When President Trump declared that he expected social distancing policies to relax “by Easter,” many of us in public health rightly guffawed. The rate at which coronavirus spreads, clearly showed that Easter is exactly when we need to be socially distancing most aggressively.
However, the President’s proclamation was a very good illustration of one of the major stress es facing all of us, and that is measured in the CANS item “Traditions and Rituals.”
The President’s proclamation enunciates the sadness and longing that many of us are going to feel during the spring holiday season. This is a time we typically see family, go to a religious service, and take time off. In contrast, this Passover I will spend hunkered down in my house, with a shaggy unkempt haircut, and anxiety over any number of things. This stressor is real, and through the “Traditions and Rituals” item on TCOM tools, is in fact measurable.
The “Traditions and Rituals” item is found in the Acculturation Domain of most CANS and ANSAs. As its anchor definition states: “This item rates the individual and family’s access to and participation in cultural tradition, rituals and practices, including the celebration of culturally specific holidays.” The item becomes actionable when “Individual and/or family experience significant barriers [… in] practicing their chosen traditions and rituals consistent with their cultural identity.”
During the time of Covid-19, participating in group traditions like Easter, Passover, and Ramadan will be significantly blocked. Those scoring TCOM tools need to do as they always do: assess if this barrier is having significant impact on a client or member. Take the time to talk to your clients and see if not being able to do their typical spring holiday traditions is stressful for them. In many cases, clients might not even realize that it is, but upon a careful assessment will reveal a well of emotion and loss, and that finding some solution to get some access to the ritual might really help them in important, clinical ways.
Possible action trajectories for this “need” could include making this a psychotherapy topic in order to grieve what is lost, as well as working to find some realistic “work around” such as a virtual religious service, or internet-based family get together. Even if it isn’t “the real thing,” just the effort and accomplishment of connection on these meaningful days, could have a very salutary impact on a person’s functioning.
Of course, not everyone is going to be bothered by the interruption of these holidays. For some people, helping them get connected to their family on Easter, or attached to an online religious ceremony in lieu of an in-person connection, will make no difference on their functioning or sense of purpose. Thus, for them, traditions and ritual interventions are not a need at this time. A strong assessment will tease out those for whom this is an issue, and those for whom it is not, and make appropriate treatment plans based on the information.
Then, for those of us on the administrative side, it will be important to see the rise in needs we should expect to see in our data. Of course, Covid-19 will correlate with rises in needs in many items and domains, but this rise in Traditions and Rituals needs should also appear in our data, and it gives us an objective understanding of the impact that cultural issues are having in our population, and our ability to address them.
Stay safe everyone,