COVID-19 and the Termination Blues

I’ve been working with kids for a long time. When I started running group therapy sessions, Ronald Reagan was winding down his second term. I was a 25 year-old graduate student, living with roommates in a crummy apartment. A few weeks ago, I turned 57. I live with my wife and teenage daughter in a house in the suburbs. Almost everything about my life is different from the days when I was an intern. But I’m still running the same type of groups.

I write this not as a prelude to wistful retrospective or as a hymn to the good old days. Rather, it’s a lead in to discuss the importance of maintaining some sense of professional detachment in doing therapeutic work. Counselors, psychologists, social workers, and other professionals involved in human services deal frequently with emotionally laden work that demands that we be fully present, empathic, and supportive. But, once our direct work is done, it’s important to be able to leave it behind. People who can’t compartmentalize tend to burn out. When I find myself spending too many non-work hours thinking about the kids I work with, it’s usually a good indicator that I need to take a few days off.

Our groups at Academy MetroWest operate on a school-year schedule so they have a natural arc. Right now, we’re going through the termination process like we do each year at this time. Saying goodbye to groups can evoke feelings of loss and a million other related emotions among both group members and leaders. I’m usually able to work my way through the process pretty well. When I say goodbye to clients I’ve known for a long time, knowing they may not return in the fall, it can be hard but, again, without being able to turn it off, I would have had to change careers ages ago.

But this year has been different. Since late March, we’ve been running groups remotely. Rather than playing with kids in our gym, we’re gazing at each other through computer screens. I’d be lying if I said that it hasn’t been a challenge for me and my staff. Zoom sessions are not for everyone. We’ve had much more success with older kids than with younger kids. Kids of all ages have suffered from school-related Zoom fatigue. They spend so much time in Zoom meetings for school that by the time our groups come around, they have nothing left. Remote sessions also demand more sustained periods of conversation. Our client base skews heavily male and they often come to us because of our more activity-based approach, making Zoom sessions a tough sell for some of them. Honestly, Zoom is a tough sell for me. The level of connection and engagement you can get through a video conference is just not the same as when you’re actually in people’s physical presence. I’ve had more than a few remote sessions in which, as soon as I signed off, I said to myself “Well that was unsatisfying.”

But this past week, as we’ve been saying goodbye to our kids, I’ve noticed something else. Termination has been a lot harder for me than it usually is. And I think I’m starting to piece together the reasons for that.

One of the main tasks involved in the therapeutic termination process is tying up loose ends and bringing closure to the group. We make a point of telling our kids that even if they’re planning on returning to the program in the fall, it’s important to treat the end of the year as a real goodbye. Plans change. Schedules change. Sometimes our staff changes. So even in cases in which groups have stayed together for years, we still emphasize the idea that saying goodbye is vital. It’s better to say goodbye and mean it and then be pleasantly surprised if a group comes back together than it is to deny that anything is ending and then being bitterly disappointed when the group dissolves. I’ve been giving that message to kids every year for a long time but I suspect that this is the first time I’m really living that message. Everything about these “unprecedented times” seems to involve uncertainty. We’ve received a lot of questions from clients about what our program is going to look like in September. While we’re starting to piece together some scenarios, the honest answer is that we have no idea what anything is going to look like in September. Sometimes it seems as though we’re over the hump in dealing with the pandemic. Then we read stories like this one that shows COVID cases increasing and everything reverts back to uncertainty. With so much sickness and sadness as a backdrop, saying goodbye somehow seems realer than it has in the past.

I have a group of hyperactive 5^th grade boys I see each Wednesday afternoon. When we were meeting in our gym, this was a difficult group. Our gym is loud, stimulating, and, at times, chaotic. For many kids with ADHD, maintaining behavioral and emotional regulation in that setting is a big challenge. This is one of those groups. A former colleague used to describe groups like this one the following way: “This group reminds me of my family. Individually, I love them all. But you put them in the same room together and they drive me crazy!” But during our remote sessions, these boys have kicked butt. Without the noise and stimulation, each and every one of them has been able to consistently express assets that, in the gym, I would have to dig down deep for. Every one of them is smart, creative, and funny and, since early April, I’ve seen those traits clearly. They’ve become my most cohesive and productive group. Sometimes, when our sessions are over, they’ll stay online and continue doing activities with each other. At a time when social opportunities are hard to find, these guys clearly value the time they get to spend with each other and I’m so proud of them for the community they’ve created for themselves.

I said goodbye to those boys a couple of days ago. We’re running some summer programs so it’s possible I may see them again soon. I fully anticipate that we’ll be running our program in some way, shape, or form come September. But it was really hard to say goodbye. Part of our justification for running remote groups was the idea that kids would need a consistent, structured, social experience. I guess what I’m learning now is that kids aren’t the only ones. We all do. The process of winding down our groups brings us to another point of uncertainty and loss. Emotionally, I’m experiencing something along these lines: “Okay, so on top of thousands of people getting sick and dying, an economy that’s in a tailspin, and issues of racial justice staring each of us in the face, NOW you mean to tell me I won’t be able to play Jackbox games with my 5^th graders anymore?!?!”

Earlier in the week, I was running a group with my colleague Hope Notaro. Hope introduced an activity to our 3^rd and 4^th graders that sought to have everyone take a look back on the past school year and answer some open-ended questions.  The first question asked us all to name one good thing that happened this year. I thought about it for a minute and answered that this year brought me to a real appreciation of the time I spend in the physical presence of my friends and family. I’ve been thinking about that all week. I appreciate video conferencing for what it’s been able to add to both my professional and personal life during the pandemic. For all of Zoom’s shortcomings, it’s what we’ve got now. But the termination process as a whole has driven home the fact that we’ve all experienced loss and uncertainty during the last few months and it’s starting to feel especially real. Acknowledging and processing those feelings can be a struggle but it’s an important one. As we continue to live with those feelings of loss and uncertainty, it’s my sincere wish that it makes the process of returning to normal – in whatever form that takes – all the sweeter.