Clinical Supervision of Couple and Family Therapy during COVID-19

Examining the Relationships Between Fear of Coronavirus, State Anxiety, and Relationship Happiness Among Married Turkish Individuals During COVID-19

The present study aimed to investigate the mediating role of state anxiety in the relationship between the fear of COVID-19 and relationship happiness among married individuals. An additional aim of the study also tested the moderating role of joint family activities between state anxiety and relationship happiness. The study sample consisted of 1713 married individuals (1031 women and 682 men). The study findings showed both the significant direct associations among the studied variables and the mediating role of state anxiety in the relationship between fear of COVID-19 and relationship happiness. It also found that the path of state anxiety to relationship happiness among married individuals having family activities was significantly lower than those who did not. Directions for future research and application were discussed.

Telepsicología en un centro de atención psicológica universitario durante el COVID-19: Experiencias de consultantes y estudiantes

El uso de la telepsicología como herramienta para la atención en salud mental ha presentado en las últimas décadas un importante incremento a nivel mundial. En Colombia, a pesar de existir servicios de teleconsulta, la publicación de estudios es limitada. A raíz de la crisis de salud generada por la pandemia por COVID-19 se implementó el servicio de atención por telepsicología en un centro de atención psicológica universitario. El presente trabajo se propuso caracterizar las experiencias de la atención en la modalidad de telepsicología de consultantes y estudiantes en práctica clínica, con el fin de ampliar el conocimiento en el área y aportar a la evaluación de la viabilidad de estos servicios. Se realizó un estudio descriptivo de caracterización con un diseño transversal. Se aplicó un cuestionario a 253 consultantes y 77 estudiantes, construido por el equipo investigador. La información obtenida mostró que la atención por telepsicología logró altos niveles de satisfacción con el tratamiento recibido, la posibilidad de establecer vínculo terapéutico y el desarrollo de habilidades clínicas en los estudiantes, siendo esta modalidad de atención una alternativa útil para deponer barreras de atención en salud. Se sugiere realizar estudios de seguimiento en diferentes momentos para mayor fiabilidad de los resultados.  

Online clinical supervision in couple and family therapy: A scoping review

Online clinical supervision, or telesupervision, is a growing practice in couple and family therapy. This scoping review aims to identify and synthesize the existing body of knowledge regarding the utilization, experiences, and perceptions of telesupervision among the couple and family therapists and to highlight gaps in the literature. The review followed the five-step approach proposed by Arksey et al. (2005). Fifteen articles were included and their analysis yielded four themes: 1. telesupervision competence; 2. setting and boundary management; 3. advantages of telesupervision; and 4. challenges of telesupervision. Our review clearly demonstrates the dearth of available conceptual and empirical work. The rapidly growing use of online therapy and telesupervision in couple and family therapy has created a critical need to expand this body of knowledge by collecting evidence that can later be translated into practice. Moreover, we identified several gaps in the existing body of knowledge, including a lack of reports on the efficacy of telesupervision and on the experiences, processes, and ascribed meanings of the supervisors and supervisees. We also noted a lack of practice and ethical guidelines for telesupervision. We conclude our analysis by suggesting areas and directions for further investigation.

Delivering Clinical Pastoral Education (CPE) Remotely: Educators’ Views and Perspectives During the COVID-19 Pandemic and Beyond

Many Clinical Pastoral Education programs pivoted to remote delivery during the COVID-19 pandemic. Our survey explored educators’ preparedness, self-efficacy, and views regarding remote Clinical Pastoral Education. Few respondents were either very (14.2%) or not at all (16.5%) prepared. Most were confident facilitating remote learning (69.8%–88.5%), believing remote Clinical Pastoral Education can achieve outcomes equivalent to in-person (59.1%). Six qualitative themes emerged: educator development, educator challenges, remote Clinical Pastoral Education efficacy, remote group dynamics, clinical practice/supervision implications, and benefits and opportunities.

The changing face of telesupervision and digital training in response to COVID-19

The COVID-19 pandemic has rapidly changed the ways in which marriage and family therapists (MFTs)/couple and family therapists (CFTs) engage in clinical supervision. Traditional face-to-face supervisory relationships have transitioned to telesupervision, which refers to supervisors using the internet as a training medium for their supervisees. Supervisors and supervisees alike are necessarily adapting to telesupervision relationships in an evolving world. As emergency protocols begin to give way to more routine procedures, it is important for supervisors to engage in meaningful conversations around the benefits, the challenges, and the future of telesupervision. This article discusses the various facets of telesupervision, including ethical implications, supervision modalities, the virtual supervisory alliance, the impact of telesupervision upon self-of-the-therapist work, and the potential benefits of telesupervision.

The COVID-19 Pandemic's Influence on Family Systems Therapists' Provision of Teletherapy

The COVID-19 pandemic has altered life globally like no other event in modern history, and psychological service changes to meet the resultant impacts on families have not been assessed in the empirical literature. The purpose of the current study was to examine whether family systems therapists increased their teletherapy use during the pandemic relative to prepandemic usage, and whether projected postpandemic rates would remain at the same level; further, environmental and demographic predictors of these changes were examined. In May 2020, a sample of 626 family systems therapists (58.6% women, 40.6% men; M = 57.4 years old; M years in practice = 25.5) completed a national online study assessing these variables. Results suggested that family systems therapists performed 7.92% of their clinical work using teletherapy before the pandemic and 88.17% during the pandemic. They also projected that they would perform 36.57% of their clinical work using teletherapy after the pandemic. Teletherapy uptake was unrelated to primary practice setting, provider age, gender, race/ethnicity, and practice location (urban/suburban vs. rural) but was higher for family systems therapists who reported increased supportive teletherapy policies and training in their practice setting. Organizational infrastructure and availability of training played an important role in influencing teletherapy uptake during the pandemic. Family systems therapists have a unique opportunity to deploy teletherapy modalities to meet the needs of families during the COVID-19 pandemic, and infrastructure and training to do so may facilitate that work.

Daily Positive Support and Perceived Stress During COVID-19 Outbreak: The Role of Daily Gratitude Within Couples

Coronavirus disease 2019 (COVID-19) has induced stress and anxiety. According to past studies, positive support within married couples reduces stress during diseases and disasters, but their mechanisms are unclear. To address this gap and help individuals better cope with COVID-19-related psychological distress, this study examined the relationships among daily positive support, daily gratitude, and daily stress within married couples. In this 14-day daily diary study, 54 heterosexually married couples (N = 108) aged 28 to 71 years participated. After reporting their demographic information at the start of the study, they reported their perceived positive support from their partner, daily stress, and feelings of gratitude at the end of each day of the study for 14 consecutive days. Using a multivariate outcome, multilevel cross-classification, we found that daily positive support was negatively associated with daily stress, mediated by daily feelings of gratitude. On a day when a person reported more perceived positive support than others, this person also reported a higher level of feelings of gratitude and a lower level of stress, regardless of age. We found only an actor effect, no partner effect. These findings show how greater daily positive support is linked to greater daily feelings of gratitude, which in turn is linked to less daily stress during an emergent public health crisis.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10902-021-00387-0.

Integration of teaming therapy and mixed-reality simulation as remote learning modality for couple and family therapy graduate training programs

In response to COVID-19, a couple and family therapy (CFT) graduate training program integrated a teaming therapy model with virtual technology using mixed-reality simulation software. By utilizing teaming therapy--a model with strong roots in systemic theory and practice-- combined with cutting-edge simulation technology, this distance learning modality provides distinctly relational therapy supervision and training for students at a time when their internships sites are struggling to offer remote clinical services due to the pandemic. This integrative framework offers a high degree of both realism and safety, allowing experiential learning to be appropriately scaffolded for optimum creativity and engagement in an online setting. This paper describes the conceptual, systemic basis for the learning modality, steps for implementation, benefits of the model, and the authors plan for further evaluation.

Moral distress of medical family therapists and their physician colleagues during the transition to COVID-19

The COVID-19 pandemic has transformed healthcare for both clinicians and patients. This conceptual article uses ideas from the moral distress literature to understand the challenges MedFTs and physicians face during the COVID-19 pandemic. The authors highlight earlier themes from the moral distress literature and share current reflections to illustrate similar challenges. Some clinicians who were already experiencing a rise in burnout due to the mass digitization of healthcare are now facing increased moral distress due to ethical dilemmas, pervasive uncertainty, boundary ambiguity, isolation, and burnout brought about by emerging COVID-19 policies. Fears about personal safety, exposing loved ones, financial concerns, self-doubt, and frustrations with telehealth have contributed to increased moral distress during the COVID-19 pandemic. Building resilience by setting one's personal moral compass can help clinicians avoid the pitfalls of moral distress. Five steps for developing resilience and implications for guiding trainees in developing resilience are discussed.

The transition to teletherapy in marriage and family therapy training settings during COVID-19: What do the data tell us?

In the wake of the COVID-19 pandemic, little is known about how university training programs transitioned to teletherapy. This study describes the transition of two university marriage and family therapy (i.e., master's and doctoral) training clinics to teletherapy and presents preliminary analyses of the types of clients and cases that converted to teletherapy. A series of chi-square analyses, a t-test, a logistic regression model, and a multiple linear regression model were employed. Four key findings emerged: (1) most cases converted to teletherapy; (2) Hispanic ethnicity was the only demographic characteristic to significantly predict conversion to teletherapy; (3) individual cases were significantly more likely to convert to teletherapy than relational cases; and (4) the number of prior in-person sessions attended significantly predicted conversion to teletherapy. Teletherapy conversion implications are discussed across four systemic levels: client, student trainee, supervision, and larger systems.

Competency-based training in the supervision of relational telemental supervision

Supervision has long been considered essential to developing effective mental health practice, especially among COAMFTE accredited training programs. But with telemental health rapidly being accepted as a standard treatment medium for couple and family therapy, there is little guidance about how to supervise clinicians who are engaged in telemental health practice. This paper presents an important step toward increasing the effectiveness of the supervision of therapists who are delivering relational therapies online through the identification of relational competencies unique to this delivery medium. These competencies have been adopted and integrated into a COAMFTE accredited master's degree program that has been providing training in telemental health since 2008. The competencies are described, and supervision strategies that can be utilized and developmentally assessed throughout the program will be detailed.

Families in the Time of the Pandemic: Breakdown or Breakthrough?

The COVID-19 pandemic has taken a toll on all individuals and their families around the world. Some suffer more adversely than others depending on their unique developmental needs, resources, and resilience. However, instead of breaking down, many families and therapists have hunkered down to cope with this 'wicked' situation as it continues to evolve. This article examines the unique challenges and opportunities of COVID-19 for families at different life developmental stages, as well as the challenges and opportunities for systemic therapists as they venture into unfamiliar territory. Through a case example and by integrating recent literature related to this pandemic, we apply three key and interconnected systemic themes (unsafe uncertainty, family life cycle, and social diversity) to discuss the challenges and opportunities for families and therapists, respectively. We are optimistic that there are many possibilities as families and therapists draw on, and often reinvent, currently available resources to navigate their course in this pandemic. We also find that while the pandemic continues to present unsafe and uncertain situations, there are new ways of being and behaving, especially when families and professionals work together collaboratively. Despite formidable challenges, there are many opportunities, both within families and communities that cut through different social contexts related to family, culture, economics, and even politics. Families and therapists could endure better when they are more cognisant of how and what these contexts may impact and offer them.

Videoconferencing Psychotherapy During the Pandemic: Exceptional Times With Enduring Effects?

With the advent of COVID-19, a sudden, unexpected, and forced shift has been produced in the field of psychotherapy. Worldwide, many therapists closed their offices and started to deliver psychotherapy online through a screen. Although different media started to be incorporated, videoconferencing is undoubtedly the most common way in which therapists are doing therapy these days. This is catalyzing a rapid change in the practice of psychotherapy with probable lasting effects and deserves to be carefully reflected upon. Therefore, in this paper our aim is to outline the main challenges for a medium that may have arrived to stay. In that sense, we review the literature to describe the state-of-the-art regarding the main aspects of videoconferencing psychotherapy as well as to suggest possible avenues for future research and practice.