Many countries did not have alternative healthcare arrangements during their initial COVID-19 lockdowns. This is surprising as partial and full lockdowns have been previously used to manage terrorism and the SARS outbreak of 2002-2003. This paper examines how lockdowns disrupt normal healthcare services and discusses countermeasures that can be used during lockdowns regardless of the emergency that engendered them. Solutions are discussed pragmatically with front-line clinicians, healthcare managers, and policymakers in mind. Mental health services are used as a case in point with generalizable lessons for other healthcare specialties.
Our theory of harmony therapy explains how therapists have helped disharmonious families or couples build relational harmony without sacrificing intrapersonal harmony. In collectivist Singapore, where the family is the basic unit of society, and racial and religious harmony is the dominant discourse, therapists may worry that family harmony is valued so much that individuals’ intrapersonal harmony might be sidelined. We used grounded theory to guide our interviewee selection and qualitative analysis of thirty clients who sought therapy to find harmony in their conflictual relationships. Clients perceived that therapists who built both family and intrapersonal harmony (1) were helpful professionals, (2) encouraged collaborative conversations, (3) had expertise, (4) were more involved than usual, and (5) were collaborative experts. Therapy was perceived as less effective due to (a) insufficient or unhelpful expertise, (b) insufficient or unhelpful involvement, and (c) perceptions of unhelpful professionalism. Practitioner points We aim to build interpersonal harmony without sacrificing intrapersonal harmony with families from collectivistic cultures This means owning our professionalism and expertise with clients lightly, as both can sometimes be experienced as unhelpful We encourage collaborative conversations, which are rarely experienced as unhelpful We want to ensure that clients feel we are sufficiently involved with them and sometimes go ‘beyond the ordinary’
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