Businesses impacted by recession stress



Over-exposure to news about the economic crisis can ramp up fear and anxiety, says Christine Farber, Ph.D, who has a psychotherapy practice in South Windsor, Conn. (photo by Tom Croke)

By Ami Albernaz

As the economic crisis wears on, news of unemployment and foreclosure figures inching upward give way to a fear that things will worsen to an unknowable degree before they start to improve. The anxiety, dread and recent loss of a job or a home for some have led to increases in calls to domestic violence and suicide prevention hotlines, and, if not a surge in requests for psychological services, at least a marked shift in the conversations taking place in therapy.

Psychologists in New England report that while they haven't seen significant changes in their numbers of clients, recession-related stress has entered the office and has, for the time being, changed people's focus.

"Many people who still have their jobs seem more motivated than ever to use treatment to find ways to empower and protect themselves, maintain perspective and hold onto what they have," says Lynn Margolies, Ph.D., a psychologist in private practice in Newton Centre, Mass. "People are shifting in their goals - for example, instead of thinking about personal fulfillment and choices, many people are rallying in an effort to function at full capacity at work, resist succumbing to fear and anger and control what is within their purview to control."

Christine Farber, Ph.D., a member of the Connecticut Psychological Association who maintains a private psychotherapy practice in South Windsor, Conn., agrees. "Individuals are likely to be more oriented to survival needs and the stress people are experiencing is more likely to come from anticipation of not being able to meet basic needs - those of security, safety, physiological comfort," she says. "This anxiety may be largely fear based - 'I am very likely to lose my job' - and/or may be based in actual circumstances - 'I have already lost my job.'" Not surprisingly, over-exposure to news about the economic crisis can ramp up fear and anxiety, Farber adds.

Psychologists who are already established might have a leg up over fairly new practitioners, says John O'Brien, Ph.D., a psychologist in Portland, Maine and president of the Maine Psychological Association.

"I have heard that mental health practitioners (such as social workers, licensed counselors and family and marriage therapists) have experienced a downturn, especially those who have gone into practice recently and don't have a strong referral base," O'Brien says. "They don't know as many people; they aren't as established. Also, people might be following through less on referrals."

The Chicago-based ComPsych, the country's largest provider of employee assistance programs, reported a 40 percent increase in demand for therapists during the second half of 2008 - attributable largely to financial anxieties. Some of those seeking out psychotherapy seem to be trying to cut costs in different ways, psychologists say - perhaps by reducing the frequency of sessions, sticking with in-network providers and avoiding medications with higher co-payments.

Patients of other health providers - not only psychologists - seem to be trying to cut costs of care, O'Brien points out.

"I've heard people are not taking doses of medication in order to save their medication," O'Brien says. A friend of O'Brien, a primary care physician, "has seen fewer people coming in� People are choosing to not do preventative care or treatment in some cases. If they see something as optional, they're choosing to not go through with it."

In Rhode Island, the New England state with the highest unemployment rate, the suicide prevention hotline The Samaritans has received more calls about financial issues such as mortgage foreclosures and job loss, says executive director Denise Panichas. Overall, the Rhode Island hotline is hearing more from repeat callers as well as new callers.

A few years ago, Rhode Island 911 reported 500 suicide rescues; last year, it reported 1,100. Panichas will not link the increased number of calls and rescues to the economy; instead, she calls it a "snapshot in time."

Financial crises can be detrimental because of the deeper issues that loss of income can tap into. "For some individuals, money can be tied into issues such as self worth, a sense of one's value in the world and a basic sense of security, and so financial stressors and fears are likely to tap into such issues for individuals and families," Farber says.

Kenneth Kraft, Ph.D., a psychologist and organizational consultant in Boston, says that depending on how long the crisis continues, there might be a need for a coordinated response. More job losses and the expiring of COBRA benefits for those already unemployed will take an ever-greater toll on mental health, he says.

"People [who have been laid off] are in a lot of pain, and they bring it into the office," he says. "There needs to be an effort to address this. I do this in my practice, but I wonder about a larger scale."

In the long run, there might be an upside coming out of the crisis for psychologists, Farber says.

"We're seeing what I would describe as the crumbling of a consumption driven society and so individuals are being and will be, I think, compelled to address questions of value - 'What do I value?' and 'What are my priorities?'" she says. "Psychotherapy can be an appropriate and effective space for doing so."