving all his appointments to a virtual platform was the easy part. Ramirez, who is 35 and considers himself a “digital native,” said that teletherapy has been a regular part of his practice for five years. But since the pandemic started, he said, it can be challenging to find time for himself to recharge, especially because he no longer has his 20-minute morning commute, which he used to ground himself before sessions.

» READ MORE: Where to find free and low-cost therapy and support right now

“I feel like I need to be there constantly,” Ramirez said. “Many of us in the field really love what we’re doing, and access to teletherapy gives us an opportunity to do more of our work. But then I find myself working 12-hour, 14-hour days, six days a week.”

Experts have pointed out that telemedicine can, in some cases, decrease access to health services for patients who lack the necessary technology or have trouble using it. But Ramirez said that, overall, teletherapy has helped improve access to marginalized communities that have fewer mental-health resources in a time when the need has increased. With teletherapy, Ramirez has been able to reach those people more easily, including queer people of color and those with mobility issues.

Meeting clients virtually in their homes “has created more opportunity to connect and relate,” he said. “I’m able to talk to people about topics that they may have been more hesitant to share before.”

Okichie Davis, a Philadelphia-based therapist, has seen an increase in demand in their private practice, Endeavoring Wellness, since George Floyd’s death. Davis, a Black queer woman who uses the pronoun “they,” intentionally addressed what was going on in the news with each of their clients.

“Racial identity is an undeniable aspect of my life that I deal with every day,” Davis said. “At this time, all of my clients are Black. It would be unethical of me not to address this issue as a clinician, so I made it a point to create space for my clients to talk about how they’re handling everything going on, and have a real conversation about how they can process their feelings and manage their own safety.”

To protect their own mental health, Davis drew firm boundaries around work. They stick to the same schedule they would have had if they were working out of a brick-and-mortar office. They also set aside a dedicated room in their home to conduct virtual sessions.

“It’s the only time I go in there,” Davis said. “I also let clients know when I can be available, through clearly listed office hours. Not only am I respecting my time as a human being who needs relaxation and leisure, I’m helping my clients set those boundaries in their own lives, as well.”

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For Saleemah McNeil, who owns Oshun Family Center in Jenkintown, reading in her free time has helped her “preserve some of my peace,” she said, during this time of heightened racial tensions.

McNeil has also found comfort in figuring out how she can help the Black community — by offering free teletherapy to people who have been most affected by racial trauma. In the last few weeks, McNeil has raised more than $76,000, hired eight therapists from across three practices, and scheduled 39 people for sessions. Although she’s increased her workload, she said that doing all this has helped her feel better.

“As a Black community, we are a collectivistic culture,” McNeil said. “It feels great not only to be able to hire Black therapists but also to expand our economic development.”

Davis encouraged other mental-health providers to embody the “same healthy skills that [therapists] are asking [their] clients to embody,” saying that during a time when so many things feel as if they are outside of people’s control, preserving personal space is that much more important.

“When we are well, we are doing our best work,” Davis said.

Holsinger said spending time, even virtually, with his colleagues has helped him recharge. He said that talking with fellow therapists about some of the same struggles they’re facing has helped him feel a sense of unity and support.

“Getting social support gets us to take a step back and make sure we’re practicing what we’re preaching,” Holsinger said.

Ramirez agreed. He is on a committee addressing white supremacy in mental health through the Pennsylvania Clinical Society of Social Work, and said that he’s been able to find refuge by talking with other therapists of color.

“We’re all in collective trauma,” Ramirez said. “The issue is, even if you are a healer, you might feel the lethargy, hypervigilance, and depression, too. Those apply to us, too. So allowing myself to be healed and held by that collective has allowed me to feel restored.”