Climate change distress is a challenge to people seeking help, and to those providing help. Those providing help are working in a new area of clinical practice where little is known, but they may also be experiencing climate change distress. The aim of this article is to highlight the personal and professional implications of the unfolding climate crisis and how we might better understand and support those with understandable, yet intense, emotional reactions to the climate crisis. This article consists of a first-person narrative by the first author, and a commentary on the narrative based on the psychology of climate change literature by the second author. We have worked independently on the narrative and commentary; each is responsible for their own contribution. The narrative highlights the first author’s personal experience of moving from denial to facing the truth of the climate crisis and the impact on professional practice. The commentary by the second author found that literature is scarce, but more familiar areas of practice may help to understand and respond to climate change distress. Practitioners face a situation where they may experience similar emotions to their clients, analogous to the shared threat of the pandemic. Awareness of the crisis is daunting, but therapy, self-reflection and action can help hold our emotions and support our clients. The evidence is limited but experience of the pandemic suggests that CBT can respond, adapt, innovate, and even revolutionise mental healthcare. These two perspectives suggest, despite the challenges, there may be reasons for hope.

1. (1) To increase familiarity with climate change distress and its multi-faceted presentations.

2. (2) To understand the importance of self-care for climate activists and the different forms this may take.

3. (3) To consider the implications of being a practitioner helping people with climate change distress, while also experiencing climate change distress.

4. (4) To reflect on the tensions between, and the potential integration of, the personal and the professional in the context of climate change.

Young people are increasingly distressed by the climate and ecological crises (eco-distress). This has been associated with the failure of people in power to act appropriately, which may cause moral distress and moral injury. We examined this hypothesis by interviewing 13 young adults (19–25 years) in the UK about their climate concerns and perceptions of how State actors and authorities are responding to climate change. Using reflexive thematic analysis, four themes were developed: (1) Climate change is a wicked problem, (2) Moral distress is associated with witnessing acts of omission and commission, (3) Moral distress drives eco-distress, and (4) Opportunities for moral repair. Climate concerns extended to broader concerns about ecological degradation (eco-distress), linked to feelings of moral distress arising from repeatedly witnessing powerful people failing to act on climate change. Eco-distress was also exacerbated by (a) witnessing others in society failing to take appropriate responsibility, (b) realising the limitations of individual action, and (c) being embedded within a culture where personal contribution to climate change is inescapable. In contrast, eco-distress was lessened by seeing authorities engage with the issues morally, and further mitigated by collective, ethical, pro-environmental action. This adds empirical evidence to support the hypothesis that eco-distress involves moral distress and injury arising when State authorities and other powerful bodies engage in wrongful acts and omissions on climate change. We argue that this is affecting the wellbeing of young people and supports the argument that such wrongful (in)action infringes human rights. Clinical implications are discussed.

1. (1) To understand how and why moral distress and moral injury relate to the distress that young people feel about climate change (eco-distress).

2. (2) To consider the clinical implications of formulating eco-distress in a way that includes reference to the violation of core moral codes.

3. (3) To explore what opportunities exist that could reduce moral distress and support young people.

4. (4) To understand how research into moral distress and moral injury in relation to climate change can offer important insight into the relevance of eco-distress to human rights infringements and justice-oriented care.

5. (5) To discuss practical solutions that might support moral repair, both in psychotherapy settings and in broader social policy.

Both extreme weather and climate change have been linked to distress and at times mental health problems. Pro-environmental actions have often been related to higher distress. The uncertainty distress model (Freeston et al., 2020) proposes that in real-world situations, perceptions of threat and uncertainty contribute to distress. The aim of this study is to integrate variables from these two literatures and examine their relationships.

A community sample (n=327) was recruited and completed an online survey. Network analysis was used to analyse the relationships between the variables. Exposure to extreme weather, perceptions of climate change, climate change distress and pro-environmental action were measured along with symptoms of adjustment disorder and post-traumatic stress disorder, and uncertainty intolerance and behaviours.

There was variable exposure to extreme weather, but greater exposure was associated with more severe post-traumatic symptoms. Pro-environmental action was associated with greater severity of adjustment disorder symptoms. The perception that climate change was happening now was linked positively to pro-environmental action and negatively to perceptions of uncertainty about whether climate change was happening.

The results replicate several findings from the emerging climate change distress literature and are consistent with some predictions of the uncertainty distress model, but not others. Uncertainty as to whether climate change is happening now may be a less distressing position. Research that simultaneously considers extreme weather and climate change may help understanding the range of complex responses that may arise as the frequency of extreme weather increases and evidence for anthropogenic climate change strengthens.

1. (1) To consider why the uncertainty distress model may be an appropriate framework to understand responses to extreme weather and climate change.

2. (2) To consider how the perceived proximity of climate change may play a role in peoples’ emotional and behavioural responses to climate change.

3. (3) To consider some of the variables that are linked to pro-environmental action.

4. (4) To consider whether an uncertainty-based understanding of extreme weather and climate change has helpful implications for practice.

We summarize some of the past year's most important findings within climate change-related research. New research has improved our understanding of Earth's sensitivity to carbon dioxide, finds that permafrost thaw could release more carbon emissions than expected and that the uptake of carbon in tropical ecosystems is weakening. Adverse impacts on human society include increasing water shortages and impacts on mental health. Options for solutions emerge from rethinking economic models, rights-based litigation, strengthened governance systems and a new social contract. The disruption caused by COVID-19 could be seized as an opportunity for positive change, directing economic stimulus towards sustainable investments.

A synthesis is made of ten fields within climate science where there have been significant advances since mid-2019, through an expert elicitation process with broad disciplinary scope. Findings include: (1) a better understanding of equilibrium climate sensitivity; (2) abrupt thaw as an accelerator of carbon release from permafrost; (3) changes to global and regional land carbon sinks; (4) impacts of climate change on water crises, including equity perspectives; (5) adverse effects on mental health from climate change; (6) immediate effects on climate of the COVID-19 pandemic and requirements for recovery packages to deliver on the Paris Agreement; (7) suggested long-term changes to governance and a social contract to address climate change, learning from the current pandemic, (8) updated positive cost–benefit ratio and new perspectives on the potential for green growth in the short- and long-term perspective; (9) urban electrification as a strategy to move towards low-carbon energy systems and (10) rights-based litigation as an increasingly important method to address climate change, with recent clarifications on the legal standing and representation of future generations.

Stronger permafrost thaw, COVID-19 effects and growing mental health impacts among highlights of latest climate science.