NORTH ADAMS — The dread of going back to school. The fear of losing the time for therapy, once offices open up again. The anxiety of renewed socialization.
These are just some of the issues that the clinicians at 413 Theraworks have been helping their clients through, via remote therapy sessions, as the end of the coronavirus pandemic becomes a possibility and its aftereffects threaten to reverberate for years.
The practice has grown fivefold since Candace Wall opened its doors just ahead of the pandemic, in August 2019. Wall made her first hire that winter and brought on three more employees during the crisis, to deal with widespread anxiety, depression, grief and trauma brought on by COVID-19, in addition to the stressors of ordinary life.
Across the country, demand for therapists has surged during the pandemic. Last fall, a poll from the American Psychological Association showed that therapists were seeing more patients with anxiety and depressive disorders compared with pre-pandemic levels, and many were seeing more patients overall.
Wall has seen that demand for herself.
“We’re in hiring mode,” she said. The need for more clinicians is there. Every time we’ve hired someone and cleared out our waitlist, it fills back up again.”
Her goals go beyond the pandemic, though. She wants to expand local behavioral health services and build options for people outside The Brien Center, a major provider in the region.
“There are huge service gaps in North County,” she said. “This community is so near and dear to my heart, and being able to offer a space that is nonstigmatizing, nonjudgmental and open for anybody is super important to me.”
Wall, a native of Adams, returned to the area after finishing graduate school and worked for The Brien Center and the Berkshire County Jail and House of Correction. After running a solo practice for about a year, she decided she wanted company.
“I realized how lonely and isolating it was to be in private practice,” she said. “The most important thing for me as a practice owner is that we’re very team-oriented.”
Unlike many psychotherapy practices, which operate under independent contractor models, Wall said, 413 Theraworks functions in an employee-based model. That means the clinicians get benefits, like paid time off and reimbursements for personal wellness, and Wall hopes to add health insurance soon.
It also means frequent meetings and collaboration to develop procedures like intake processes and internal referrals.
Since most of the hiring took place remotely, the practice stretches from Tyringham to North Adams. One clinician is located in Pittsfield, and another in New York, with licenses to practice in that state, Vermont and Massachusetts. Wall jokingly calls it a “tri-state practice.”
Each clinician brings specific specialties and expertise, which means the practice serves a range of people. The staff includes clinicians trained in working with children, couples, families and members of the military, among others.
The different populations they serve have had a range of responses as the pandemic reaches a turning point, they noted.
Erika Baluk-Shepardson, who works with kids and adolescents, says a lot of her clients have found remote learning challenging.
“It’s been a long and stressful time for families,” she said. “Teletherapy has been a way to connect with people who are isolated at home … and a place where I can work with students and families on what they’ve been able to support each other doing, their small successes.”
Amid rolling reopenings for different grades in schools across the state, many of the kids have been eager to get back — but not all of them.
“Some are resistant because they might be returning to situations that were not ideal before the pandemic,” she said. “And now, with so much increased anxiety and depression, the thought of going back is just as challenging as remaining remote.”
Meanwhile, parents with jobs, as well as childless employees, have begun to dread the churn of work. Several had questioned whether commutes to the office and the resurgence of ordinary pressures will leave enough time for therapy.
“A lot of my clients are popping on right as soon as they end work, or during their lunch break,” Kayla Quick said. “They’re making it work with their schedule. So, the anxiety I’ve been working with is, ‘How can I continue to do therapy and do this really good work when I’m probably going to be at the office?’”
Some clients, spread across the county, also worry about having to come into the office, and Wall says she wants to continue to be able to provide virtual services.
For a large portion of the practice’s existence, the team has met and provided services over remote platforms. In January, the state mandated that insurers have to continue to cover remote behavioral health services after the public health emergency, though Wall says some insurers are more flexible than others about which providers their clients can use.
Meanwhile, some of 413 Theraworks’ clients face a simpler anxiety: They just dread the idea of returning to socialization. Wall has been working with people to adjust to the new reality that they will not be able to fall back on the pandemic as a way to skirt social outings.
In some ways, she is helping people readjust to a more “normal” life.
“A lot of my folks actually are talking about social anxiety, this pressure that ‘I have to see people again,’ ” Wall said. “The words they’re using are, ‘Forgetting how to people. I don’t remember how to people.’ ”