1
|
Laczkovics C, Blüml V, Kapusta N, Hoffmann-Lamplmair D, Casini E, Bazan M, Torres MAG, Lendvay J, Normandin L, Nowacki H, Snigur V, Doering S, Yeomans F, Clarkin J, Preti E. Videoconferencing psychotherapy from a psychodynamic point of view. A qualitative analysis. Front Psychiatry 2023; 14:1235478. [PMID: 37779629 PMCID: PMC10540621 DOI: 10.3389/fpsyt.2023.1235478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/28/2023] [Indexed: 10/03/2023] Open
Abstract
There is a growing interest in delivering videoconferencing psychotherapy (VCP) due to the enormous impact of the COVID-19 pandemic on our lives since the beginning of severe restrictions worldwide in March 2020. Scientific literature has provided interesting results about the transition to remote sessions and its implications, considering different psychotherapy orientations. Less is known about whether and how VCP affects psychodynamic psychotherapeutic approaches and reports on remote work with severe and complex mental health problems such as severe personality disorders are still scarce. The aim of the study was to examine the experiences of psychodynamic psychotherapists, mainly delivering Transference-Focused Psychotherapy (TFP), with the transition and delivery of VCP during the first wave of the COVID-19 pandemic. Four hundred seventy-nine licensed psychotherapists completed an online survey during the peak of the pandemic. Survey data were analyzed using qualitative analysis. Results are presented and discussed concerning advantages and disadvantages regarding the access to psychotherapy, the specificity of the online video setting, bodily aspects, the quality of the therapeutic relationship, the therapeutic process including technical aspects and therapist's experience. Furthermore, we analyzed and discussed the statements concerning transference and countertransference reactions differentiating between high-level borderline and neurotic patients and low-level borderline patients. Our results support the importance to identify patients who potentially benefit from VCP. Further research including more prospective randomized controlled trials are needed to investigate the therapeutic implications of the findings.
Collapse
Affiliation(s)
- Clarissa Laczkovics
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Victor Blüml
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Nestor Kapusta
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | | | - Erica Casini
- Department of Psychology, University of Milano-Bicocca, Milano, Italy
| | - Maria Bazan
- Polish Society for Psychodynamic Psychotherapy, Cracow Psychodynamic Center, Kraków, Poland
| | - Miguel Angel Gonzalez Torres
- Department of Neuroscience. University of the Basque Country, San Sebastian, Spain
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
- CIBERSAM, Spanish Network of Research in Mental Health, Bilbao, Spain
- Biocruces-Bizkaia Research Institute, Barakaldo, Spain
| | - Judit Lendvay
- Personality Disorders Institute, Weill Cornell Medical College, White Plains, NY, United States
- Columbia Center for Psychoanalytic Training and Research, New York, NY, United States
| | - Lina Normandin
- École de Psychologie, Université Laval (Québec), Québec, QC, Canada
| | - Henryk Nowacki
- Polish Society for Psychodynamic Psychotherapy, Cracow Psychodynamic Center, Kraków, Poland
| | - Vladimir Snigur
- Russophone Society for the Transference Focused Psychotherapy, Moscow, Russia
| | - Stephan Doering
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Frank Yeomans
- Personality Disorders Institute, Weill Cornell Medical College, White Plains, NY, United States
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States
| | - John Clarkin
- Personality Disorders Institute, Weill Cornell Medical College, White Plains, NY, United States
| | - Emanuele Preti
- Department of Psychology, University of Milano-Bicocca, Milano, Italy
| |
Collapse
|
2
|
Walton CJ, Gonzalez S, Cooney EB, Leigh L, Szwec S. Engagement over telehealth: comparing attendance between dialectical behaviour therapy delivered face-to-face and via telehealth for programs in Australia and New Zealand during the Covid-19 pandemic. Borderline Personal Disord Emot Dysregul 2023; 10:16. [PMID: 37208784 DOI: 10.1186/s40479-023-00221-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 04/24/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND While the COVID-19 crisis has had numerous global negative impacts, it has also presented an imperative for mental health care systems to make digital mental health interventions a part of routine care. Accordingly, through necessity, many Dialectical Behaviour Therapy (DBT) programs transitioned to telehealth, despite little information on clinical outcomes compared with face-to-face treatment delivery. This study examined differences in client engagement (i.e. attendance) of DBT: delivered face-to-face prior to the first COVID-19 lockdown in Australia and New Zealand; delivered via telehealth during the lockdown; and delivered post-lockdown. Our primary outcomes were to compare: [1] client attendance rates of DBT individual therapy delivered face-to-face with delivery via telehealth, and [2] client attendance rates of DBT skills training delivered face-to-face compared with delivery via telehealth. METHODS DBT programs across Australia and New Zealand provided de-identified data for a total of 143 individuals who received DBT treatment provided via telehealth or face-to-face over a six-month period in 2020. Data included attendance rates of DBT individual therapy sessions; attendance rates of DBT skills training sessions as well as drop-out rates and First Nations status of clients. RESULTS A mixed effects logistic regression model revealed no significant differences between attendance rates for clients attending face-to-face sessions or telehealth sessions for either group therapy or individual therapy. This result was found for clients who identified as First Nations persons and those who didn't identify as First Nations persons. CONCLUSIONS Clients were as likely to attend their DBT sessions over telehealth as they were face-to-face during the first year of the Covid-19 pandemic. These findings provide preliminary evidence that providing DBT over telehealth may be a viable option to increase access for clients, particularly in areas where face-to-face treatment is not available. Further, based on the data collected in this study, we can be less concerned that offering telehealth treatment will compromise attendance rates compared to face-to-face treatment. Further research is needed comparing clinical outcomes between treatments delivered face-to-face compared delivery via telehealth.
Collapse
Affiliation(s)
- Carla J Walton
- Centre for Psychotherapy, Hunter New England Mental Health Service, 2300, PO Box 833, Newcastle, NSW, Australia
| | - Sharleen Gonzalez
- Centre for Psychotherapy, Hunter New England Mental Health Service, 2300, PO Box 833, Newcastle, NSW, Australia
| | - Emily B Cooney
- Department of Psychological Medicine, Wellington Medical School, University of Otago (Te Whare, Wānanga o Otāgo ki Te Whanga-Nui-a-Tara), Newtown, Wellington, New Zealand
- Yale University, New Haven, Connecticut, United States of America
| | - Lucy Leigh
- Data Sciences Unit, Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, 2305, New Lambton Heights, NSW, Australia
| | - Stuart Szwec
- Data Sciences Unit, Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, 2305, New Lambton Heights, NSW, Australia
| |
Collapse
|
3
|
Duquette CL, Morgan SM. Experiences of psychotherapists transitioning to private practice during
COVID
‐19. COUNSELLING & PSYCHOTHERAPY RESEARCH 2023. [DOI: 10.1002/capr.12643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
|
4
|
Kline ER, Thibeau H, Sanders AS, Davis BJ, Fenley A, McIntyre T, English K, Keshavan MS. The School of Hard Talks: A telehealth parent training group for caregivers of adolescents and young adults. Early Interv Psychiatry 2023; 17:244-251. [PMID: 35715966 PMCID: PMC10588675 DOI: 10.1111/eip.13321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/19/2022] [Accepted: 05/29/2022] [Indexed: 11/27/2022]
Abstract
AIM A large body of evidence demonstrates the importance of the family environment in the developmental trajectory of mental illness in young people. Caregiver communication skills training represents a potential model for influencing the outcomes of adolescents and young adults struggling with emerging mental health and behavioural difficulties. The aim of the current study is to describe the development of a telehealth group training intervention for caregivers of adolescents and young adults, and to report the results of a pilot feasibility-effectiveness study that took place in 2020-2021. METHODS The "School of Hard Talks" intervention consisted of 8 h of training in communication skills consistent with motivational interviewing techniques. All pilot study participants were assigned to receive the intervention. Outcomes of interest were family conflict, caregiver stress, caregiver self-efficacy and expressed emotion (EE). Participants were assessed three times: prior to the intervention, after the intervention and 12 weeks later. RESULTS A total of 62 participants enrolled in the study, of whom 49 completed the intervention. Large, significant improvements were observed over time in all four domains of interest. Qualitative feedback from parents was very positive and added context to quantitative observations. CONCLUSIONS The School of Hard Talks was a feasible and effective intervention targeting both caregiver wellbeing as well as important mechanisms of risk for youth psychopathology, namely family conflict and EE. Further research involving a larger sample and a control condition are needed to confirm these findings.
Collapse
Affiliation(s)
- Emily R. Kline
- Department of Psychiatry, Boston Medical Center, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Heather Thibeau
- Department of Psychiatry, Boston Medical Center, Boston, Massachusetts, USA
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - A. Simone Sanders
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Beshaun J. Davis
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Alicia Fenley
- Department of Psychology, Boston University, Boston, Massachusetts, USA
| | - Theresa McIntyre
- Children’s Behavioral Health Knowledge Center, Massachusetts Department of Mental Health, Boston, Massachusetts, USA
| | - Kelly English
- Children’s Behavioral Health Knowledge Center, Massachusetts Department of Mental Health, Boston, Massachusetts, USA
| | - Matcheri S. Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
5
|
König VL, Fontao MI, Casari LM, Taborda AR. Psychotherapists' experiences of telepsychotherapy during the COVID-19 pandemic in Argentina: impact on therapy setting, therapeutic relationship and burden. RESEARCH IN PSYCHOTHERAPY (MILANO) 2023; 26. [PMID: 36786228 DOI: 10.4081/ripppo.2023.632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 01/20/2023] [Indexed: 02/05/2023]
Abstract
In order to prevent the spread of the coronavirus in Argentina, quarantine and distancing measures were adopted. This has led to a large increase in the use of online psychotherapy. Several international studies have already examined the transition from face-to-face therapy to telepsychotherapy during the COVID-19 pandemic from a therapist perspective, but within these studies, the Latin American context is not represented. To fill this research gap, this qualitative study explored the Argentinean psychotherapists' experiences with online psychotherapy during the COVID-19 pandemic by means of in-depth interviews and content analysis. Based on the international literature, an interview guideline was created which covered three main topics: setting, therapeutic relationship, and burden among therapists. For the analysis of the therapists' answers, a detailed codebook was developed. Effects were identified in all three areas investigated. The nine interviewed psychotherapists described unfavorable therapy conditions which affected the therapeutic setting, the psychotherapeutic methods and contents. Positive effects in the therapeutic relationship included patients being more open, but also negative effects such as discontinuation of therapies were reported. Therapists experienced telepsychotherapy as more exhausting than in-person psychotherapy, but they considered it a valuable tool during the pandemic, and the transition an enriching experience. These results, which are partially consistent with international findings, have practical implications for the practice of telepsychotherapy in Argentina. Technical conditions should be improved and patients' privacy during the session should be ensured. Treatment techniques and diagnostics need to be adapted for their use in telepsychotherapy.
Collapse
Affiliation(s)
| | | | - Leandro Martín Casari
- Institute of Human, Social and Environmental Sciences, CONICET Scientific and Technological Center, and Faculty of Humanities and Economic Sciences, Pontifical Catholic University of Argentina, Mendoza.
| | | |
Collapse
|
6
|
van Kessel K, de Pont S, Gasteiger C, Goedeke S. Clients' experiences of online therapy in the early stages of a COVID‐19 world: A scoping review. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Kirsten van Kessel
- Department of Psychology and Neuroscience Auckland University of Technology Auckland New Zealand
| | - Sarita de Pont
- Department of Psychology and Neuroscience Auckland University of Technology Auckland New Zealand
| | - Chiara Gasteiger
- Department of Psychology and Neuroscience Auckland University of Technology Auckland New Zealand
- Department of Psychological Medicine, Faculty of Medical and Health Sciences University of Auckland Auckland New Zealand
| | - Sonja Goedeke
- Department of Psychology and Neuroscience Auckland University of Technology Auckland New Zealand
| |
Collapse
|
7
|
Fernández O, Espinosa HD, Krause M, Altimir C, Mantilla C, Paz C, Lozano AG, Argumedo D, De La Cerda C, Juan S, Fernández S, Lancho MP, Fernández-Álvarez J. Personal experience of Latin American therapists on their clinical practice during the COVID-19 pandemic ( Experiencia personal de terapeutas latinoamericanos sobre su práctica clínica durante la pandemia por COVID-19). STUDIES IN PSYCHOLOGY 2022. [DOI: 10.1080/02109395.2022.2133456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
| | | | | | | | | | - Clara Paz
- Universidad de las Américas, Ecuador
| | | | | | | | | | | | | | | |
Collapse
|
8
|
Finkbeiner M, Kühnhausen J, Schmid J, Conzelmann A, Dürrwächter U, Wahl LM, Kelava A, Gawrilow C, Renner TJ. E-Mental-Health aftercare for children and adolescents after partial or full inpatient psychiatric hospitalization: study protocol of the randomized controlled DigiPuR trial. Trials 2022; 23:713. [PMID: 36028894 PMCID: PMC9412803 DOI: 10.1186/s13063-022-06508-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 07/05/2022] [Indexed: 11/10/2022] Open
Abstract
Background During reintegration to daily school life following psychiatric hospitalization, children and adolescents are confronted with various challenges and are at risk for rehospitalization. Tailored post-discharge services could support a successful readjustment and accompany the high-risk transition period after discharge. The study DigiPuR (“Digital gestützte Psychotherapie und Reintegration,” digitally supported psychotherapy and reintegration) aims to establish and to evaluate an innovative digital aftercare program to alleviate challenges during reintegration and improve cross-sectoral care. Methods DigiPuR is a randomized controlled trial comparing a digital aftercare service with regular aftercare (TAU) (planned N = 150, 25 children/adolescents, 25 parents, and 25 teachers in each group). In the intervention group, direct communication via secure and regular video calls until 8 weeks after discharge and a secure messenger system between the hospital, family, and school, as well as, if needed, external support systems, are established. A longitudinal pre-post-follow-up assessment at admission, discharge, and 8, 24, and 36 weeks after discharge takes place supplemented by a daily smartphone-based ambulatory assessment from a triadic perspective of patients, parents, and teachers. Primary outcomes include whether participants in the intervention group have fewer readmissions and higher treatment satisfaction and health-related quality of life as well as lower symptom severity than participants in the control group. Discussion The present study is essential to address the cross-sectoral challenges associated with reintegration into daily (school) life following child and adolescent psychiatric hospitalization and to determine possible needed adaptations in partial or full inpatient settings. If applicability and efficacy of the aftercare service can be demonstrated, integration into regular care will be sought. Trial registration ClinicalTrials.govNCT04986228. Registered on August 2, 2021 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06508-1.
Collapse
Affiliation(s)
- Marlene Finkbeiner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, Osianderstrasse 14-16, 72076, Tuebingen, Germany.
| | - Jan Kühnhausen
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, Osianderstrasse 14-16, 72076, Tuebingen, Germany
| | - Johanna Schmid
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, Osianderstrasse 14-16, 72076, Tuebingen, Germany
| | - Annette Conzelmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, Osianderstrasse 14-16, 72076, Tuebingen, Germany.,PFH - Private University of Applied Sciences, Department of Psychology (Clinical Psychology II), Weender Landstraße 3-7, 37073, Goettingen, Germany
| | - Ute Dürrwächter
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, Osianderstrasse 14-16, 72076, Tuebingen, Germany
| | - Lena-Marie Wahl
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, Osianderstrasse 14-16, 72076, Tuebingen, Germany
| | - Augustin Kelava
- Methods Center, University of Tuebingen, Hausserstrasse 11, 72076, Tuebingen, Germany
| | - Caterina Gawrilow
- Department of Psychology, University of Tuebingen, Schleichstrasse 4, 72076, Tuebingen, Germany
| | - Tobias J Renner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, Osianderstrasse 14-16, 72076, Tuebingen, Germany
| |
Collapse
|
9
|
E Stubbe D. Through the Lens: Telepsychotherapy and the Working Alliance. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2022; 20:309-312. [PMID: 37205018 PMCID: PMC10172521 DOI: 10.1176/appi.focus.20220051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Affiliation(s)
- Dorothy E Stubbe
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut
| |
Collapse
|
10
|
Leuchtenberg S, Gromer D, Käthner I. Videoconferencing versus
face‐to‐face
psychotherapy: Insights from patients and psychotherapists about comparability of therapeutic alliance, empathy and treatment characteristics. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Sophie Leuchtenberg
- Department of Psychology I, Biological Psychology, Clinical Psychology and Psychotherapy University of Würzburg Würzburg Germany
| | - Daniel Gromer
- Department of Psychology I, Biological Psychology, Clinical Psychology and Psychotherapy University of Würzburg Würzburg Germany
| | - Ivo Käthner
- Department of Psychology I, Biological Psychology, Clinical Psychology and Psychotherapy University of Würzburg Würzburg Germany
| |
Collapse
|
11
|
Stress, PTSD, and COVID-19: the Utility of Disaster Mental Health Interventions During the COVID-19 Pandemic. CURRENT TREATMENT OPTIONS IN PSYCHIATRY 2022; 9:14-40. [PMID: 35223372 PMCID: PMC8860255 DOI: 10.1007/s40501-021-00253-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/06/2021] [Indexed: 02/08/2023]
Abstract
Purpose of review In the context of an ongoing, highly uncertain pandemic, disaster mental health measures can increase community capacity for resilience and well-being, support formal mental health treatment, and help address the risk for mental health reactions in high-stress occupations. The purpose of this review is to summarize the literature on disaster mental health interventions that have been helpful both prior to and during the pandemic in a broad range of applications, including for use with high-stress occupations in an effort to mitigate risk for post-traumatic stress disorder (PTSD) and other mental health sequelae. Recent findings Evidence-based and evidence-informed disaster mental health interventions, frameworks, and treatments have been studied in pilot studies, non-randomized trials, and randomized clinical trials prior to and in the context of the current COVID-19 pandemic. The studies have demonstrated feasibility and acceptability of these modalities and improved perceived support, as well as significant reductions in distress, and mental health symptoms such as depression, anxiety, and PTSD. Summary A disaster mental health approach to the COVID-19 pandemic can generate opportunities for prevention and support at multiple levels with timely interventions tailored for different concerns, cultures, and available resources.
Collapse
|
12
|
van Leeuwen H, Sinnaeve R, Witteveen U, Van Daele T, Ossewaarde L, Egger JIM, van den Bosch LMC. Reviewing the availability, efficacy and clinical utility of Telepsychology in dialectical behavior therapy (Tele-DBT). Borderline Personal Disord Emot Dysregul 2021; 8:26. [PMID: 34717772 PMCID: PMC8556811 DOI: 10.1186/s40479-021-00165-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 09/14/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Telepsychology is increasingly being implemented in mental health care. We conducted a scoping review on the best available research evidence regarding availability, efficacy and clinical utility of telepsychology in DBT. The review was performed using PRISMA-ScR guidelines. Our aim was to help DBT-therapists make empirically supported decisions about the use of telepsychology during and after the current pandemic and to anticipate the changing digital needs of patients and clinicians. METHODS A search was conducted in PubMed, Embase, PsycARTICLES and Web of Science. Search terms for telepsychology were included and combined with search terms that relate to DBT. RESULTS Our search and selection procedures resulted in 41 articles containing information on phone consultation, smartphone applications, internet delivered skills training, videoconferencing, virtual reality and computer- or video-assisted interventions in DBT. CONCLUSIONS The majority of research about telepsychology in DBT has focused on the treatment mode of between-session contact. However, more trials using sophisticated empirical methodologies are needed. Quantitative data on the efficacy and utility of online and blended alternatives to standard (i.e. face-to-face) individual therapy, skills training and therapist consultation team were scarce. The studies that we found were designed to evaluate feasibility and usability. A permanent shift to videoconferencing or online training is therefore not warranted as long as face-to-face is an option. In all, there is an urgent need to compare standard DBT to online or blended DBT. Smartphone apps and virtual reality (VR) are experienced as an acceptable facilitator in access and implantation of DBT skills. In addition, we have to move forward on telepsychology applications by consulting our patients, younger peers and experts in adjacent fields if we want DBT to remain effective and relevant in the digital age.
Collapse
Affiliation(s)
- Hanneke van Leeuwen
- Vincent van Gogh Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Stationsweg 46, 5803, AC, Venray, the Netherlands. .,Cognition and Behaviour, Donders Institute for Brain, Radboud University, Nijmegen, the Netherlands. .,Dialexis, Training institute for Dialectical Behavior Therapy, Nijmegen, The Netherlands.
| | - Roland Sinnaeve
- Dialexis, Training institute for Dialectical Behavior Therapy, Nijmegen, The Netherlands.,UPC KU Leuven, Kortenberg, Belgium.,Department of Neurosciences, Mind Body Research, KU Leuven, Leuven, Belgium
| | - Ursula Witteveen
- Dialexis, Training institute for Dialectical Behavior Therapy, Nijmegen, The Netherlands.,GGNet for Psychiatry, Apeldoorn, the Netherlands.,Dutch Centre for treatment in DBT (NB-DBT), Harderwijk, the Netherlands
| | - Tom Van Daele
- Expertise Unit Psychology, Technology & Society, Thomas More University of Applied Sciences, Antwerp, Belgium
| | - Lindsey Ossewaarde
- Centre for Anxiety and Obsessive-Compulsive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands
| | - Jos I M Egger
- Vincent van Gogh Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Stationsweg 46, 5803, AC, Venray, the Netherlands.,Cognition and Behaviour, Donders Institute for Brain, Radboud University, Nijmegen, the Netherlands.,Stevig Specialized and Forensic Care for People with Intellectual Disabilities, Dichterbij, Oostrum, The Netherlands
| | - Louisa M C van den Bosch
- Dialexis, Training institute for Dialectical Behavior Therapy, Nijmegen, The Netherlands.,Dutch Centre for treatment in DBT (NB-DBT), Harderwijk, the Netherlands
| |
Collapse
|
13
|
Gumz A, Kanal S, Ünser A, Kästner D, Beck-Hiestermann FML. ["Achieving closeness in video treatment despite distance"]. PSYCHOTHERAPEUT 2021; 66:382-397. [PMID: 34456515 PMCID: PMC8386344 DOI: 10.1007/s00278-021-00529-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/15/2021] [Indexed: 11/04/2022]
Abstract
Background As a result of the contact ban issued at the beginning of the coronavirus disease 2019 (COVID-19) outbreak in March 2020, psychotherapists provided significantly more video-based therapy (VBT) and most of them provided it the first time. To date, there is little research on how therapists experienced VBT during the pandemic and no studies are available that look at possible procedure-specific features. Objective The aim was to analyze what subjective experiences therapists of different guideline procedures had with the implementation of VBT in times of the COVID 19 pandemic and what advantages and disadvantages they experienced. Methods This was a mixed methods study with a cross-sectional online survey. In addition to quantitative data, seven open-ended questions were used to collect therapists' subjective experiences with conducting VBT and analyzed using qualitative content analysis. The identified categories were subjected to a frequency analysis. Data from 174 medical or psychological psychotherapists were included in the analysis. Results Particularly frequently mentioned advantages were flexibility of location and time, continuity of contact during pandemic periods and avoidance of risk of infection. The most commonly cited disadvantage was the lack of sensory input, facial expressions, gestures, eye contact, and nonverbal communication. The VBT was well-accepted by most, but not all, patients. Technical problems made the implementation difficult. Conclusion For many therapists VBT remained a stopgap solution that was not designed to last; however, VBT could help to solve known care problems (e.g., underprovision in rural areas) beyond the pandemic period. The results of the study make an important contribution to weighing up the opportunities and risks of VBT for psychotherapeutic care and for keeping an eye on possible dangers and difficulties.
Collapse
Affiliation(s)
- Antje Gumz
- Arbeitsgruppe für Psychosomatik und Psychotherapie, Psychologische Hochschule Berlin, Am Köllnischen Park 2, 10179 Berlin, Deutschland
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Hamburg‑Eppendorf, Hamburg, Deutschland
| | - Sulenur Kanal
- Arbeitsgruppe für Psychosomatik und Psychotherapie, Psychologische Hochschule Berlin, Am Köllnischen Park 2, 10179 Berlin, Deutschland
| | - Aydan Ünser
- Arbeitsgruppe für Psychosomatik und Psychotherapie, Psychologische Hochschule Berlin, Am Köllnischen Park 2, 10179 Berlin, Deutschland
| | - Denise Kästner
- Arbeitsgruppe für Psychosomatik und Psychotherapie, Psychologische Hochschule Berlin, Am Köllnischen Park 2, 10179 Berlin, Deutschland
| | | |
Collapse
|