News and Events

COVID-19: Daily Behavioral Health Blogs

Dr. George Vergolias, PsyD, CTM & Dr. Tyler Arvig, PsyD
March 30, 2020





Addiction Recovery In a Time of Isolation


In Minnesota we are known for an abundance of two things, lakes and addiction treatment programs! Neither of those are exactly easily accessible at the moment (the lakes are still frozen as of today, and COVID-19 has severely impacted treatment). Recovering from alcohol or drug addiction is a long and challenging process. You will hear people talk about sobriety as a full time job. A recent news article highlighted one expert’s experience of seeing more relapses since COVID-19, with the associated disruption in treatment. Although it is impossible, at present, to know whether this is a trend, it warrants our attention now, as there are millions of Americans who struggle with addiction.


For millions throughout the world, one of the constant avenues of support is Alcoholics Anonymous and the closely related Narcotics Anonymous and Al-Anon. These mutual support groups are at the heart and soul of the 12-step model of addiction treatment. However, such groups have been largely shuttered in person due to social distancing and shelter-in-place orders. Likewise, other treatment programs have had to temporarily stop in person services, leaving many reeling with a lack of critical support.


The concern goes well beyond lack of access to support or treatment. There are various risk factors present that may increase risk of relapse.


  • Anxiety is ubiquitous—and anxiety can be a major trigger for use.


  • Isolation is expected—this provides more opportunity for boredom and more opportunity to use without others knowing.


  • Financial stress is likely present—Stress associated with potential job loss, or the general economic downturn may lead to feelings of depression, increasing potential for relapse.


  • Lack of primary support—As COVID-19 has isolated us socially, it also is isolating from parents, children, or other key supports.


The good news here goes something like this…For the person struggling with maintaining sobriety, treatment resources have not disappeared…they might just look a bit different. Support groups, such as AA, are now being held virtually. Treatment programs, like Hazelden Betty Ford, are offering programming via tele-medicine. Like other areas of behavioral and medical treatment, addiction treatment is quickly working to adapt to the current situation.


And for every person struggling with addiction or to maintain sobriety, it is important to remember that the current circumstances do not preclude many helpful things, such as: phone calls to loved ones, exercise, engaging in meaningful activity, and continuing to take one day at a time.


If you or someone you know needs more information about addiction treatment or support, these websites may be helpful: (Alcoholics Anonymous) (Hazelden Betty Ford) (Substance Abuse and Mental Health Services Administration)


Everyone familiar with the 12-step model of sobriety knows about the concept of taking one day at a time. I only have control over my actions today, in this moment. Tomorrow is too far away and outside of my control. This sentiment should apply to us all, particularly at a time of such uncertainty about what tomorrow, next week, or next month may hold. If we take one day at a time, we will get through this together.


Tyler Arvig, PsyD, LP

Associate Medical Director

R3 Continuum


For more information from our Subject Matter Expert’s regarding COVID-19, check out some of our other daily blogs:

Daily Security Blog:

General COVID-19 Updates:




Find Something to Enjoy Today


Unfortunately, as it relates to COVID-19 in the United States, there are difficult times ahead. If we don’t yet know someone personally affected by the virus, we soon will. I don’t know how you are feeling now, but I feel a mix of anxiety, gratefulness, uncertainty, and numbness. It, honestly, can be quite draining.


Two things happened to me today that pulled me out of 24/7 focus about our current situation. You might find these highly individualized and not applicable to you. I would not expect these to apply to anyone but me. Likewise, I wouldn’t expect your examples to generalize to others. In any case, as you indulge me, be thinking about how this may look in your life.


Today marked the release of a new album by one of my favorite bands, Pearl Jam—their first new release in several years. I’m doing my first cursory listen to it now, and will no doubt listen several more times in the coming days. Why is this important? Because this music has been part of my life for 25+ years, and everything, good and bad, that has happened in that time. The new music reflects something familiar and something new…. We have not lost what was, and can look forward to something new.


Also, today, my old car (some might call it a sentimental money pit on wheels) was returned after being in the shop for almost a year. I had all but forgotten about it until the shop owner called yesterday to ask if I wanted it delivered to my home. An hour ago, it was delivered and is now in my garage. It feels good to have it back. It brings back memories that are comforting—driving around with my grandfather, leaving my wedding ceremony with my wife, and of course the all too common being broken down on the side of the road, at night, waiting for a tow! These are reminders of life as it was before COVID-19, and how it will be again, eventually. In the coming days, I will find time to clean it up, change the oil, or just go for a drive, even if it’s just for 10 minutes.


Find what works for you. A welcome escape for some may be considered work for someone else. Whatever we choose, it should help to recharge, refocus, and disengage from negativity. This is not being selfish or uncaring. On the contrary, self-care increases our capacity to help those around us when needed.


We will get through this together.


Tyler Arvig, PsyD, LP

Associate Medical Director

R3 Continuum


For more information from our Subject Matter Expert’s regarding COVID-19, check out some of our other daily blogs:

Daily Security Blog:

General COVID-19 Updates:





Supporting Our Essential Workforce During COVID-19


I spent some time in a recent blog discussing social distancing, isolation, and the behavioral health impact of work from home. Shortly after, a colleague was talking about having family members  who were essential employees, and therefore unable to work from home. How do we support those that do not have the work from home option? Our medical support staff, doctors, cashiers, gas station attendants, hotel workers, flight attendants, and trash collectors? In other words, the people who are critical to keeping the systems running that allow our society to keep moving forward?


A recent trip to a large retail store made me wonder if I had inadvertently traveled to a parallel universe. Customers were polite, kept good social distance, showed genuine appreciation for the workers and their safety, and even smiled at each other. Questions that are normally filler (such as, how are you?) were meant to elicit a real meaningful response. This is not the first time we have experienced a collective sense of togetherness and genuine compassion in recent decades (in the days following 9/11 we saw a similar sense of community), but it was great to see again and instilled a sense of hope. The reality is, whether we see them or not, millions of Americans will need to continue to go out into the world as the rest of us shelter in place; and they need our support.


There are things that we all can do in support of essential employees. Here are just a few:


Ask, how can I help?—Rather than making assumptions that someone may need something, ask how we can support them. The answers will vary, but we can be assured that we are supporting them in a way that matters. And even if they don’t need help, they now know they can come back to ask for help at a later time.


Liberally and creatively say thank you—Leave a note for your mail delivery person; give a gift card to your UPS driver; leave a larger tip for take-out food with a note of appreciation. These intangible things can make a huge difference in someone’s day.


Be a support—One of the most effective things we can do to support others is to listen and engage. It does not require us to be an expert, it only requires that we care. People who feel supported are better able to deal with adverse situations.


Be a resource— Essential workers may need help getting the resources needed to allow them to continue working, likely long hours. Maybe they need help figuring out a childcare situation, keeping track of appointments, or finding a treatment provider for themself or a family member.


Check in— Staying connected is important, and taking time out of your day to connect is a great way to keep human contact. Particularly for those who may be working long hours, under high levels of stress. The more connected, the less likely we are to feel depressed.


Encourage professional help if needed—COVID-19 has done something rather interesting to the field of medicine/behavioral health in that it has, in full force, made tele-medicine/tele-health the go-to method of treatment. This means that professional help is easier to access than ever. Having a computer, tablet, or smart phone means access a behavioral health or medical specialist from anywhere. If there is concern about someone needing more help, don’t hesitate to encourage they see a professional. It is easier than ever.


Lastly, Empathize—while I can’t understand what it takes to be a nurse, retail worker, or delivery driver in this time, it is not difficult to comprehend the level of stress and anxiety that may go along with such a role. Putting ourselves in that head-space can help determine the best ways to show support.


Take some time, today, to show support for some of the essential employee’s you may know or encounter in your life. We are all in this together.



Tyler Arvig, PsyD, LP

Associate Medical Director

R3 Continuum


For more information from our Subject Matter Expert’s regarding COVID-19, check out some of our other daily blogs:

Daily Security Blog:

General COVID-19 Updates:




Expect Unexpected Distractions


As of this morning, more than 100 million Americans are under some version of shelter-in-place, some under Statewide and others under city or countywide restrictions. Many of us are, or soon will be, working from home. This is a large paradigm shift and not so easy transition for most.


When I’m not traveling for R3c, I work from my home office in North Carolina. I’ve been working from home for almost 7 years now. It took lots of adjustment at first, but I like it a great deal. I have my productivity routines pretty much locked in, even with a 9 and 12 year old running around. Yet, I’ve been struggling these past two weeks to keep focused and as productive as usual, and struggling with why is that so?


It finally occurred to me. This is all different. I now have to expect and anticipate the unexpected distractions and build those into my view of the how the day will go.  This is different than Summer break or track-out. While those pose challenges for working from home parents, currently navigating the daily grind is more complex.


There are a number of effective productivity patterns that can help, including establishing a routine, prepping for the day as you usually would, and setting a clear schedule. Yet one that is often overlooked is approaching the entire endeavor with the proper perspective and working to keep that perspective front and center. But now we have to acknowledge that thing are a bit different.


Even those of us who have worked from home for some time are finding things a bit odd, because now in this current crisis working from home is different than it used to be. It’s important for us to remember that. Kids being out of school, businesses shut down, reduced mobility of family and friends, loss of prior childcare options such as dropping the kids off at grannies house – it’s all different now.


You see it’s not just about “working” from home anymore. Now, for many it also means being caretaker, and teacher, and short-order cook, and cleaning crew and a myriad other duties and rolls that need to get done because those tasks don’t know or care about a pandemic.


Additionally, there are a myriad of ways everyday decisions get infinitely more complex. A few examples.


On a typical track-out my son may come in and ask if he can go to his friends house down the block. “Sure, be back by Noon”. Easy, right? Not anymore. The same question now brings a deluge of follow-up interrogation-like questions: Has that family been exposed? What do the parents do, do they travel, where do they work? What is the parents view of this situation, are they acting responsible? Is this friend mature and responsible enough to keep reasonable social distance? Will my son stay outside their house? What if he has to use the bathroom? Will they share food, or a drink? What if other kids come by that house? Does that family have anyone staying with them, from here, when did they arrive? Do they have any elderly people over there? And so on, and so on.


Sorting these questions and conflicts out takes time than the previously quick “sure, go ahead”. Now I have to think it through, I have to call my wife at work and ask her opinion, I may need to call the other kids parents, etc. Then if I say “no” I have to explain the decision to a 9-year old who isn’t quite getting it, bored to death with cabin fever, and just wants to see his friend and have something to do.


And underneath all of that, at some level, he’s scared. Because shelter them as much as we may want to, kids pick up stuff. He hears the hushed discussions between my wife and I at the breakfast island or after dinner cleaning up dishes. He picks up snippets from social media, or the news. He notices the markedly reduced traffic and interaction in our neighborhood. He overhears my calls with colleagues at the hospital.


This isn’t just about parents. A close friend calls to say he’s heading to an outdoor concern this evening, or inviting me to a block party at the clubhouse of their apartment community. Normal response is, “great, have fun.”  Not anymore. This also leads to a host of questions, some stated, some kept to oneself, but all marinated in worry and concern. My friend is upset that I won’t join him, thinks I’m acting paranoid, says we’re “growing apart”. This leads to discussion and explaining risk and reaffirming of the friendship and my care for them, and so on.


My mother-in-law calls to say they are on the way over to our house, to spend time with us. Normal response is “great, we’d love to see you.” But now? Wait, what? Bad idea, and yes I have to tell them that, but I can’t just say it and hang up. I have to explain why it’s a bad idea, why they need to turn around now, why if they come over we’re not letting them in. This takes time because feelings are hurt, and they miss their daughter and son-in-law, miss the grand kids, and they have a right to see us, and so on.


People want normalcy. Normalcy is a sign that “all is ok”, and normal is for me to say “sure, go ahead” or “great, come on over”. Normalcy is now gone. People are scared, some are confused, and most just want normal back. To manage that takes time, and discussion, and a deep sense of care, and those conflicts and challenging moments don’t care about your work schedule, or your conference call in 15 minutes or that deliverable you need to get out to your boss.


These are the unexpected distractions that are creeping up in all of our lives. We should plan and adjust for them. That can mean many things: longer days but more spread out to handle these distractions intermittently; if possible planned breaks in the day to address these issues (“Let me call you back at X”); orienting our family and friends to how things may be for a bit; and perhaps most importantly being patient and kind and understanding, with ourselves and others, that we’re all just not getting as much done as we used to. For a little bit, this is the new normal, for us all.


George L. Vergolias, PsyD, CMT

Medical Director

Forensic Psychologist


For more information from our Subject Matter Expert’s regarding COVID-19, check out some of our other daily blogs:

Daily Security Blog:

General COVID-19 Updates:




Keeping a sense of normal during COVID-19


Human beings are creatures of habit, and when we are outside of our routine, things can get uncomfortable. COVID-19 has, to put it mildly, thrown our daily life and habits into disarray, leading to a sense of fear, confusion, and anxiety. Our personal and work lives and routines don’t resemble what they did just a few days and in some cases weeks ago. The speed of change is practically incomprehensible. We are trying to stay grounded at a time when the ground keeps shifting.


As of a few weeks ago (pre-COVID-19), there were likely things that became staples of yours and your employee’s existence. These things represented what was a “normal day”. Having a morning cup of coffee in the office, listening to a radio program during the morning commute, working out at the gym, or having lunch with friends. As of today, how many of those staples are still there? Maybe some, but probably not many.


Along with that, a great majority of the workforce has moved to remote work style in an effort to follow guidelines and directions of self-distancing. With that some employees may struggle with how to create and maintain a new sense of normal during this unprecedented time. Some may even begin to feel isolated and lonely as they miss the social interaction, they have become accustomed to and, in some cases, depended on.


So how do we maintain a sense of normal when things are decidedly abnormal?


  1. Keep the small things going—The small things help us to stay grounded every day and provide a sense of comfort.
  2. Take stock of the positive – Even in the most difficult of circumstances, there are positives and things to celebrate.
  3. Limit exposure to negative news – While it is important to stay informed and be proactive, too much exposure to “doom and gloom” can have a real impact on our mental health. At the very least, make portions of the day “news free”.
  4. Find something new – What better time to take on a new project or learn a new skill? Not only is it a welcome distraction, it is also productive.
  5. Stay productive – Just because we are limited in what we can do does not mean we can’t do anything of value. Whether work related or personal, keep busy.
  6. Have fun! – While having fun may seem inappropriate in such a time, fun is a critical component to our behavioral health. Find time to laugh, play games, go for a drive or bike ride, or do something that engages our inner child.
  7. Seek out relationships – Practicing “social distancing” does not mean we cannot engage with loved ones, friends, and colleagues. There are more ways than ever to stay in touch. Set aside time every day to engage with others.
  8. Ask for help when you need it – It will be common for people to struggle with the current situation, and some may need additional professional support. There are many resources available that do not require leaving home.


As an employer, if you have an employee who may be experiencing distress or increased anxiety, R3 Continuum can help. In a recent blog, Supporting Employees and Organization Operations During an Epidemic we provide some general information of what your employees are looking for from you, along with what to watch for within your employees that may be red flags, warranting additional support.


You are not alone in helping to support the emotional wellbeing and resilience of your employees. Should you have an employee who is in distress, or several employees R3 Continuum has telephonic group sessions and one-on-one support solutions available. We can help.