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Biancalani G, Orkibi H, Keisari S, Guglielmin MS, Bertagna G, Meola P, Viezzoli D, Finco N, Testoni I. Italian adolescents' perception of tele-psychodrama treatment during the COVID-19 Pandemic. Arts Health 2024; 16:1-14. [PMID: 36472222 DOI: 10.1080/17533015.2022.2154942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 11/26/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Psychodrama is an experiential group psychotherapy that is used to enhance adolescents' wellbeing. The COVID-19 pandemic forced the adaptation of this method to an online setting. OBJECTIVE This qualitative study investigated whether and how tele-psychodrama provides psychological support to adolescents, in order to better understand its strengths and weaknesses. PARTICIPANTS 14 adolescents from Northern and Central Italy. METHOD 14 interviews were conducted at the end of group tele-psychodrama treatment and were analysed with qualitative thematic analysis. RESULTS Three themes were identified: (1) contribution of tele-psychodrama to adolescents' well-being; (2) implementation of psychodrama to the online setting; and (3) (the) shortcomings of tele-psychodrama. CONCLUSIONS Despite the differences between online and in-person psychodrama, all the participants expressed their appreciation of group tele-psychodrama, which contributed to their overall psychological wellbeing and helped them process difficulties that emerged during the lockdowns.
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Affiliation(s)
- Gianmarco Biancalani
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, Italy
| | - Hod Orkibi
- Drama & Health Science Lab, School of Creative Arts Therapies, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa Israel
- Emili Sagol Creative Arts Therapies Research Center, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa Israel
| | - Shoshi Keisari
- Drama & Health Science Lab, School of Creative Arts Therapies, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa Israel
- Emili Sagol Creative Arts Therapies Research Center, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa Israel
| | | | - Giuseppe Bertagna
- School of Psychodrama, Italian School of Biblical Psychodrama, Milan, Italy
| | - Patrizia Meola
- Center for Studies of Psychodrama and Active Methods, Milan, Italy
| | - Davide Viezzoli
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, Italy
| | - Nicoletta Finco
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, Italy
| | - Ines Testoni
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, Italy
- Emili Sagol Creative Arts Therapies Research Center, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa Israel
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Paige SR, Bylund CL, Wilczewski H, Ong T, Barrera JF, Welch BM, Bunnell BE. Communicating about online health information with patients: Exploring determinants among telemental health providers. PEC Innov 2023; 2:100176. [PMID: 37384157 PMCID: PMC10294076 DOI: 10.1016/j.pecinn.2023.100176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 04/25/2023] [Accepted: 05/09/2023] [Indexed: 06/30/2023]
Abstract
Objective To investigate determinants of telemental health (TMH) providers' openness to discuss and confidence to use online mental health information with patients, focusing on providers' eHealth literacy and perceived usefulness of online MH information. Methods TMH providers (N = 472) completed a web-based survey with questions about discussing and using online health information with patients, perceived usefulness of the Internet as a source of patient information, and eHealth literacy. Results Providers were open to discussing online health information with patients if they were not treating substance abuse disorders (b = -0.83), felt the Internet was a useful resource (b = 0.18), and felt confident in their skills to evaluate the online information (b = 0.21). Providers were confident using online health information if they worked in a small clinic (b = 0.37), felt the Internet was a useful resource (b = 0.31), knew where to access relevant online health information (b = 0.13), and had skills to help their patients find (b = 0.17) and evaluate (b = 0.54) online information. Conclusion TMH providers are likely to use online health information resources if they know where and how to find them and perceive the Internet as a useful resource. Innovation To effectively discuss online health information with patients, providers require skills to evaluate the information with patients.
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Affiliation(s)
| | - Carma L. Bylund
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | | | - Triton Ong
- Doxy.me Research, Doxy.me Inc., Rochester, NY, USA
| | - Janelle F. Barrera
- Doxy.me Research, Doxy.me Inc., Rochester, NY, USA
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, USA
| | - Brandon M. Welch
- Doxy.me Research, Doxy.me Inc., Rochester, NY, USA
- Biomedical Informatics Center, Medical University of South Carolina, Charleston, SC, USA
| | - Brian E. Bunnell
- Doxy.me Research, Doxy.me Inc., Rochester, NY, USA
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, USA
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Schmidt-Hantke J, Jacobi C. Investigating perspectives on e-health interventions to enhance maternal mental well-being: Results of a stakeholder interview. PLOS Digit Health 2023; 2:e0000326. [PMID: 37611049 PMCID: PMC10446204 DOI: 10.1371/journal.pdig.0000326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 07/12/2023] [Indexed: 08/25/2023]
Abstract
Peripartum mental disorders are highly prevalent conditions and associated with adverse outcomes for the mother, the infant and the whole family. Despite the high burden, help-seeking is low. E-mental health interventions could overcome help-seeking barriers and thus improve perinatal mental health. However, usage and adherence are rather low. This study aims to assess attitudes and needs of different stakeholder groups and to identify relevant topics to develop an intervention meeting the needs of pregnant and postpartum women and thus, increasing utilization and adherence. Therefore, semi-structured interviews and focus groups with pregnant women (n = 3), mothers (n = 4), women who have suffered from a postpartum mood disorder in the past (n = 5), gynaecologists (n = 5), and midwives (n = 5) were conducted. All interviews were audio-recorded, transcribed verbatim, and analyzed using a thematic analysis. Almost half of the stakeholders reported previous experiences with e-mental health services. Anonymity, flexibility, promoting help-seeking, or bridging waiting-time for treatment as usual were regarded as the main benefits. Concerns regarding the usefulness of e-mental health interventions, absence of face-to-face contact or lack of integration into routine care were considered as barriers. With regard to the desired program content, six main topics were identified: pregnancy and puerperium, peripartum mood swings and disorders, support options, self-care, partnership, and fatherhood. Regarding preferred characteristics of e-mental health programs, stakeholders mentioned customizability, individual guidance, evaluation of user-feedback and continuous adoption, as well as a responsive and user-friendly design. Overall, online interventions for perinatal mental health were mainly considered as beneficial. Stakeholders underlined the high need for education regarding the use and effectiveness of e-mental health, to overcome concerns and obstacles and improve acceptability. Furthermore, developing customizable and individually-guided interventions were considered as promising to increase utilization of and adherence to e-mental health interventions.
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Affiliation(s)
| | - Corinna Jacobi
- Department of Psychology, Technical University Dresden, Dresden, Germany
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Reatto LL, Werbart A, Oasi O, De Salve F, Ierardi E, Giordano M, Riva Crugnola C. Understanding psychoanalytic work online and back to the couch in the wake of the COVID-19 pandemic: an investigation among Italian psychoanalysts. Front Psychol 2023; 14:1167582. [PMID: 37425145 PMCID: PMC10324410 DOI: 10.3389/fpsyg.2023.1167582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 06/06/2023] [Indexed: 07/11/2023] Open
Abstract
Background Worldwide, psychotherapists' clinical experience went through rapid developments with transition to teletherapy during the COVID-19 pandemic. Literature on the use of remote psychoanalysis was not conclusive, leaving the issue of the consequences of the necessary setting alternation open. This study aimed to investigate the psychoanalysts' experiences of shifting to remote work and then returning to in-person setting, considering the effect of the patients' attachment styles and personality configurations. Method Seventy-one analysts of the Italian Psychoanalytic Society were asked to fill out an online survey about patients who found the transition easier and patients who found it more difficult. General questions on therapeutic work, ISTS (Interpretive and Supportive Technique Scale) for interpretive and supportive aspects of technique, WAI-S-TR (Working Alliance Inventory-Short Revised-Therapist) for therapeutic alliance, RQ (Relationship Questionnaire) for attachment style, and PMAI (Prototype Matching of Anaclitic-Introjective Personality Configuration) for personality configurations were administered. Results All of the analysts chose to continue the treatment using audio-visual tools. Patients with difficult transitions had a significantly higher frequency of insecure attachment and a higher score on RQ Dismissing scale than patients with easy transitions. No significant differences were found between the two groups in personality configurations, psychotherapeutic alliance, and psychotherapeutic technique. Moreover, a higher level of therapeutic alliance was positively correlated to RQ Secure scale and was negatively correlated to RQ Dismissing scale. Patients with easy transition both to remote work and back to in-person setting had higher scores of therapeutic alliances than those with difficult transition both to remote work and back to in-person setting. Conclusion Online psychoanalytic therapy was widely used during the COVID-19 pandemic. Patients with insecure attachment styles had greater difficulties in adapting to setting alternations, thus confirming that insecure attachment is a vulnerability factor not only for psychopathological problems but also for a well-functioning therapeutic collaboration. Patient's personality configuration did not influence their adaptation to the setting alternation. The supportive and interpretive styles did not undergo significant changes in the transition from in-person setting to remote setting and vice versa, thus suggesting a continuity in the analysts' "internal setting."
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Affiliation(s)
| | - Andrzej Werbart
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Osmano Oasi
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Francesca De Salve
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Elena Ierardi
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Mattia Giordano
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
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Asbrand J, Gerdes S, Breedvelt J, Guidi J, Hirsch C, Maercker A, Douilliez C, Andersson G, Debbané M, Cieslak R, Rief W, Bockting C. Clinical psychology and the COVID-19 pandemic: A mixed methods survey among members of the European Association of Clinical Psychology and Psychological Treatment (EACLIPT). Clin Psychol Eur 2023; 5:e8109. [PMID: 37064999 PMCID: PMC10103154 DOI: 10.32872/cpe.8109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 11/21/2022] [Indexed: 04/03/2023] Open
Abstract
Background
The COVID-19 pandemic has affected people globally both physically and psychologically. The increased demands for mental health interventions provided by clinical psychologists, psychotherapists and mental health care professionals, as well as the rapid change in work setting (e.g., from face-to-face to video therapy) has proven challenging. The current study investigates European clinical psychologists and psychotherapists’ views on the changes and impact on mental health care that occurred due to the COVID-19 pandemic. It further aims to explore individual and organizational processes that assist clinical psychologists’ and psychotherapists’ in their new working conditions, and understand their needs and priorities.
Method
Members of the European Association of Clinical Psychology and Psychological Treatment (EACLIPT) were invited (N = 698) to participate in a survey with closed and open questions covering their experiences during the first wave of the pandemic from June to September 2020. Participants (n = 92) from 19 European countries, mostly employed in universities or hospitals, completed the online survey.
Results
Results of qualitative and quantitative analyses showed that clinical psychologists and psychotherapists throughout the first wave of the COVID-19 pandemic managed to continue to provide treatments for patients who were experiencing emotional distress. The challenges (e.g., maintaining a working relationship through video treatment) and opportunities (e.g., more flexible working hours) of working through this time were identified.
Conclusions
Recommendations for mental health policies and professional organizations are identified, such as clear guidelines regarding data security and workshops on conducting video therapy.
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Herrmann WJ, Buspavanich P, Oeser P, Berger M, Lech S, Gellert P. [Changes in the provision of primary care and psychotherapy in Germany during the first two lockdowns in 2020 and 2021: A two-wave survey giving consideration to gender identity and sexual orientation]. Z Evid Fortbild Qual Gesundhwes 2023; 177:26-34. [PMID: 36964120 PMCID: PMC10032457 DOI: 10.1016/j.zefq.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 12/21/2022] [Accepted: 01/23/2023] [Indexed: 03/24/2023]
Abstract
INTRODUCTION Measures against the COVID-19 pandemic led to restrictions in ambulatory health care in Germany. While the restrictions have been described from claims data, the patients' perspective has been missing. Lesbian, gay, bisexual, trans-, inter- and asexual persons (LGBTIA) might have been particularly affected by these restrictions because of their vulnerability. Thus, our research questions were: 1) How did the restrictions during the pandemic influence primary care and psychotherapy in Germany from the patients' perspective? 2) Are there differences between LGBTIA and cis-heterosexual persons regarding these restrictions? METHODS We conducted an online survey with two survey waves in March/April 2020 and January/February 2021. Sampling was conducted via multiplicators and via snowball sampling. Amongst others, the survey contained open-ended questions regarding primary care and psychotherapy. From the answers of the first survey wave we constructed quantitative items for the second survey wave. Descriptive and inferential statistical analysis was conducted, including linear regression with R. RESULTS 6,784 participants took part in the survey (2,641 in the first survey wave), 5,442 of whom identified as LGBTIA. Categories of changes in primary care were: no health care utilization, no changes in primary care, insecurity regarding primary care, and changes in primary care which could be less frequent utilization, differing procedures or changes in ways of communication. In the second wave, LGBTIA participants rated the worsening of primary care during the pandemic as being more pronounced. Regarding psychotherapy, the change can be described as no change in care, changes in the form of therapy, treatment in emergencies only and a longer break from psychotherapy. There was no different rating by LGBTIA persons compared to cis-heterosexual persons in the second survey wave. Telephone and video consultations were more common in psychotherapy than in primary care. DISCUSSION LGBTIA persons were oversampled, so the sample included more people from urban areas than the German population. Due to the online survey form, older people were underrepresented relative to their numbers in the general German population. CONCLUSION With respect to future pandemics GENERAL practitioners in primary care must be prepared that psychotherapy might be paused and delayed for some time. Video and telephone consultations should be offered to overcome pandemic-related restrictions in the future. General practitioners should know the gender identity and sexual orientation of their patients in order to proactively address health care barriers.
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Affiliation(s)
- Wolfram J Herrmann
- Charité - Universitätsmedizin Berlin, Institut für Allgemeinmedizin, Berlin, Deutschland.
| | - Pichit Buspavanich
- Charité - Universitätsmedizin Berlin, Klinik für Psychiatrie und Psychotherapie, Berlin, Deutschland; Charité - Universitätsmedizin Berlin, Geschlechterforschung in der Medizin (GIM) & Institut für Sexualwissenschaft und Sexualmedizin, Berlin, Deutschland; Medizinische Hochschule Brandenburg CAMPUS GmbH, Fehrbelliner Straße 38, 16816 Neuruppin, Deutschland
| | - Philip Oeser
- Charité - Universitätsmedizin Berlin, Institut für Allgemeinmedizin, Berlin, Deutschland
| | - Maximilian Berger
- Charité - Universitätsmedizin Berlin, Klinik für Psychiatrie und Psychotherapie, Berlin, Deutschland
| | - Sonia Lech
- Charité - Universitätsmedizin Berlin, Klinik für Psychiatrie und Psychotherapie, Berlin, Deutschland; Charité - Universitätsmedizin Berlin, Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Berlin, Deutschland
| | - Paul Gellert
- Charité - Universitätsmedizin Berlin, Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Berlin, Deutschland
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Cataldo F, Mendoza A, Chang S, Buchanan G, Van Dam NT. Enhancing Therapeutic Processes in Videoconferencing Psychotherapy: Interview Study of Psychologists' Technological Perspective. JMIR Form Res 2023; 7:e40542. [PMID: 36927506 PMCID: PMC10019766 DOI: 10.2196/40542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 01/13/2023] [Accepted: 01/30/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic caused a surge in the use of telehealth platforms. Psychologists have shifted from face-to-face sessions to videoconference sessions. Therefore, essential information that is easily obtainable via in-person sessions may be missing. Consequently, therapeutic work could be compromised. OBJECTIVE This study aimed to explore the videoconference psychotherapy (VCP) experiences of psychologists around the world. Furthermore, we aimed to identify technological features that may enhance psychologists' therapeutic work through augmented VCP. METHODS In total, 17 psychologists across the world (n=7, 41% from Australia; n=1, 6% from England; n=5, 29% from Italy; n=1, 6% from Mexico; n=1, 6% from Spain; and n=2, 12% from the United States) were interviewed. We used thematic analysis to examine the data collected from a sample of 17 psychologists. We applied the Chaos Theory to interpret the system dynamics and collected details about the challenges posed by VCP. For collecting further information about the technology and processes involved, we relied on the Input-Process-Output (IPO) model. RESULTS The analysis resulted in the generation of 9 themes (input themes: psychologists' attitude, trust-reinforcing features, reducing cognitive load, enhancing emotional communication, and engaging features between psychologists and patients; process themes: building and reinforcing trust, decreasing cognitive load, enhancing emotional communication, and increasing psychologist-patient engagement) and 19 subthemes. Psychologists found new strategies to deal with VCP limitations but also reported the need for more technical control to facilitate therapeutic processes. The suggested technologies (eye contact functionality, emergency call functionality, screen control functionality, interactive interface with other apps and software, and zooming in and out functionality) could enhance the presence and dynamic nature of the therapeutic relationship. CONCLUSIONS Psychologists expressed a desire for enhanced control of VCP sessions. Psychologists reported a decreased sense of control within the therapeutic relationship owing to the influence of the VCP system. Great control of the VCP system could better approximate the critical elements of in-person psychotherapy (eg, observation of body language). To facilitate improved control, psychologists would like technology to implement features such as improved eye contact, better screen control, emergency call functionality, ability to zoom in and out, and an interactive interface to communicate with other apps. These results contribute to the general perception of the computer as an actual part of the VCP process. Thus, the computer plays a key role in the communication, rather than remaining as a technical medium. By adopting the IPO model in the VCP environment (VCP-IPO model), the relationship experience may help psychologists have more control in their VCP sessions.
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Affiliation(s)
- Francesco Cataldo
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, University of Melbourne, Melbourne, Australia
| | - Antonette Mendoza
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, University of Melbourne, Melbourne, Australia
| | - Shanton Chang
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, University of Melbourne, Melbourne, Australia
| | - George Buchanan
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, University of Melbourne, Melbourne, Australia
| | - Nicholas T Van Dam
- School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
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Stadler M, Jesser A, Humer E, Haid B, Stippl P, Schimböck W, Maaß E, Schwanzar H, Leithner D, Pieh C, Probst T. Remote Psychotherapy during the COVID-19 Pandemic: A Mixed-Methods Study on the Changes Experienced by Austrian Psychotherapists. Life (Basel) 2023; 13:life13020360. [PMID: 36836720 PMCID: PMC9961677 DOI: 10.3390/life13020360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
The outbreak of the COVID-19 pandemic and associated measures to contain the SARS-CoV-2 coronavirus required a change in treatment format from face-to-face to remote psychotherapy. This study investigated the changes experienced by Austrian therapists when switching to psychotherapy at a distance. A total of 217 therapists participated in an online survey on changes experienced when switching settings. The survey was open from 26 June until 3 September 2020. Several open questions were evaluated using qualitative content analysis. The results show that the setting at a distance was appreciated by the therapists as a possibility to continue therapy even during an exceptional situation. Moreover, remote therapy offered the respondents more flexibility in terms of space and time. Nevertheless, the therapists also reported challenges of remote therapy, such as limited sensory perceptions, technical problems and signs of fatigue. They also described differences in terms of the therapeutic interventions used. There was a great deal of ambivalence in the data regarding the intensity of sessions and the establishment and/or maintenance of a psychotherapeutic relationship. Overall, the study shows that remote psychotherapy seems to have been well accepted by Austrian psychotherapists in many settings and can offer benefits. Clinical studies are also necessary to investigate in which contexts and for which patient groups the remote setting is suitable and where it is potentially contraindicated.
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Affiliation(s)
- Michael Stadler
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
| | - Andrea Jesser
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
- Correspondence:
| | - Elke Humer
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
| | - Barbara Haid
- Austrian Federal Association for Psychotherapy, 1030 Vienna, Austria
| | - Peter Stippl
- Austrian Federal Association for Psychotherapy, 1030 Vienna, Austria
| | | | - Elisabeth Maaß
- Österreichische Gesellschaft Für Wissenschaftliche, Klientenzentrierte Psychotherapie und Personorientierte Gesprächsführung (ÖGWG), 4020 Linz, Austria
| | - Helmut Schwanzar
- Österreichische Gesellschaft Für Wissenschaftliche, Klientenzentrierte Psychotherapie und Personorientierte Gesprächsführung (ÖGWG), 4020 Linz, Austria
| | - Daniela Leithner
- Österreichische Gesellschaft Für Wissenschaftliche, Klientenzentrierte Psychotherapie und Personorientierte Gesprächsführung (ÖGWG), 4020 Linz, Austria
| | - Christoph Pieh
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
| | - Thomas Probst
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
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Winter S, Jesser A, Probst T, Schaffler Y, Kisler IM, Haid B, Pieh C, Humer E. How the COVID-19 Pandemic Affects the Provision of Psychotherapy: Results from Three Online Surveys on Austrian Psychotherapists. Int J Environ Res Public Health 2023; 20:1961. [PMID: 36767327 PMCID: PMC9915415 DOI: 10.3390/ijerph20031961] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
This study aimed to assess patient numbers and the format in which psychotherapy was delivered by Austrian psychotherapists during different time points of the COVID-19 pandemic and to explore psychotherapists` experiences on pandemic-associated changes in their psychotherapeutic work as well as their wishes for support in their professional activities. Three cross-sectional online surveys were conducted between March 2020 and May 2022. The total number of participating psychotherapists was n = 1547 in 2020, n = 238 in 2021, and n = 510 in 2022. The number of patients treated was highest in 2022 and lowest at the beginning of the pandemic (p < 0.001). During the lockdown in 2020, only 25.0% of patients were treated in personal contact. This proportion increased in the following years, reaching 86.9% in 2022 (p < 0.001). After a substantial increase in the proportion of patients treated via the telephone and internet during the first lockdown, both proportions decreased during the pandemics' second and third year (p < 0.001). However, a larger proportion of patients were treated via the internet in 2022 compared to pre-pandemic times (p < 0.001). Psychotherapists reported that the pandemic affected mainly the setting in which psychotherapy was provided (29.6%), the working conditions and workload (27.1%), as well as the demand for psychotherapy (26.9%). About one-third of psychotherapists expressed support wishes for their psychotherapeutic work. Results suggest that the pandemic went along with a partial shift in the provision of psychotherapy towards psychotherapy via the internet but not the telephone. The increase in patient numbers and psychotherapists` reports of increased workload suggest a rise in the demand for mental health care during and in the aftermath of the pandemic.
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Affiliation(s)
- Stefanie Winter
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
| | - Andrea Jesser
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
| | - Thomas Probst
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
| | - Yvonne Schaffler
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
| | | | - Barbara Haid
- Austrian Federal Association for Psychotherapy, 1030 Vienna, Austria
| | - Christoph Pieh
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
| | - Elke Humer
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
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Correia KCR, Araújo JLD, Barreto SRV, Bloc L, Melo AK, Moreira V. Saúde Mental na Universidade: Atendimento Psicológico Online na Pandemia da Covid-19. Psicol cienc prof 2023. [DOI: 10.1590/1982-3703003245664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
Resumo Com a pandemia da covid-19, o contexto universitário, que já vinha sendo palco de discussões em relação à saúde mental, tem vivenciado crises mais severas pelos estudantes. Diante deste cenário, foi desenvolvido o projeto Escuta Solidária, voltado à saúde mental dos discentes de graduação e de pós-graduação. Neste artigo, temos como objetivo discutir o atendimento psicológico online com estudantes do curso de psicologia durante o período de isolamento social rígido (maio a junho de 2020). Fizemos, com os psicólogos voluntários, um grupo focal direcionado para a experiência de atendimento psicológico online de curta duração no contexto pandêmico. Trata-se de um estudo qualitativo, realizado com os 11 psicólogos clínicos participantes do referido projeto. A partir de uma análise fenomenológica crítica, os resultados foram divididos em cinco categorias: a) limitações e contribuições do projeto; b) a importância da capacitação e supervisão clínica para a qualidade do projeto; c) atendimento psicológico online; d) ser psicólogo clínico durante a crise da covid-19; e e) demandas emergentes nos atendimentos psicológicos na quarentena. Por fim, discutimos a importância da desmistificação do atendimento psicológico em situações de crise, especialmente na modalidade online, fomentando questionamentos à formação e atuação dos profissionais, no sentido de estarmos atentos às demandas psicológicas que o contexto de crise acarreta na sociedade.
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Seow LSE, Chang S, Sambasivam R, Subramaniam M, Lu SH, Assudani H, Tan CYG, Vaingankar JA. Psychotherapists’ perspective of the use of eHealth services to enhance positive mental health promotion. Digit Health 2023. [DOI: 10.1177/20552076221147411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Objective Keyes’s two-continua model of mental health proposes that mental illness and positive mental health are two separate, correlated, unipolar dimensions. eHealth services have been used to deliver mental health care, though the focus remained largely on symptom reduction and management of negative aspects of mental health. The potential of eHealth services to promote positive mental well-being, however, has not been tapped sufficiently. The present study aims to explore psychotherapists’ perspective on the feasibility of eHealth services to enhance positive mental health promotion. Methods Seven focus group discussions were conducted among professionals ( n = 38) who delivered psychotherapy to examine positive mental health in their practice. Responses related to the use of e-psychotherapy to promote mental well-being were extracted for use in a secondary analysis of data in this study. Thematic analysis of data via inductive approach was conducted to allow emergence of common themes. Results Three main themes related to psychotherapists’ perspective on the feasibility of eHealth intervention in enhancing positive mental health were identified: (1) use of eHealth to educate and improve positive mental health; (2) concerns on incorporating psychotherapy into online services; (3) other factors that affect uptake or effectiveness of eHealth intervention for positive mental health. Conclusions The study generally found support among psychotherapists for the feasibility of eHealth intervention in promoting positive mental health among clients. Potential difficulties in implementation and practicality concerns were discussed.
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Affiliation(s)
| | - Sherilyn Chang
- Research Division, Institute of Mental Health, Singapore
| | | | | | | | - Hanita Assudani
- Department of Psychology, Institute of Mental Health, Singapore
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Beck EJ, Mandalia S, Yfantopoulos P, Leon A, Merino MJ, Garcia F, Wittevogel M, Apers L, Benkovic I, Zekan S, Begovac J, Cunha AS, Teofilo E, Rodrigues G, Borges MDF, Fatz D, Vera J, Whetham J. Efficiency of the EmERGE Pathway of Care in Five European HIV Centres. Pharmacoeconomics 2022; 40:1235-1246. [PMID: 36227463 DOI: 10.1007/s40273-022-01193-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/11/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE We aimed to calculate the efficiency of the EmERGE Pathway of Care in five European HIV clinics, developed and implemented for medically stable people living with HIV. METHODS Participants were followed up for 1 year before and after implementation of EmERGE, between April 2016 and October 2019. Micro-costing studies were performed in the outpatient services of the clinics. Unit costs for outpatient services were calculated in national currencies and converted to US$ 2018 OECD purchasing parity prices to enable between clinic comparisons in terms of outcomes and costs. Unit costs were linked to the mean use of services for medically stable people living with HIV, before and after implementation of EmERGE. Primary outcome measures were CD4 count and viral load; secondary outcomes were patient activation (PAM13) and quality of life (PROQOL-HIV). Out-of-pocket expenditure data were collected. RESULTS There were 2251 participants: 87-93% were male, mean age at entry was 41-47 years. Medically stable people living with HIV had outpatient visits in four sites which decreased by 9-31% and costs by 5-33%; visits and costs increased by 8% in one site, which had to revert back to face-to-face visits. Antiretroviral drugs comprised 83-91% of annual costs: the Portuguese site had the highest antiretroviral drug costs in US$ purchasing parity prices. Primary and secondary outcome measures of participants did not change during the study. CONCLUSIONS EmERGE is acceptable and provided cost savings in different socio-economic settings. Antiretroviral drug costs remain the main cost drivers in medically stable people living with HIV. While antiretroviral drug prices in local currencies did not differ that much between countries, conversion to US$ purchasing parity prices revealed antiretroviral drugs were more expensive in the least wealthy countries. This needs to be taken into consideration when countries negotiate drug prices with pharmaceutical vendors. Greater efficiencies can be anticipated by extending the use of the EmERGE Pathway to people with complex HIV infection or other chronic diseases. Extending such use should be systematically monitored, implementation should be evaluated and funding should be provided to monitor and evaluate future changes in service provision.
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Affiliation(s)
- Eduard J Beck
- NPMS-HHC CIC, 21 Bedford Square, London, WC1B 3HH, UK.
- Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK.
| | | | | | - Agathe Leon
- Infectious Diseases Department, Hospital Clínic-IDIBAPS (HC-IDIBAPS), University of HC-IDIBAPS, Barcelona, Spain
| | - Marie J Merino
- Infectious Diseases Department, Hospital Clínic-IDIBAPS (HC-IDIBAPS), University of HC-IDIBAPS, Barcelona, Spain
| | - Felipe Garcia
- Infectious Diseases Department, Hospital Clínic-IDIBAPS (HC-IDIBAPS), University of HC-IDIBAPS, Barcelona, Spain
| | | | - Ludwig Apers
- Institute of Tropical Medicine (ITM), Antwerp, Belgium
| | - Ivana Benkovic
- University Hospital for Infectious Diseases (UHID), Zagreb, Croatia
| | - Sime Zekan
- University Hospital for Infectious Diseases (UHID), Zagreb, Croatia
| | - Josip Begovac
- University Hospital for Infectious Diseases (UHID), Zagreb, Croatia
| | - Ana S Cunha
- Hospital Capuchos, Centro Hospitalar De Lisboa Central, EPE (HC-CHLC), Lisbon, Portugal
| | - Eugenio Teofilo
- Hospital Capuchos, Centro Hospitalar De Lisboa Central, EPE (HC-CHLC), Lisbon, Portugal
| | - Goncalo Rodrigues
- Hospital Capuchos, Centro Hospitalar De Lisboa Central, EPE (HC-CHLC), Lisbon, Portugal
| | - Margarida D F Borges
- Hospital Capuchos, Centro Hospitalar De Lisboa Central, EPE (HC-CHLC), Lisbon, Portugal
| | - Duncan Fatz
- Brighton and Sussex University Hospitals NHS Trust (BSUHT), Brighton, UK
| | - Jamie Vera
- Brighton and Sussex University Hospitals NHS Trust (BSUHT), Brighton, UK
| | - Jennifer Whetham
- Brighton and Sussex University Hospitals NHS Trust (BSUHT), Brighton, UK
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Marazzi F, Piano Mortari A, Belotti F, Carrà G, Cattuto C, Kopinska J, Paolotti D, Atella V. Psychotropic drug purchases during the COVID-19 pandemic in Italy and their relationship with mobility restrictions. Sci Rep 2022; 12:19336. [PMID: 36369240 PMCID: PMC9651906 DOI: 10.1038/s41598-022-22085-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 10/10/2022] [Indexed: 11/13/2022] Open
Abstract
Recent literature on the mental health consequences of social distancing measures has found a substantial increase in self-reported sleep disorders, anxiety and depressive symptoms during lockdown periods. We investigate this issue with data on monthly purchases of psychotropic drugs from the universe of Italian pharmacies during the first wave of the COVID-19 pandemic and find that purchases of mental health-related drugs have increased with respect to 2019. However, the excess volumes do not match the massive increase in anxiety and depressive disorders found in survey-based studies. We also study the interplay between mobility, measured with anonymized mobile phone data, and mental health and report no significant effect of mobility restrictions on antidepressants and anxiolytics purchases during 2020. We provide three potential mechanisms that could drive the discrepancy between self-reported mental health surveys and psychotropic drugs prescription registries: (1) stockpiling practices in the early phases of the pandemic; (2) the adoption of compensatory behavior and (3) unexpressed and unmet needs due to both demand- and supply-side shortages in healthcare services.
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Affiliation(s)
- Francesca Marazzi
- grid.6530.00000 0001 2300 0941Centre for Economic and International Studies, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Andrea Piano Mortari
- grid.6530.00000 0001 2300 0941Department of Economics and Finance, University of Rome Tor Vergata, 00133 Rome, Italy ,grid.415788.70000 0004 1756 9674Directorate General for Planning, Ministry of Health, 00144 Rome, Italy
| | - Federico Belotti
- grid.6530.00000 0001 2300 0941Department of Economics and Finance, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Giuseppe Carrà
- grid.7563.70000 0001 2174 1754School of Medicine and Surgery, University of Milano Bicocca, 20126 Milan, Italy
| | - Ciro Cattuto
- grid.418750.f0000 0004 1759 3658ISI Foundation, 10126 Turin, Italy ,grid.7605.40000 0001 2336 6580Department of Informatics, University of Turin, 10124 Turin, Italy
| | - Joanna Kopinska
- grid.7841.aDepartment of Social Sciences and Economics, University of Rome La Sapienza, 00185 Rome, Italy
| | - Daniela Paolotti
- grid.418750.f0000 0004 1759 3658ISI Foundation, 10126 Turin, Italy
| | - Vincenzo Atella
- grid.6530.00000 0001 2300 0941Department of Economics and Finance, University of Rome Tor Vergata, 00133 Rome, Italy
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Shi Z, Jing X. New developments during the COVID-19 pandemic: Drama therapy as an online psychological intervention tool. Front Psychol 2022; 13:930002. [DOI: 10.3389/fpsyg.2022.930002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 10/17/2022] [Indexed: 11/11/2022] Open
Abstract
The COVID-19 pandemic has caused many art therapists and psychotherapists to change their practice modes and workplace setup. As a creative arts therapy (CAT), drama therapy has also shifted to an online mode—a shift that has been highly consequential for practice. This paper reviews the existing practice of tele-CAT and tele-drama therapy, explores the advantages and disadvantages of online drama therapy as a psychological intervention tool, and puts forward some developmental suggestions for online drama therapy.
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15
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Kertzscher L, Baldofski S, Kohls E, Schomerus G, Rummel-Kluge C. Stable through the COVID-19 pandemic: Results from a longitudinal telephone interview study in psychiatric outpatients. PLoS One 2022; 17:e0276982. [PMID: 36327339 PMCID: PMC9632763 DOI: 10.1371/journal.pone.0276982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic was associated with far-reaching changes all over the world. Health care systems were and are also affected. Little is known about the impact of these changes and the duration of the pandemic on people with mental disorders. The aim of this longitudinal follow-up study was to investigate the mental health status, medical care provision, and attitudes towards the pandemic of these people at the end of the second pandemic lockdown in Germany in 2021, and to compare these findings with the results of 2020. METHODS People with mental disorders currently receiving treatment in the psychiatric outpatient department of the University Hospital Leipzig, Germany, were asked about depressive symptoms (PHQ-9), self-reported medical care provision, attitudes and social and emotional aspects of the pandemic (social support [ESSI], perceived stress [PSS-4], loneliness [UCLA-3-LS], and resilience [BRS]) using structured telephone interviews. RESULTS In total, N = 75 participants who had already participated in the first survey in 2020 took part in the follow-up telephone interviews. The most frequent clinician-rated diagnoses were attention deficit disorder/attention deficit hyperactivity disorder (n = 21; 28.0%) and obsessive-compulsive disorder (n = 16; 21.3%). In comparison to 2020, a significantly higher proportion of participants reported no problems in receiving medical care provision. Compared to the previous year, the resilience of the participants had significantly decreased. Depressive symptoms, social support, perceived stress, and loneliness remained stable. Significantly more participants felt restricted by the pandemic-related government measures in 2021 than in 2020. CONCLUSIONS This study highlights the importance for continued efforts to maintain stable medical care provision for people with mental disorders during the COVID-19 pandemic, as except for a decrease in resilience, mental health status remained stable. Nonetheless there is still a need for continued treatment to stabilise and improve this status.
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Affiliation(s)
- Lisa Kertzscher
- Medical Faculty, Department of Psychiatry and Psychotherapy, Leipzig University, Leipzig, Germany
| | - Sabrina Baldofski
- Medical Faculty, Department of Psychiatry and Psychotherapy, Leipzig University, Leipzig, Germany
| | - Elisabeth Kohls
- Medical Faculty, Department of Psychiatry and Psychotherapy, Leipzig University, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University Leipzig Medical Center, Leipzig, Germany
| | - Georg Schomerus
- Medical Faculty, Department of Psychiatry and Psychotherapy, Leipzig University, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University Leipzig Medical Center, Leipzig, Germany
| | - Christine Rummel-Kluge
- Medical Faculty, Department of Psychiatry and Psychotherapy, Leipzig University, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University Leipzig Medical Center, Leipzig, Germany
- * E-mail:
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16
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Beck EJ, Mandalia S, Yfantopoulos P, Jones CI, Bremner S, Whetham J, Cunha AS, Teofilo E, Rodrigues G, Borges M, on behalf of the EmERGE Consortium. The efficiency of the EmERGE platform for medically stable people living with HIV in Portugal. Porto Biomed J 2022; 7:e191. [DOI: 10.1097/j.pbj.0000000000000191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 05/27/2022] [Indexed: 11/22/2022] Open
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Zangani C, Ostinelli EG, Smith KA, Hong JSW, Macdonald O, Reen G, Reid K, Vincent C, Syed Sheriff R, Harrison PJ, Hawton K, Pitman A, Bale R, Fazel S, Geddes JR, Cipriani A. Impact of the COVID-19 Pandemic on the Global Delivery of Mental Health Services and Telemental Health: Systematic Review. JMIR Ment Health 2022; 9:e38600. [PMID: 35994310 PMCID: PMC9400843 DOI: 10.2196/38600] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/05/2022] [Accepted: 07/21/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic required mental health services around the world to adapt quickly to the new restrictions and regulations put in place to reduce the risk of transmission. As face-to-face contact became difficult, virtual methods were implemented to continue to safely provide mental health care. However, it is unclear to what extent service provision transitioned to telemental health worldwide. OBJECTIVE We aimed to systematically review the global research literature on how mental health service provision adapted during the first year of the pandemic. METHODS We searched systematically for quantitative papers focusing on the impact of the COVID-19 pandemic on mental health services published until April 13, 2021, in the PubMed, Embase, medRxiv, and bioXriv electronic bibliographic databases, using the COVID-19 Open Access Project online platform. The screening process and data extraction were independently completed by at least two authors, and any disagreement was resolved by discussion with a senior member of the team. The findings were summarized narratively in the context of each country's COVID-19 Stringency Index, which reflects the stringency of a government's response to COVID-19 restrictions at a specific time. RESULTS Of the identified 24,339 records, 101 papers were included after the screening process. Reports on general services (n=72) showed that several countries' face-to-face services reduced their activities at the start of the pandemic, with reductions in the total number of delivered visits and with some services forced to close. In contrast, telemental health use rapidly increased in many countries across the world at the beginning of the pandemic (n=55), with almost complete virtualization of general and specialistic care services by the end of the first year. Considering the reported COVID-19 Stringency Index values, the increased use of virtual means seems to correspond to periods when the Stringency Index values were at their highest in several countries. However, due to specific care requirements, telemental health could not be used in certain subgroups of patients, such as those on clozapine or depot treatments and those who continued to need face-to-face visits. CONCLUSIONS During the pandemic, mental health services had to adapt quickly in the short term, implementing or increasing the use of telemental health services across the globe. Limited access to digital means, poor digital skills, and patients' preferences and individual needs may have contributed to differences in implementing and accessing telemental health services during the pandemic. In the long term, a blended approach, combining in-person and virtual modalities, that takes into consideration the needs, preferences, and digital skills of patients may better support the future development of mental health services. It will be required to improve confidence with digital device use, training, and experience in all modalities for both clinicians and service users.
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Affiliation(s)
- Caroline Zangani
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | | | - Katharine A Smith
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - James S W Hong
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Orla Macdonald
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, United Kingdom
| | - Gurpreet Reen
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - Katherine Reid
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, United Kingdom
| | - Charles Vincent
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | | | - Paul J Harrison
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Keith Hawton
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Alexandra Pitman
- Division of Psychiatry, University College London, London, United Kingdom
| | - Rob Bale
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, United Kingdom
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - John R Geddes
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Andrea Cipriani
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, United Kingdom
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18
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Beck EJ, Mandalia S, Yfantopoulos P, Jones CI, Bremner S, Whetham J, Etcheverry F, Moreno L, Gonzalez E, Merino MJ, Leon A, Garcia F. Efficiency of the EmERGE Pathway to provide continuity of care for Spanish people living with medically stable HIV. Enferm Infecc Microbiol Clin (Engl Ed) 2022; 40:388-395. [PMID: 35906033 DOI: 10.1016/j.eimce.2020.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 11/23/2020] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Calculate the efficiency of the EmERGE Pathway of Care for medically stable people living with HIV at the Hospital Clínic-IDIBAPS, Barcelona, Spain. METHODS 546 study participants were followed between 1st July 2016 and 30th October 2019 across three HIV outpatient clinics, but the virtual clinic was closed during the second year. Unit costs were calculated, linked to mean use outpatient services per patient year, one-year before and after the implementation of EmERGE. Costs were combined with primary and secondary outcomes. RESULTS Annual costs across HIV-outpatient services increased by 8%: €1073 (95%CI €999-€1157) to €1158 (95%CI €1084-€1238). Annual cost of ARVs was €7,557; total annual costs increased by 1% from €8430 (95%CI €8356-8514) to €8515 (95%CI €8441-8595). Annual cost for 433 participants managed in face-to-face (F2F) clinics decreased by 5% from €958 (95%CI 905-1018) to €904 (95%CI 863-945); participants transferred from virtual to F2F outpatient clinics (V2F) increased their annual cost by a factor of 2.2, from €115 (95%CI 94-139) to €251 (95%CI 219-290). No substantive changes were observed in primary and secondary outcomes. CONCLUSION EmERGE Pathway is an efficient and acceptable intervention. Increases in costs were caused by internal structural changes. The cost reduction observed in F2F clinics were off-set by the transfer of participants from the virtual to the F2F clinics due to the closure of the virtual clinic during the second year of the Study. Greater efficiencies are likely to be achieved by extending the use of the Pathway to other PLHIV.
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Affiliation(s)
- E J Beck
- NPMS-HHC CIC, London, UK; Department of Health Services Research and Policy, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, UK.
| | | | | | - C I Jones
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, UK
| | - S Bremner
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, UK
| | - J Whetham
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - F Etcheverry
- Fundació Clínic per a la Recerca Biomèdica, University of Barcelona, Barcelona, Spain
| | - L Moreno
- Fundació Clínic per a la Recerca Biomèdica, University of Barcelona, Barcelona, Spain
| | - E Gonzalez
- Fundació Clínic per a la Recerca Biomèdica, University of Barcelona, Barcelona, Spain
| | - M J Merino
- Fundació Clínic per a la Recerca Biomèdica, University of Barcelona, Barcelona, Spain
| | - A Leon
- Fundació Clínic per a la Recerca Biomèdica, University of Barcelona, Barcelona, Spain
| | - F Garcia
- Fundació Clínic per a la Recerca Biomèdica, University of Barcelona, Barcelona, Spain
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Aafjes-van Doorn K, Békés V, Prout TA, Hoffman L. Practicing Online During COVID-19: Psychodynamic and Psychoanalytic Therapists' Experiences. J Am Psychoanal Assoc 2022; 70:665-694. [PMID: 36047620 DOI: 10.1177/00030651221114053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
During the Covid-19 pandemic, psychotherapists quickly transitioned to provide online therapy, while facing many challenges. This study aimed to explore psychodynamic and psychoanalytically oriented therapists' (N = 1450) experiences with online therapy during the first weeks of the pandemic and two months later. Results showed that therapists had little pre-pandemic experience with providing online therapy and even less training in it, and that younger therapists reported more challenges in the transition to online therapy. During the first weeks of the pandemic, most therapists thought that online therapy was less effective than in-person therapy, and they reported a wide range of relational and technical challenges, feeling more tired, less confident and competent, and less connected and authentic in online sessions, compared to previous in-person sessions. At follow-up, therapists viewed online therapy as more comparable to in-person therapy; the majority felt connected and authentic as they had during the initial weeks of the pandemic, or more so, but were still as tired as before. The most challenging aspect of online therapy was distraction in sessions, which increased over time. This study demonstrates the professional adaptability of therapists and highlights the need for more training and professional support for clinicians providing remote psychotherapy.
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Staeck R, Drüge M, Albisser S, Watzke B. Acceptance of E-mental health interventions and its determinants among psychotherapists-in-training during the first phase of COVID-19. Internet Interv 2022; 29:100555. [PMID: 35789691 PMCID: PMC9242936 DOI: 10.1016/j.invent.2022.100555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/07/2022] [Accepted: 06/22/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Although E-mental health (EMH) interventions have been shown to be effective in the treatment of mental health problems and empirical knowledge regarding EMH acceptance for different occupations in health care is established, little is known regarding EMH and psychotherapists-in-training. This seems particularly relevant as psychotherapists-in-training will shape the future health care system since they are as being the next generation of psychotherapists. With social distancing measures in place, COVID-19 has led to an increased demand for EMH, which is broadening the way psychological treatments are delivered. OBJECTIVE The present study aims to assess the acceptance of EMH and its determinants among psychotherapists-in-training of different EMH modalities and to retrospectively compare current acceptance with pre-COVID-19 times. METHODS Altogether, 29 training institutions in Switzerland and 232 training institutions in Germany were contacted, resulting in a sample of N = 216 psychotherapists-in-training (88.4 % female) who filled out the self-administered web-based questionnaire in summer 2020. The acceptance of EMH was assessed considering several different modalities (e.g., videoconference, guided self-help programs) as well as further possible predictors of EMH acceptance based on the Unified Theory of Acceptance and Use of Technology. Acceptance scores were categorized as low, moderate or high based on prior research and predicted using multiple regression. RESULTS Acceptance of EMH was moderate (M = 3.40, SD = 1.11) and increased significantly (t(215) = 12.03, p < .01; d = 0.88) compared to pre-COVID-19 (M = 2.67, SD = 1.11); however, acceptance varied significantly between modalities (F(2.6, 561.7) = 62.93, p < .01, partial η2 = 0.23), with videoconferencing being the most accepted and unguided programs the least. Stepwise regression including three of 14 variables (R2 = 0.55, F (14, 201) = 17.68, p < .001) identified performance expectancy, social influence and concerns about the therapeutic alliance as significant determinants of EMH acceptance. DISCUSSION Acceptance by psychotherapists-in-training was moderate and in line with prior research and comparable with other clinicians' acceptance scores. Performance expectancy, social influence and concerns about the therapeutic alliance were predictive of EMH acceptance, indicating their significance in the implementation of EMH in health care. CONCLUSION These findings underline the importance of the aforementioned determinants of EMH acceptance and the need for further studies investigating EMH acceptance in order to derive adequate educational programs and to facilitate dissemination among psychotherapists-in-training.
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Schaffler Y, Kuska M, Barke A, Doering BK, Gossmann K, Meier Z, Kascakova N, Tavel P, Humer E, Pieh C, Stippl P, Schimböck W, Haid B, Probst T. Psychotherapists' Reports regarding the Impact of the COVID-19 Pandemic on Their Patients: A Cross-National Descriptive Study Based on the Social-Ecological Model (SEM). Int J Environ Res Public Health 2022; 19:6825. [PMID: 35682406 PMCID: PMC9180390 DOI: 10.3390/ijerph19116825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/29/2022] [Accepted: 05/31/2022] [Indexed: 11/28/2022]
Abstract
The COVID-19 outbreak has raised questions about how vulnerable groups experience the pandemic. Research that focuses on the view of individuals with pre-existing mental health conditions is still limited, and so are cross-country comparative surveys. We gathered our sample of qualitative data during the first lockdown after governmental measures against the spread of the SARS-CoV-2 virus came into force in Austria, Czechia, Germany, and Slovakia. A total of n = 1690 psychotherapists from four middle European countries answered the question of how the COVID-19 pandemic was addressed in sessions by their patients during the early stage of unprecedented public health conditions. We employed a descriptive qualitative methodology to determine themes following levels of the social-ecological model (SEM) regarding how the COVID-19 pandemic affected patients. At the public policy level, stressful environmental conditions concerned the governmental mitigation efforts. At the level of community/society, reported key themes were employment, restricted access to educational and health facilities, socioeconomic consequences, and the pandemic itself. Key themes at the interpersonal level regarded forced proximity, the possibility of infection of loved ones, childcare, and homeschooling. Key themes at the individual level were the possibility of contracting COVID-19, having to stay at home/isolation, and a changing environment. Within the SEM framework, adaptive and maladaptive responses to these stressors were reported, with more similarities than differences between the countries. A quantification of word stems showed that the maladaptive reactions predominated.
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Affiliation(s)
- Yvonne Schaffler
- Department for Psychosomatic Medicine and Psychotherapy, Danube University Krems, 3500 Krems, Austria; (M.K.); (E.H.); (C.P.); (T.P.)
| | - Martin Kuska
- Department for Psychosomatic Medicine and Psychotherapy, Danube University Krems, 3500 Krems, Austria; (M.K.); (E.H.); (C.P.); (T.P.)
- College of Applied Psychology, 41155 Terezin, Czech Republic
| | - Antonia Barke
- Clinical and Biological Psychology, Catholic University of Eichstätt-Ingolstadt, 85072 Eichstätt, Germany; (A.B.); (K.G.)
| | - Bettina K. Doering
- Clinical Psychology and Psychotherapy, Brandenburg Medical School Theodor Fontane, 16861 Neuruppin, Germany;
| | - Katharina Gossmann
- Clinical and Biological Psychology, Catholic University of Eichstätt-Ingolstadt, 85072 Eichstätt, Germany; (A.B.); (K.G.)
| | - Zdenek Meier
- Olomouc University Social Health Institute (OUSHI), Palacky University Olomouc, 77111 Olomouc, Czech Republic; (Z.M.); (N.K.); (P.T.)
| | - Natalia Kascakova
- Olomouc University Social Health Institute (OUSHI), Palacky University Olomouc, 77111 Olomouc, Czech Republic; (Z.M.); (N.K.); (P.T.)
- Psychiatric-Psychotherapeutic Outpatient Clinic, Pro Mente Sana, 81108 Bratislava, Slovakia
| | - Peter Tavel
- Olomouc University Social Health Institute (OUSHI), Palacky University Olomouc, 77111 Olomouc, Czech Republic; (Z.M.); (N.K.); (P.T.)
| | - Elke Humer
- Department for Psychosomatic Medicine and Psychotherapy, Danube University Krems, 3500 Krems, Austria; (M.K.); (E.H.); (C.P.); (T.P.)
| | - Christoph Pieh
- Department for Psychosomatic Medicine and Psychotherapy, Danube University Krems, 3500 Krems, Austria; (M.K.); (E.H.); (C.P.); (T.P.)
| | - Peter Stippl
- Austrian Federal Association for Psychotherapy, 1030 Vienna, Austria; (P.S.); (W.S.); (B.H.)
| | - Wolfgang Schimböck
- Austrian Federal Association for Psychotherapy, 1030 Vienna, Austria; (P.S.); (W.S.); (B.H.)
| | - Barbara Haid
- Austrian Federal Association for Psychotherapy, 1030 Vienna, Austria; (P.S.); (W.S.); (B.H.)
| | - Thomas Probst
- Department for Psychosomatic Medicine and Psychotherapy, Danube University Krems, 3500 Krems, Austria; (M.K.); (E.H.); (C.P.); (T.P.)
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22
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Wilczewski H, Paige SR, Ong T, Soni H, Barrera JF, Welch BM, Bunnell BE. Provider Perspectives on Telemental Health Usage After COVID-19: A Retrospective Analysis (Preprint). JMIR Form Res 2022; 6:e39634. [PMID: 36322787 PMCID: PMC9662289 DOI: 10.2196/39634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 10/12/2022] [Accepted: 10/31/2022] [Indexed: 11/05/2022] Open
Abstract
Background Mental health care pivoted to telemedicine during the COVID-19 pandemic, and there is uncertainty around the sustainability of this rapid shift. Objective This study examined how intentions to continue using telemedicine after the COVID-19 pandemic are influenced by provider perceptions of usefulness, ease of use, and professional social influence, facilitating organizational conditions. Methods We conducted a web-based, cross-sectional survey of 369 telemental health providers between February and March 2021. A hierarchical linear regression analysis was conducted to predict intentions to continue using telemedicine after the COVID-19 pandemic. Results Most providers began using telemedicine in March 2020 or later (257/369, 69.6%) and attended to ≥50% of their clients via telemedicine (299/369, 81.0%). Intention to continue using telemedicine after the COVID-19 pandemic was predicted by the telemedicine caseload (β=.10; P=.005), perceived usefulness in general (β=.10; P=.008), ease of use (β=.08; P=.04), social influence (β=.68; P<.001), and facilitating conditions (β=.08; P=.047). Conclusions Exploration of the predictors of telemedicine usage beyond the COVID-19 pandemic aids in surveillance of telemedicine usage, integration with future clinic workflows, and the shaping of public policy. It is important to consider telemedicine services as not only a response to a crisis but also an effective and useful solution for everyday life. Our results suggest widespread, sustainable telemedicine adoption.
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Affiliation(s)
| | | | - Triton Ong
- Doxy.me Research, Doxy.me Inc, Rochester, NY, United States
| | - Hiral Soni
- Doxy.me Research, Doxy.me Inc, Rochester, NY, United States
| | - Janelle F Barrera
- Doxy.me Research, Doxy.me Inc, Rochester, NY, United States
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, United States
| | - Brandon M Welch
- Doxy.me Research, Doxy.me Inc, Rochester, NY, United States
- Biomedical Informatics Center, Medical University of South Carolina, Charleston, SC, United States
| | - Brian E Bunnell
- Doxy.me Research, Doxy.me Inc, Rochester, NY, United States
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, United States
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23
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Haghshomar M, Shobeiri P, Brand S, Rossell SL, Akhavan Malayeri A, Rezaei N. Changes of symptoms of eating disorders (ED) and their related psychological health issues during the COVID-19 pandemic: a systematic review and meta-analysis. J Eat Disord 2022; 10:51. [PMID: 35418108 PMCID: PMC9006500 DOI: 10.1186/s40337-022-00550-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 02/02/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic and its related social restrictions have profoundly affected people's mental health. It can be assumed that symptomatic behaviors and mental health of individuals with eating disorders (ED) deteriorated during this time. To get a thorough overview, we conducted a systematic review and meta-analysis with the following aims: First, to provide a comprehensive overview of symptoms of ED during the COVID-19-related confinement; second, to identify psychological mechanisms which impacted the emergence and maintenance of ED symptoms; third, to describe changes of daily routine and changes of access to healthcare in individuals with ED during confinement. METHODS We searched Embase, PubMed, and Scopus databases for observational studies published between January 1st, 2020, to July 1st, 2021, which investigated the symptomatology of ED during the COVID-19 pandemic. RESULTS After the screening, 13 studies with 7848 participants were included in the present systematic review and meta-analysis. The overall pooled prevalence of exacerbation of binge eating, food restriction, purging behaviors, and concerns about food intake in the pooled sample of 7848 was 59.65% (95% CI: 49.30%; 69.60%), and the overall prevalence of improved symptoms of ED in the pooled sample of 741 individuals was 9.37% (95% CI: 3.92%; 16.57%). Furthermore, COVID-19-related social restrictions negatively impacted the psychological health, daily routines, and physical activity of individuals with ED. More specifically, symptoms of anxiety and depression related to ED were increased significantly over time. However, there were also positive aspects to the COVID-19 pandemic. The main positive consequences included more emotional support from the family, less pressure to engage in social activities, and more flexible meal planning. Individuals with ED reported having difficulties getting access to healthcare centers and using telemedicine. They also found a hard time communicating via online sessions. CONCLUSIONS According to our interpretation, based on the data included in the systematic review and meta-analysis, the COVID-19 pandemic and its related social restrictions detrimentally impacted the mental health of majority of individuals with ED. Limited and impaired access to healthcare interventions appeared to have further exacerbated mental health issues of individuals with ED. Given this background, it seems that individuals with ED demand more attention during the COVID-19 crisis, and it is necessary to ensure that their course of treatment remains uninterrupted.
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Affiliation(s)
- Maryam Haghshomar
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Parnian Shobeiri
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Dr. Gharib St, Keshavarz Blvd, Tehran, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Serge Brand
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.,Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002, Basel, Switzerland.,Department of Sport, Exercise and Health, Division of Sport Science and Psychosocial Health, University of Basel, 4052, Basel, Switzerland.,Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Susan L Rossell
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC, Australia.,Department of Mental Health, St Vincent's Hospital, Melbourne, VIC, Australia
| | | | - Nima Rezaei
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Dr. Gharib St, Keshavarz Blvd, Tehran, Iran. .,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran. .,Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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24
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Beck EJ, Mandalia S, Yfantopoulos P, Jones CI, Bremner S, Fatz D, Vera J, Whetham J. The efficiency of the EmERGE pathway of care for people living with HIV in England. AIDS Care 2022; 35:899-908. [PMID: 35348411 DOI: 10.1080/09540121.2022.2040723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study estimated the efficiency of implementing the EmERGE Pathway of Care for people living with medically stable HIV in Brighton, UK; an App enables individuals to communicate with caregivers via their smart-phone. Individual data on the use of HIV outpatient services were collected one-year pre- and post-implementation of EmERGE. Unit costs of HIV outpatient services were calculated and linked with mean use of services per patient year. Primary outcomes were CD4 count and viral load; patient activation and quality-of-life measures were secondary outcomes. 565 participants were followed up April 2017 - October 2018: 93% men, mean age at recruitment 47.0 years (95%CI:46.2-47.8). Outpatient visits decreased by 9% from 5.6 (95%CI:5.4-5.8) to 5.1 (95%CI:4.9-5.3). Face-to-face visits decreased and virtual visits increased. Annual costs decreased by 9% from £751 (95%CI: £722-£780) to £678 (95%CI: £653-£705). Including anti-retroviral drugs, total annual cost decreased from £7,343 (95%CI: £7,314-7,372) to £7,270 (95%CI: £7,245-7,297): ARVs costs comprised 90%. EmERGE was a cost-saving intervention, patients remained engaged and clinically stable. Annual costs were reduced, but ARVs continue to dominate costs. Extension of EmERGE to other people with chronic conditions, could produce greater efficiencies but these needs to be evaluated and monitored over time.
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Affiliation(s)
- E J Beck
- NPMS-HHC CIC, London, UK.,Department of Health Services Research and Policy, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - C I Jones
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - S Bremner
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - D Fatz
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - J Vera
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - J Whetham
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
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25
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Galasiński D, Ziółkowska J, Witkowicz M. Experience of the Absence of the Journey to Sessions in Clients' Narratives About Online Psychotherapy. Front Psychol 2022; 13:798960. [PMID: 35250734 PMCID: PMC8888532 DOI: 10.3389/fpsyg.2022.798960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 01/18/2022] [Indexed: 11/26/2022] Open
Abstract
Background Remotely provided psychotherapy due to the COVID-19 pandemic became common. One of the most significant changes related to providing online psychotherapy services is that clients no longer travel to their sessions. Aims In the article we are interested in the narrated experience of the absence of journey to psychotherapy sessions. We study clients' stories of past journeys and how their absence, resulting from the change of the mode of therapy provision, is coped with and replaced by other activities in their narratives. Methods The study takes a constructionist approach to discourse and focuses on the lexico-grammatical form of the notes. The data come from 12 semi-structured interviews with people who declared attending remote psychotherapy sessions after the national lockdown had been introduced. Results In the collected data, the physical journey is constructed not only as travel time, solitude which can be used for reflection, but, importantly, as an active process which ends with a resolution. In contrast, in narratives of the time before an online session, constructions of unfettered agents are replaced with those of people whose actions are hedged and qualified. Conclusion We argue that in the informants' narratives the journey to psychotherapy is meaningful and is part of the therapeutic process. We propose that it is a time of passing between two states—one before therapy and one in session. The journey therefore is experienced as a process of change, and not only a process of traveling.
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Affiliation(s)
- Dariusz Galasiński
- Centre for Interdisciplinary Research into Health and Illness, University of Wroclaw, Wrocław, Poland
| | - Justyna Ziółkowska
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wrocław, Poland
| | - Magdalena Witkowicz
- Centre for Interdisciplinary Research into Health and Illness, University of Wroclaw, Wrocław, Poland
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26
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Braun P, Drüge M, Hennemann S, Nitsch FJ, Staeck R, Apolinário-Hagen J. Acceptance of E-Mental Health Services for Different Application Purposes Among Psychotherapists in Clinical Training in Germany and Switzerland: Secondary Analysis of a Cross-Sectional Survey. Front Digit Health 2022; 4:840869. [PMID: 35295621 PMCID: PMC8918841 DOI: 10.3389/fdgth.2022.840869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 01/27/2022] [Indexed: 11/13/2022] Open
Abstract
Background Despite solid evidence supporting the efficacy of electronic mental health (EMH) services, their acceptance among psychotherapists is limited and uptake rates remain low. However, the acceptance of different EMH services has yet barely been examined in future generations of psychotherapists in a differentiated manner. The aims of this study were (1) to elaborate the intention to use various EMH services for different application purposes and (2) to determine predictors of EMH service acceptance among psychotherapists in clinical training (PiT). Materials and Methods Our paper is based on a secondary data analysis of a cross-sectional survey. Respondents were recruited via recognized educational institutions for psychotherapy within Germany and the German-speaking part of Switzerland between June and July of 2020. The survey contained items on the intention to use different EMH services (i.e., guided and unguided programs, virtual reality, psychotherapy by telephone and videoconference) for various application purposes (i.e., prevention, treatment addition, treatment substitute, aftercare). Potential predictors of EMH service acceptance (e.g., barriers and advantages) were examined based on an extension of the Unified Theory of Acceptance and Use of Technology (UTAUT). Results Most of the n = 216 respondents were female (88.4%) and located in Germany (72.2%). General acceptance of EMH was moderate (M = 3.4, SD = 1.12, range 1-5), while acceptance of psychotherapy via videoconference was highest (M = 3.7, SD = 1.15) and acceptance of unguided programs was lowest (M = 2.55, SD = 1.14). There was an interaction effect of EMH service and application purpose (η2 = 0.21). Barriers and advantages both had a uniform influence on EMH service acceptance (Pr > 0.999), while impersonality, legal concerns, concerns about therapeutic alliance, simplified information provision, simplified contact maintenance, time flexibility, and geographic flexibility were significant predictors (all p < 0.05). Results showed that the extended UTAUT model was the best fitting model to predict EMH service acceptance (Pr > 0.999). Conclusions The intention to use different EMH services varied between application purposes among PiT. To increase acceptance of EMH services and reduce misconceptions, we identified predictors that should be addressed in future acceptance-facilitating interventions when educating PiT.
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Affiliation(s)
- Pia Braun
- Faculty of Medicine, Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Marie Drüge
- Department of Clinical Psychology/Psychotherapy Research, Institute of Psychology, University of Zurich, Zurich, Switzerland
| | - Severin Hennemann
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Institute of Psychology, University of Mainz, Mainz, Germany
| | - Felix Jan Nitsch
- Marketing Area, INSEAD, Fontainebleau, France
- Paris Brain Institute (ICM), INSERM U 1127, CNRS UMR 7225, Sorbonne Université, Paris, France
| | - Robert Staeck
- Department of Clinical Psychology/Psychotherapy Research, Institute of Psychology, University of Zurich, Zurich, Switzerland
| | - Jennifer Apolinário-Hagen
- Faculty of Medicine, Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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27
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Wilczewski H, Paige SR, Ong T, Barrera JF, Soni H, Welch BM, Bunnell BE. Perceptions of Telemental Health Care Delivery During COVID-19: A Cross-Sectional Study With Providers, February-March 2021. Front Psychiatry 2022; 13:855138. [PMID: 35444579 PMCID: PMC9013879 DOI: 10.3389/fpsyt.2022.855138] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/09/2022] [Indexed: 01/02/2023] Open
Abstract
The COVID-19 pandemic accelerated adoption of telemental health (TMH). Providers with limited TMH experience faced challenges during the rapid switch to remote patient care. We investigated TMH providers' perceptions about remote care one year into the pandemic according to when providers adopted telemedicine (i.e., before vs. after March 2020) and how much of their caseloads were served remotely (i.e., < 50% vs. ≥ 50%). Between February-March 2021, 472 TMH providers completed a cross-sectional, web-based survey that measured perceived benefits and satisfaction with telemedicine, therapeutic alliance, patient-centered communication, eHealth literacy, multicultural counseling self-efficacy, and facilitating factors of using telemedicine. Providers who began using telemedicine before the pandemic reported having better training, task-related therapeutic alliance with patients, and ability to conduct multicultural interventions, assessments, and session management. Providers who served ≥ 50% of their caseload remotely reported greater satisfaction with their practice, stronger beliefs about the benefits of telemedicine, and greater perceived effects of telemedicine on alleviating the impact of COVID-19. There were no differences in reports of patient-centered communication nor eHealth literacy. In conclusion, providers who adopted TMH more recently may require additional training and support to successfully establish a working alliance with their patients, especially with multicultural aspects of care.
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Affiliation(s)
| | | | - Triton Ong
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States
| | - Janelle F Barrera
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States.,Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, United States
| | - Hiral Soni
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States
| | - Brandon M Welch
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States.,Biomedical Informatics Center, Medical University of South Carolina, Charleston, SC, United States
| | - Brian E Bunnell
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States.,Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, United States
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28
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Békés V, Aafjes-van Doorn K, McCollum J, Prout TR, Hoffman L. The development of a self-report scale to assess therapists' acceptance of telepsychotherapy. J Clin Psychol 2021; 78:1240-1260. [PMID: 34897674 DOI: 10.1002/jclp.23289] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 11/17/2021] [Accepted: 11/24/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE We aimed to develop a self-report measure of therapist acceptance of telepsychotherapy based on the Unified Theory of Acceptance and Use of Technology (UTAUT) framework. METHODS Using a cross-sectional survey design, 1265 therapists completed the UTAUT-T, as well as additional questions. RESULTS Confirmatory analysis indicated that the original UTAUT model did not fit the therapist context well. Exploratory factor analysis specified a better-fitting five-factor model, which showed good internal validity fit (χ2 = 17,753.36, RMSEA = 0.063, TLI = 0.886, SRMSR = 0.04). The five UTAUT-T subscales showed high internal consistency (Cronbach's α = 0.86) and together predicted the intention to use online therapy in the future (R2 = 0.42, F(5, 1259) = 181.9, p < 0.001). CONCLUSION The 21-item UTAUT-T offers a promising self-report measure of therapist acceptance of telepsychotherapy and intention towards using it in the future. Future studies on the convergent and predictive validity of the UTAUT-T are warranted.
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Affiliation(s)
- Vera Békés
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, United States, USA
| | | | - James McCollum
- San Francisco Psychotherapy Research Group, San Francisco, California, USA
| | - Tracy R Prout
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, United States, USA
| | - Leon Hoffman
- New York Psychoanalytic Society and Institute, New York, New York, USA
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29
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Appleton R, Williams J, Vera San Juan N, Needle JJ, Schlief M, Jordan H, Sheridan Rains L, Goulding L, Badhan M, Roxburgh E, Barnett P, Spyridonidis S, Tomaskova M, Mo J, Harju-Seppänen J, Haime Z, Casetta C, Papamichail A, Lloyd-Evans B, Simpson A, Sevdalis N, Gaughran F, Johnson S. Implementation, Adoption, and Perceptions of Telemental Health During the COVID-19 Pandemic: Systematic Review. J Med Internet Res 2021; 23:e31746. [PMID: 34709179 PMCID: PMC8664153 DOI: 10.2196/31746] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/20/2021] [Accepted: 10/01/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Early in 2020, mental health services had to rapidly shift from face-to-face models of care to delivering the majority of treatments remotely (by video or phone call or occasionally messaging) due to the COVID-19 pandemic. This resulted in several challenges for staff and patients, but also in benefits such as convenience or increased access for people with impaired mobility or in rural areas. There is a need to understand the extent and impacts of telemental health implementation, and barriers and facilitators to its effective and acceptable use. This is relevant both to future emergency adoption of telemental health and to debates on its future use in routine mental health care. OBJECTIVE To investigate the adoption and impacts of telemental health approaches during the COVID-19 pandemic, and facilitators and barriers to optimal implementation. METHODS Four databases (PubMed, PsycINFO, CINAHL, and Web of Science) were searched for primary research relating to remote working, mental health care, and the COVID-19 pandemic. Preprint servers were also searched. Results of studies were synthesized using framework synthesis. RESULTS A total of 77 papers met our inclusion criteria. In most studies, the majority of contacts could be transferred to a remote form during the pandemic, and good acceptability to service users and clinicians tended to be reported, at least where the alternative to remote contacts was interrupting care. However, a range of impediments to dealing optimal care by this means were also identified. CONCLUSIONS Implementation of telemental health allowed some continuing support to the majority of service users during the COVID-19 pandemic and has value in an emergency situation. However, not all service users can be reached by this means, and better evidence is now needed on long-term impacts on therapeutic relationships and quality of care, and on impacts on groups at risk of digital exclusion and how to mitigate these. TRIAL REGISTRATION PROSPERO International prospective register of systematic reviews CRD42021211025; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021211025.
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Affiliation(s)
- Rebecca Appleton
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Julie Williams
- Centre for Implementation Science, King's College London, London, United Kingdom
| | - Norha Vera San Juan
- NIHR Mental Health Policy Research Unit, King's College London, London, United Kingdom
| | - Justin J Needle
- Centre for Health Services Research, City, University of London, London, United Kingdom
| | - Merle Schlief
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Harriet Jordan
- Centre for Implementation Science, King's College London, London, United Kingdom
| | - Luke Sheridan Rains
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Lucy Goulding
- King's Improvement Science, King's College London, London, United Kingdom
| | - Monika Badhan
- Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Emily Roxburgh
- Kingston iCope, Camden & Islington NHS Trust, London, United Kingdom
| | - Phoebe Barnett
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Spyros Spyridonidis
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Magdalena Tomaskova
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Jiping Mo
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | | | - Zoë Haime
- Division of Psychiatry, University College London, London, United Kingdom
| | - Cecilia Casetta
- Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Alexandra Papamichail
- NIHR Mental Health Policy Research Unit, King's College London, London, United Kingdom
| | - Brynmor Lloyd-Evans
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Alan Simpson
- NIHR Mental Health Policy Research Unit, King's College London, London, United Kingdom
| | - Nick Sevdalis
- Centre for Implementation Science, King's College London, London, United Kingdom
- NIHR Mental Health Policy Research Unit, King's College London, London, United Kingdom
| | - Fiona Gaughran
- Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Sonia Johnson
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
- Camden and Islington NHS Foundation Trust, London, United Kingdom
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30
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Abraham A, Jithesh A, Doraiswamy S, Al-Khawaga N, Mamtani R, Cheema S. Telemental Health Use in the COVID-19 Pandemic: A Scoping Review and Evidence Gap Mapping. Front Psychiatry 2021; 12:748069. [PMID: 34819885 PMCID: PMC8606591 DOI: 10.3389/fpsyt.2021.748069] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 10/15/2021] [Indexed: 01/07/2023] Open
Abstract
Background: The COVID-19 pandemic has highlighted telemedicine use for mental illness (telemental health). Objective: In the scoping review, we describe the scope and domains of telemental health during the COVID-19 pandemic from the published literature and discuss associated challenges. Methods: PubMed, EMBASE, and the World Health Organization's Global COVID-19 Database were searched up to August 23, 2020 with no restrictions on study design, language, or geographical, following an a priori protocol (https://osf.io/4dxms/). Data were synthesized using descriptive statistics from the peer-reviewed literature and the National Quality Forum's (NQF) framework for telemental health. Sentiment analysis was also used to gauge patient and healthcare provider opinion toward telemental health. Results: After screening, we identified 196 articles, predominantly from high-income countries (36.22%). Most articles were classified as commentaries (51.53%) and discussed telemental health from a management standpoint (86.22%). Conditions commonly treated with telemental health were depression, anxiety, and eating disorders. Where data were available, most articles described telemental health in a home-based setting (use of telemental health at home by patients). Overall sentiment was neutral-to-positive for the individual domains of the NQF framework. Conclusions: Our findings suggest that there was a marked growth in the uptake of telemental health during the pandemic and that telemental health is effective, safe, and will remain in use for the foreseeable future. However, more needs to be done to better understand these findings. Greater investment into human and financial resources, and research should be made by governments, global funding agencies, academia, and other stakeholders, especially in low- and middle- income countries. Uniform guidelines for licensing and credentialing, payment and insurance, and standards of care need to be developed to ensure safe and optimal telemental health delivery. Telemental health education should be incorporated into health professions curricula globally. With rapidly advancing technology and increasing acceptance of interactive online platforms amongst patients and healthcare providers, telemental health can provide sustainable mental healthcare across patient populations. Systematic Review Registration: https://osf.io/4dxms/.
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Affiliation(s)
- Amit Abraham
- Institute for Population Health, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
| | - Anupama Jithesh
- Institute for Population Health, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
| | | | | | - Ravinder Mamtani
- Institute for Population Health, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
| | - Sohaila Cheema
- Institute for Population Health, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
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Jesser A, Muckenhuber J, Lunglmayr B, Dale R, Humer E. Provision of Psychodynamic Psychotherapy in Austria during the COVID-19 Pandemic: A Cross-Sectional Study. Int J Environ Res Public Health 2021; 18:9046. [PMID: 34501635 PMCID: PMC8431203 DOI: 10.3390/ijerph18179046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 12/05/2022]
Abstract
The COVID-19 pandemic has brought massive changes in the provision of psychotherapy. To avoid or reduce the risk of infection, many therapists switched from face-to-face sessions in personal contact to remote psychotherapy, i.e., psychotherapy delivered by telephone or videoconferencing. This study examined the attitudes toward and practice of remote psychotherapy among Austrian therapists with a psychodynamic orientation at the onset of the pandemic as well as changes in the therapeutic process that were experienced by the therapists due to switching to a remote setting. A total of 161 therapists with psychodynamic orientation took part in an online survey. The results show that attitudes toward remote psychotherapy changed positively in psychodynamically orientated therapists and most are willing to switch to remote settings, if necessary. However, many therapists reported negative effects of remote psychotherapy and prefer seeing their patients in-person. The strongest changes were experienced with regard to transference/countertransference, the therapeutic process and the intensity of session. The analysis further revealed an overall decrease in the number of patients treated, indicating an undersupply of psychotherapy, at least during the first wave of COVID-19 infection in Austria. In summary, the experience during the first COVID-19 lockdown has led to an increase in remote psychotherapy and more openness toward these treatment modalities among psychodynamically oriented therapists. However, in-person therapy will remain the first choice for most therapists.
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Affiliation(s)
- Andrea Jesser
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (R.D.); (E.H.)
| | - Johanna Muckenhuber
- Institut für Soziale Arbeit, FH Joanneum University of Applied Science, 8020 Graz, Austria;
| | - Bernd Lunglmayr
- Research Workgroup, Austrian Society for Applied Depth Psychology and Psychotherapy (ÖGATAP), 1150 Vienna, Austria;
- Doctorate in Psychotherapy by Professional Studies Programme, Metanoia Institute, Ealing, London W5 2QB, UK
| | - Rachel Dale
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (R.D.); (E.H.)
| | - Elke Humer
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (R.D.); (E.H.)
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Radanliev P, De Roure D. Alternative mental health therapies in prolonged lockdowns: narratives from Covid-19. Health Technol (Berl) 2021; 11:1101-1107. [PMID: 34395155 PMCID: PMC8349233 DOI: 10.1007/s12553-021-00581-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 07/28/2021] [Indexed: 12/25/2022]
Abstract
Identify and review alternative (home-based) therapies for prolonged lockdowns. Interdisciplinary study using multi-method approach – case study, action research, grounded theory. Only secondary data has been used in this study. Epistemological framework based on a set of digital humanities tools. The set of tools are based on publicly available, open access technological solutions, enabling generalisability of the findings. Alternative therapies can be integrated in healthcare systems as home-based solutions operating on low-cost technologies.
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Affiliation(s)
- Petar Radanliev
- Department of Engineering Sciences, University of Oxford, Oxford, OX1 3QG England, UK
| | - David De Roure
- Department of Engineering Sciences, University of Oxford, Oxford, OX1 3QG England, UK
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Ong T, Wilczewski H, Paige SR, Soni H, Welch BM, Bunnell BE. Extended Reality for Enhanced Telehealth During and Beyond COVID-19: Viewpoint. JMIR Serious Games 2021; 9:e26520. [PMID: 34227992 PMCID: PMC8315161 DOI: 10.2196/26520] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 05/07/2021] [Accepted: 06/15/2021] [Indexed: 12/15/2022] Open
Abstract
The COVID-19 pandemic caused widespread challenges and revealed vulnerabilities across global health care systems. In response, many health care providers turned to telehealth solutions, which have been widely embraced and are likely to become standard for modern care. Immersive extended reality (XR) technologies have the potential to enhance telehealth with greater acceptability, engagement, and presence. However, numerous technical, logistic, and clinical barriers remain to the incorporation of XR technology into telehealth practice. COVID-19 may accelerate the union of XR and telehealth as researchers explore novel solutions to close social distances. In this viewpoint, we highlight research demonstrations of XR telehealth during the COVID-19 pandemic and discuss future directions to make XR the next evolution of remote health care.
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Affiliation(s)
- Triton Ong
- Doxy.me, LLC, Rochester, NY, United States
| | | | | | - Hiral Soni
- Doxy.me, LLC, Rochester, NY, United States
| | - Brandon M Welch
- Doxy.me, LLC, Rochester, NY, United States
- Biomedical Informatics Center, Medical University of South Carolina, Charleston, SC, United States
| | - Brian E Bunnell
- Doxy.me, LLC, Rochester, NY, United States
- Department of Psychiatry, University of South Florida, Tampa, FL, United States
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Biancalani G, Franco C, Guglielmin MS, Moretto L, Orkibi H, Keisari S, Testoni I. Tele-psychodrama therapy during the COVID-19 pandemic: Participants' experiences. Arts Psychother 2021; 75:101836. [PMID: 34305221 PMCID: PMC8294105 DOI: 10.1016/j.aip.2021.101836] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/12/2021] [Accepted: 07/18/2021] [Indexed: 01/07/2023]
Abstract
Italy was severely hit by the COVID-19 pandemic. In early March 2020, a series of legislative decrees have been issued, establishing the restrictions that all Italian citizens are required to respect, according to which it is strictly forbidden to leave the house if not for reasons of necessity, health, or work. This qualitative study investigated which aspects clients find helpful or hindering in shifting to group tele-psychodrama due to the COVID-19 pandemic, after participation in an in-person psychodrama group. Participants were 15 adults who were members of a pre-existing in-person psychodrama group that shifted to a tele-psychodrama group format facilitated by two psychodrama therapists. The Client Change Interview was used at the end of the tele-psychodrama as a post-treatment assessment. All the interviews were transcribed and then underwent a thematic analysis. The analysis yielded six shared themes: the role of tele-psychodrama sessions during COVID-19 pandemic; perceived effectiveness of tele-psychodrama; main advantages of tele-psychodrama; limitations encountered during the online intervention; the termination of tele-psychodrama; and the relationship with the therapist. The findings provide preliminary evidence for the clinical practice of tele-psychodrama and lays the groundwork for further studies that can contribute to the use of electronic platforms in psychodrama interventions.
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Affiliation(s)
- Gianmarco Biancalani
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, Padova, Italy
| | - Chiara Franco
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, Padova, Italy
| | | | | | - Hod Orkibi
- Emili Sagol Creative Arts Therapies Research Center, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Shoshi Keisari
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, Padova, Italy
| | - Ines Testoni
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, Padova, Italy.,Emili Sagol Creative Arts Therapies Research Center, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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35
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Reitzle L, Schmidt C, Färber F, Huebl L, Wieler LH, Ziese T, Heidemann C. Perceived Access to Health Care Services and Relevance of Telemedicine during the COVID-19 Pandemic in Germany. Int J Environ Res Public Health 2021; 18:7661. [PMID: 34300110 PMCID: PMC8303178 DOI: 10.3390/ijerph18147661] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 12/23/2022]
Abstract
During the COVID-19 pandemic in Germany, non-pharmaceutical interventions were imposed to contain the spread of the virus. Based on cross-sectional waves in March, July and December 2020 of the COVID-19 Snapshot Monitoring (COSMO), the present study investigated the impact of the introduced measures on the perceived access to health care. Additionally, for the wave in December, treatment occasion as well as utilization and satisfaction regarding telemedicine were analysed. For 18-74-year-old participants requiring medical care, descriptive and logistic regression analyses were performed. During the less strict second lockdown in December, participants reported more frequently ensured access to health care (91.2%) compared to the first lockdown in March (86.8%), but less frequently compared to July (94.2%) during a period with only mild restrictions. In December, main treatment occasions of required medical appointments were check-up visits at the general practitioner (55.2%) and dentist (36.2%), followed by acute treatments at the general practitioner (25.6%) and dentist (19.0%), treatments at the physio-, ergo- or speech therapist (13.1%), psychotherapist (11.9%), and scheduled hospital admissions or surgeries (10.0%). Of the participants, 20.0% indicated utilization of telemedical (15.4% telephone, 7.6% video) consultations. Of them, 43.7% were satisfied with the service. In conclusion, for the majority of participants, access to medical care was ensured during the COVID-19 pandemic; however, access slightly decreased during phases of lockdown. Telemedicine complemented the access to medical appointments.
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Affiliation(s)
- Lukas Reitzle
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, Germany; (C.S.); (F.F.); (T.Z.); (C.H.)
| | - Christian Schmidt
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, Germany; (C.S.); (F.F.); (T.Z.); (C.H.)
| | - Francesca Färber
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, Germany; (C.S.); (F.F.); (T.Z.); (C.H.)
| | - Lena Huebl
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine, University Medical Center Hamburg-Eppendorf, 20359 Hamburg, Germany;
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | | | - Thomas Ziese
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, Germany; (C.S.); (F.F.); (T.Z.); (C.H.)
| | - Christin Heidemann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, Germany; (C.S.); (F.F.); (T.Z.); (C.H.)
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Demirtaş-Madran HA. Accepting Restrictions and Compliance With Recommended Preventive Behaviors for COVID-19: A Discussion Based on the Key Approaches and Current Research on Fear Appeals. Front Psychol 2021; 12:558437. [PMID: 34163389 PMCID: PMC8215168 DOI: 10.3389/fpsyg.2021.558437] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 05/10/2021] [Indexed: 12/15/2022] Open
Abstract
COVID-19 (Coronavirus disease 2019) is a novel coronavirus which was first detected in late December 2019 in the Wuhan Province of China. This novel coronavirus, caused by a zoonotic beta-coronavirus (SARS-CoV-), is described as highly infectious. The World Health Organization (WHO) named the novel coronavirus as COVID-19 on February 11, 2020, and declared it as a "pandemic." Almost all countries have undertaken wide-scale precautions so as to prevent or limit the spread of the virus, with most having practiced some form of "lockdown" along with "social distancing," as well as dispensed recommendations for proper hand washing, avoiding touching the face, wearing facemasks, and using disposable tissues when either coughing or sneezing. Whereas it is well known that slowing the spread of this new epidemic requires the cooperation of all citizens, some people still seem to willfully disregard the rules and guidelines, and thereby ignore the health risks posed to both themselves and to others they come into contact with. People have responded differently to lockdown rules and social distancing practices. Whilst the majority follow the rules and recommendations with great care, others are more lax or simply refuse to comply. These differences might be accounted for according to a number of factors including personal, social, cultural, mental, and economic variables. Being persuaded to comply with preventive rules, especially those concerned with health-related behaviors, also bring certain other factors into play. Fear is one of those factors, and is one of the most powerful. It is well known that fear-based appeals can be effective in inculcating health behaviors, with many theories having been developed in this area. However, both the content of the message (the level of the fear it contains) and certain personal variables can determine the persuasive power of the fear appeal. It can even have an adverse effect if not properly applied. Many theories have been developed to address the persuasive effectiveness of the fear appeal (e.g., fear-drive theory, protection-motivation theory), and this study aims to discuss these individual differences in precautionary and preventive measures for the COVID-19 pandemic within the framework of the basic assumptions of these theoretical approaches.
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Probst T, Haid B, Schimböck W, Stippl P, Humer E. Psychotherapie auf Distanz in Österreich während COVID‑19. Zusammenfassung der bisher publizierten Ergebnisse von drei Onlinebefragungen. Psychotherapie Forum 2021; 25:30-36. [DOI: 10.1007/s00729-021-00168-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Die Donau-Universität Krems untersuchte in Kooperation mit dem Österreichischen Bundesverband für Psychotherapie mit drei Onlinebefragungen Psychotherapie auf Distanz in Österreich während der COVID-19-Pandemie. Dieser Artikel fasst die bisherigen bereits publizierten Ergebnisse dieser Befragungen zusammen. An der ersten Onlinebefragung, welche in den ersten Wochen des ersten coronabedingten Lockdowns in Österreich stattfand, beteiligten sich insgesamt 1547 Psychotherapeut*innen. Die Ergebnisse zeigen, dass Psychotherapeut*innen während des Lockdowns Psychotherapie im persönlichen Kontakt verstärkt durch Psychotherapie auf Distanz (Telefon oder Internet) ersetzten. Ein erhöhtes Stresserleben sowie jobbezogene Ängste waren v. a. bei Psychotherapeut*innen vorhanden, bei denen Psychotherapie die einzige Einnahmequelle darstellte. Die Erfahrungen mit Psychotherapie auf Distanz wurden als insgesamt positiver beschrieben als sie erwartet wurden. Nichtsdestotrotz wurde Psychotherapie auf Distanz als nicht vollständig vergleichbar mit Psychotherapie im persönlichen Kontakt angesehen. An einer zweiten Onlinebefragung nach dem ersten Lockdown (Sommer 2020) beteiligten sich 222 Psychotherapeut*innen aus Österreich. Ziel dieser Befragung war es den Wechsel des Behandlungsformats (persönlich zu digital oder digital zu persönlich) im Hinblick auf die Anwendung spezifischer therapeutischer Interventionen genauer zu untersuchen. Unter digital wurden verschiede Medien wie z. B. Sprachtelefonie, Videokonferenz, Chats und E‑Mail subsumiert. Zeitgleich mit der zweiten Befragung wurde eine dritte Onlinebefragung durchgeführt, an der 139 Patient*innen der 222 österreichischen Psychotherapeut*innen teilnahmen, um auch die Patient*innen-Perspektive beim Wechsel des Behandlungsformats zu untersuchen. Erste Ergebnisse zeigen, dass Psychotherapeut*innen und Patient*innen beim Wechsel des Behandlungsformats einen Unterschied hinsichtlich der angewandten therapeutischen Interventionen erlebten. So wurden die untersuchten therapeutischen Interventionen als typischer für die Therapie im direkten persönlichen Kontakt als für die Psychotherapie auf Distanz bewertet. Zudem veränderte sich die subjektive Bedeutung verschiedener Bereiche des Lebens während der Corona-Pandemie. Die bisherigen Auswertungen zeigen, dass die COVID-19 Pandemie einen deutlichen Impact auf die Psychotherapiepraxis in Österreich hat. Weitere quantitative und qualitative Auswertungen der Daten werden noch tiefergehende Erkenntnisse liefern.
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Stricker J, Lukies R. [Digital Options for Treating Mental Disorders during the COVID-19 Pandemic]. Fortschr Neurol Psychiatr 2021; 89:308-313. [PMID: 33951739 DOI: 10.1055/a-1486-7019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The COVID-19 pandemic and its consequences, such as contact restrictions, pose new challenges to psychiatric-psychotherapeutic care in many parts of the world. This article provides an overview of digital methods for treating mental disorders under pandemic conditions and for reducing pandemic-related psychological distress (e.g., due to social isolation). Current challenges and limitations in the use of digital treatment options and their long-term perspectives in psychiatric-psychotherapeutic care are discussed.
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Strauß B, Rosendahl J, Berger U. [Importance of the COVID-19 pandemic for public health and group psychological aspects-Part 2 of a (preliminary) review]. Psychotherapeut (Berl) 2021; 66:186-194. [PMID: 33776213 PMCID: PMC7988379 DOI: 10.1007/s00278-021-00505-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/21/2021] [Indexed: 12/22/2022]
Abstract
Based upon the findings related to the impact of the coronavirus disease 2019 (COVID-19) pandemic on human living conditions and psychological health, in the first part of this review the authors discuss the consequences of the pandemic for public health. It is surprising to see that related to public health but also psychological factors and sequelae of the pandemic, a broad knowledge was already available based upon former pandemics and disasters long before the outbreak of COVID-19. This knowledge has been used very sparsely, if at all, for health political decisions. In view of the social significance of the pandemic and its social impact, findings from group psychology and group dynamics seem to be specifically important for a better understanding of behavior within the population as well as the conceptualization of public health interventions. An increase in psychological disorders was described related to the pandemic. For the treatment of these disorders, a range of psychotherapeutic approaches including evidence-based group psychotherapy are available. Whereas the use of telemedical and digital techniques is increasingly more common within individual psychotherapy, many questions are still open related to online group treatment.
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Affiliation(s)
- Bernhard Strauß
- Institut für Psychosoziale Medizin, Psychotherapie und Psychoonkologie, Universitätsklinikum Jena, Stoystr. 3, 07740 Jena, Deutschland
| | - Jenny Rosendahl
- Institut für Psychosoziale Medizin, Psychotherapie und Psychoonkologie, Universitätsklinikum Jena, Stoystr. 3, 07740 Jena, Deutschland
| | - Uwe Berger
- Institut für Psychosoziale Medizin, Psychotherapie und Psychoonkologie, Universitätsklinikum Jena, Stoystr. 3, 07740 Jena, Deutschland
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Shklarski L, Abrams A, Bakst E. Will We Ever Again Conduct in-Person Psychotherapy Sessions? Factors Associated with the Decision to Provide in-Person Therapy in the Age of COVID-19. J Contemp Psychother 2021;:1-8. [PMID: 33746247 DOI: 10.1007/s10879-021-09492-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2021] [Indexed: 11/29/2022]
Abstract
The COVID-19 pandemic has forced a new reality on the delivery of psychotherapeutic services. Therapists have had to rapidly adapt to telehealth therapy using various video conferencing technologies while working from spaces that were not necessarily designed for delivering therapy sessions. While COVID-19 continues to be present in therapists’ lives and shapes how they provide services, answering the question of whether to meet with clients in person again is a decision laden with complexity and ambivalence. In this mixed-method study, surveys with 169 therapists and interviews with 17 therapists were used to determine the factors that currently influence their attitudes toward resuming traditional in-person psychotherapy in light of COVID-19. We focused on the therapists’ personal and professional characteristics to assess their plans to continue with telepsychotherapy or return to a traditional psychotherapy setting. Our findings suggest that positive attitudes toward telepsychotherapy, the lack of an effective vaccine, clients’ satisfaction with telepsychotherapy, insurance reimbursement for telepsychotherapy, and negative attitudes toward wearing masks during sessions influenced therapists’ decisions on whether or not to return to traditional in-person psychotherapy in the age of COVID-19.
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Fernández-Álvarez J, Fernández-Álvarez H. Videoconferencing Psychotherapy During the Pandemic: Exceptional Times With Enduring Effects? Front Psychol 2021; 12:589536. [PMID: 33679513 PMCID: PMC7933024 DOI: 10.3389/fpsyg.2021.589536] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 01/12/2021] [Indexed: 12/16/2022] Open
Abstract
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.
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Affiliation(s)
- Javier Fernández-Álvarez
- Department of Basic Psychology, Clinical and Psychobiology, Jaume I University, Castellón de la Plana, Spain
- Asociación Aiglé, Valencia, Spain
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Beck EJ, Mandalia S, Yfantopoulos P, Jones CI, Bremner S, Whetham J, Etcheverry F, Moreno L, Gonzalez E, Merino MJ, Leon A, Garcia F. Efficiency of the EmERGE Pathway to provide continuity of care for Spanish people living with medically stable HIV. Enferm Infecc Microbiol Clin 2021; 40:S0213-005X(20)30422-5. [PMID: 33549335 DOI: 10.1016/j.eimc.2020.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/13/2020] [Accepted: 11/23/2020] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Calculate the efficiency of the EmERGE Pathway of Care for medically stable people living with HIV at the Hospital Clínic-IDIBAPS, Barcelona, Spain. METHODS 546 study participants were followed between 1st July 2016 and 30th October 2019 across three HIV outpatient clinics, but the virtual clinic was closed during the second year. Unit costs were calculated, linked to mean use outpatient services per patient year, one-year before and after the implementation of EmERGE. Costs were combined with primary and secondary outcomes. RESULTS Annual costs across HIV-outpatient services increased by 8%: €1073 (95%CI €999-€1157) to €1158 (95%CI €1084-€1238). Annual cost of ARVs was €7,557; total annual costs increased by 1% from €8430 (95%CI €8356-8514) to €8515 (95%CI €8441-8595). Annual cost for 433 participants managed in face-to-face (F2F) clinics decreased by 5% from €958 (95%CI 905-1018) to €904 (95%CI 863-945); participants transferred from virtual to F2F outpatient clinics (V2F) increased their annual cost by a factor of 2.2, from €115 (95%CI 94-139) to €251 (95%CI 219-290). No substantive changes were observed in primary and secondary outcomes. CONCLUSION EmERGE Pathway is an efficient and acceptable intervention. Increases in costs were caused by internal structural changes. The cost reduction observed in F2F clinics were off-set by the transfer of participants from the virtual to the F2F clinics due to the closure of the virtual clinic during the second year of the Study. Greater efficiencies are likely to be achieved by extending the use of the Pathway to other PLHIV.
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Affiliation(s)
- E J Beck
- NPMS-HHC CIC, London, UK; Department of Health Services Research and Policy, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, UK.
| | | | | | - C I Jones
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, UK
| | - S Bremner
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, UK
| | - J Whetham
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - F Etcheverry
- Fundació Clínic per a la Recerca Biomèdica, University of Barcelona, Barcelona, Spain
| | - L Moreno
- Fundació Clínic per a la Recerca Biomèdica, University of Barcelona, Barcelona, Spain
| | - E Gonzalez
- Fundació Clínic per a la Recerca Biomèdica, University of Barcelona, Barcelona, Spain
| | - M J Merino
- Fundació Clínic per a la Recerca Biomèdica, University of Barcelona, Barcelona, Spain
| | - A Leon
- Fundació Clínic per a la Recerca Biomèdica, University of Barcelona, Barcelona, Spain
| | - F Garcia
- Fundació Clínic per a la Recerca Biomèdica, University of Barcelona, Barcelona, Spain
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Probst T, Haid B, Schimböck W, Reisinger A, Gasser M, Eichberger-Heckmann H, Stippl P, Jesser A, Humer E, Korecka N, Pieh C. Therapeutic interventions in in-person and remote psychotherapy: Survey with psychotherapists and patients experiencing in-person and remote psychotherapy during COVID-19. Clin Psychol Psychother 2021; 28:988-1000. [PMID: 33448499 PMCID: PMC8013388 DOI: 10.1002/cpp.2553] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 01/04/2021] [Indexed: 02/06/2023]
Abstract
Objective First, to investigate how psychotherapists and patients experience the change from in‐person to remote psychotherapy or vice versa during COVID‐19 regarding the therapeutic interventions used. Second, to explore the influence of therapeutic orientations on therapeutic interventions in in‐person versus remote psychotherapy. Method Psychotherapists (N = 217) from Austria were recruited, who in turn recruited their patients (N = 133). The therapeutic orientation of the therapists was psychodynamic (22.6%), humanistic (46.1%), systemic (20.7%) or behavioural (10.6%). All the data were collected remotely via online surveys. Therapists and patients completed two versions of the ‘Multitheoretical List of Therapeutic Interventions’ (MULTI‐30) (version 1: in‐person; version 2: remote) to investigate differences between in‐person and remote psychotherapy in the following therapeutic interventions: psychodynamic, common factors, person‐centred, process‐experiential, interpersonal, cognitive, behavioural and dialectical‐behavioural. Results Therapists rated all examined therapeutic interventions as more typical for in‐person than for remote psychotherapy. For patients, three therapeutic interventions (psychodynamic, process‐experiential, cognitive interventions) were more typical for in‐person than for remote psychotherapy after correcting for multiple testing. For two therapeutic interventions (behavioural, dialectical‐behavioural), differences between the four therapeutic orientations were more consistent for in‐person than for remote psychotherapy. Conclusions Therapeutic interventions differed between in‐person and remote psychotherapy and differences between therapeutic orientations in behavioural‐oriented interventions become indistinct in remote psychotherapy.
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Affiliation(s)
- Thomas Probst
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems an der Donau, Austria
| | - Barbara Haid
- Austrian Federal Association for Psychotherapy, Vienna, Austria
| | | | | | - Marion Gasser
- Austrian Federal Association for Psychotherapy, Vienna, Austria
| | | | - Peter Stippl
- Austrian Federal Association for Psychotherapy, Vienna, Austria
| | - Andrea Jesser
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems an der Donau, Austria
| | - Elke Humer
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems an der Donau, Austria
| | - Nicole Korecka
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems an der Donau, Austria
| | - Christoph Pieh
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems an der Donau, Austria
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Abstract
BACKGROUND The prevalence of mental illnesses in the population has enormously increased during the corona pandemic due to the accompanying burdens and distress. Therefore, it is important to continue with the provision of psychotherapeutic treatment even in times of social distancing. As a result, psychotherapists were soon confronted with the need to expand their traditional treatment setting and offer remote treatment. OBJECTIVE Which digital treatment options are available to psychotherapists since the pandemic, also with respect to the legal regulations? To what extent and how did they use video-based or telephone-based psychotherapy? What is the current stage of research regarding the effectiveness of video(telephony)? How can therapeutic alliance be built into video(telephony) settings? How can psychotherapists successfully apply their personal therapeutic method to different patient groups (children, adolescents, adults) in the new digital setting? METHODS These questions are answered based on a literature search and clinical considerations. RESULTS The majority of psychotherapists have immediately adapted to remote treatment. This has been supported by the government by expanding existing regulations in order to continue treatment with current and new patients without physical contact during the pandemic crisis. Survey studies have shown that psychotherapists consider the effectiveness of digital treatment settings to be lower than the traditional setting. CONCLUSION Further training is necessary to educate psychotherapists in the theory, practice and self-awareness for quality assurance in the video(telephony) setting.
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Affiliation(s)
- Christiane Eichenberg
- Institut für Psychosomatik, Fakultät für Medizin, Sigmund Freud PrivatUniversität Wien, Freudplatz 3, 1020 Wien, Österreich
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Brusadelli E, Ferrari L, Benetti M, Bruzzese S, Tonelli GM, Gullo S. Online Supportive Group as social intervention to face COVID lockdown. A qualitative study on psychotherapists, psychology trainees and students, and community people. Res Psychother 2020; 23:501. [PMID: 33585302 PMCID: PMC7875067 DOI: 10.4081/ripppo.2020.501] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 12/01/2020] [Indexed: 11/23/2022]
Abstract
Several psychological interventions have been activated to help people during the coronavirus pandemic, and research highlights the crucial role of group interventions as a space for sharing and processing the psychological experiences linked to this emergency and the consequent changes in people's lifestyles. In this context, psychologists are mostly providers of this kind of service more than users. This study aimed at investigating and comparing post-hoc the subjective experience of psychotherapists, psychology trainees & students, and individuals of the general population who participated in a psychodynamically-oriented supportive group intervention. Fifty-two subjects were enrolled to participate to focus groups aimed at exploring participants' decision to participate, their perceptions on how the support group influenced their elaboration of the psychological effects of pandemic/lockdown, and their feedback on its utility. Transcripts of the focus groups were analyzed with the Linguistic Inquiry Word Count (LIWC). Differences in the use of words/linguistic categories between groups were tested through chi-square tests. Content analysis was conducted by independent judges who extracted the most relevant comments. Preliminary results showed the main features related to the crisis response, and how belonging to different social roles was associated with different ways of experiencing and sharing emotions. People react in different ways to traumatic events, and how people react may say a lot about how they cope with the event and the extent to which the event plays a role in the future. Clinical implications on the use of this data for future treatment planning are also discussed.
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Affiliation(s)
- Emanuela Brusadelli
- School of Psychology, Faculty of Arts, Social Sciences & Humanities, University of Wollongong, Australia
| | - Laura Ferrari
- C.O.I.R.A.G., Scuola Coirag Sede di Milano
- Ariele Psicoterapia, Italy
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Humer E, Schimböck W, Kisler IM, Schadenhofer P, Pieh C, Probst T. How the COVID-19 Pandemic Changes the Subjective Perception of Meaning Related to Different Areas of Life in Austrian Psychotherapists and Patients. Int J Environ Res Public Health 2020; 17:E8600. [PMID: 33228105 PMCID: PMC7699404 DOI: 10.3390/ijerph17228600] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 11/09/2020] [Accepted: 11/16/2020] [Indexed: 01/26/2023]
Abstract
We assessed psychotherapists' and patients' ratings of their subjective perception of meaning related to different areas of life before the COVID-19 pandemic as compared to the time during the COVID-19 pandemic. In a quantitative cross-sectional study, Austrian psychotherapists (N = 222) were recruited by e-mail, who in turn recruited their patients (N = 139). Therapists and patients were asked to rate the meaning of different areas of life before as well as during the COVID-19 crisis. The psychotherapists showed an overall higher rating of the importance of areas of life compared to their patients (p < 0.001). The rating of the importance of the domains of living was differently affected by the COVID-19 situation (p < 0.001). While the meaning of physical and mental health during COVID-19 was rated higher than before, the opposite was observed for work (p < 0.001). No differences were found for relationships and friends, as well as for hobbies. As no interactions between perspective (therapists vs. patients), area of life, and time point (before vs. during COVID-19) were observed, it can be concluded that the COVID-19 situation changed the subjective attribution of meaning concerning different aspects of life similarly in therapists as well as patients. While mental and physical health gained subjective importance, the opposite was observed for work.
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Affiliation(s)
- Elke Humer
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (E.H.); (C.P.)
| | - Wolfgang Schimböck
- ABILE-Viktor Frankl Education Austria, 3390 Melk, Austria; (W.S.); (I.-M.K.); (P.S.)
| | - Ida-Maria Kisler
- ABILE-Viktor Frankl Education Austria, 3390 Melk, Austria; (W.S.); (I.-M.K.); (P.S.)
| | - Petra Schadenhofer
- ABILE-Viktor Frankl Education Austria, 3390 Melk, Austria; (W.S.); (I.-M.K.); (P.S.)
- Telephone Emergency Service—Lower Austria (TelefonSeelsorge NÖ), Diocese St. Pölten, 3100 St. Pölten, Austria
| | - Christoph Pieh
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (E.H.); (C.P.)
| | - Thomas Probst
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (E.H.); (C.P.)
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Humer E, Stippl P, Pieh C, Schimböck W, Probst T. Psychotherapy via the Internet: What Programs Do Psychotherapists Use, How Well-Informed Do They Feel, and What Are Their Wishes for Continuous Education? Int J Environ Res Public Health 2020; 17:E8182. [PMID: 33167478 PMCID: PMC7663907 DOI: 10.3390/ijerph17218182] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/01/2020] [Accepted: 11/04/2020] [Indexed: 11/16/2022]
Abstract
The outbreak of the COVID-19 pandemic has caused changes in the provision of psychotherapy around the world. The common format of delivering in-person psychotherapy is replaced by psychotherapy via the Internet to a great extent. This study examined how well Austrian psychotherapists feel informed about the use of the Internet in psychotherapy, where additional information needs exist, and which software is used. A link to an online survey was sent to all psychotherapists providing a valid email address in the official list of licensed psychotherapists at the start of the COVID-19 lockdown in Austria. A total of 1547 people took part in the survey. The results show that psychotherapy via the Internet was primarily offered via Skype and Zoom during the COVID-19 pandemic and that the majority of the therapists felt well-informed about psychotherapy via the Internet; however, several therapists stated that they wish to have further information on data protection and security. Overall, the study shows that Austrian psychotherapists coped well with the rapid change from the provision of psychotherapy through personal contact to psychotherapy via the Internet. Security and data protection aspects of therapy via the Internet should be addressed in training and further education of psychotherapists. As this study was conducted online, it might have caused some respondent bias towards a higher participation of psychotherapists with higher preference for new technologies.
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Affiliation(s)
- Elke Humer
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (E.H.); (C.P.)
| | - Peter Stippl
- Austrian Federal Association for Psychotherapy, 1030 Vienna, Austria; (P.S.); (W.S.)
| | - Christoph Pieh
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (E.H.); (C.P.)
| | - Wolfgang Schimböck
- Austrian Federal Association for Psychotherapy, 1030 Vienna, Austria; (P.S.); (W.S.)
- Viktor Frankl Education Austria (ABILE), 3390 Melk, Austria
| | - Thomas Probst
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (E.H.); (C.P.)
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Korecka N, Rabenstein R, Pieh C, Stippl P, Barke A, Doering B, Gossmann K, Humer E, Probst T. Psychotherapy by Telephone or Internet in Austria and Germany Which CBT Psychotherapists Rate It more Comparable to Face-to-Face Psychotherapy in Personal Contact and Have more Positive Actual Experiences Compared to Previous Expectations? Int J Environ Res Public Health 2020; 17:E7756. [PMID: 33114136 PMCID: PMC7660328 DOI: 10.3390/ijerph17217756] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/19/2020] [Accepted: 10/22/2020] [Indexed: 12/18/2022]
Abstract
Objectives: COVID-19 has led to changes in the provision in mental health services. The current study investigated influencing factors on: (i) the comparability of psychotherapy via internet/telephone with psychotherapy in face-to-face contact as well as (ii) the actual experience with psychotherapy via internet/telephone compared to respective prior expectations in CBT therapists. Methods: A quantitative cross-sectional study was conducted in the form of an online survey. The research samples, registered cognitive-behavioral therapy (CBT) psychotherapists in Austria and Germany, were contacted by e-mail. Results: One hundred and ninety CBT therapists were analyzed in this study. The total number of patients treated via telephone/internet is a decisive factor for the subjective evaluation of the comparability of psychotherapy via telephone/internet and psychotherapy in personal contact. This factor also influences the extent (positive/negative) of the assessment of the actual experience with psychotherapy via internet/telephone compared to previous expectations. Neither age nor gender were associated with comparability of psychotherapy via internet/telephone with psychotherapy in face-to-face contact or the actual experience with psychotherapy via internet/telephone compared to respective prior expectations. Conclusions: Implications of the results are that attitudes towards remote psychotherapy might be increased in CBT therapists when they treat more patients remotely and experiences with remote psychotherapies should be included in psychotherapy training.
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Affiliation(s)
- Nicole Korecka
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (N.K.); (R.R.); (C.P.); (E.H.)
| | - Rafael Rabenstein
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (N.K.); (R.R.); (C.P.); (E.H.)
| | - Christoph Pieh
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (N.K.); (R.R.); (C.P.); (E.H.)
| | - Peter Stippl
- Austrian Federal Association for Psychotherapy, Löwengasse 3, 1030 Vienna, Austria;
| | - Antonia Barke
- Clinical and Biological Psychology, Catholic University of Eichstätt-Ingolstadt, Ostenstraße 26, 85072 Eichstätt, Germany; (A.B.); (B.D.); (K.G.)
| | - Bettina Doering
- Clinical and Biological Psychology, Catholic University of Eichstätt-Ingolstadt, Ostenstraße 26, 85072 Eichstätt, Germany; (A.B.); (B.D.); (K.G.)
| | - Katharina Gossmann
- Clinical and Biological Psychology, Catholic University of Eichstätt-Ingolstadt, Ostenstraße 26, 85072 Eichstätt, Germany; (A.B.); (B.D.); (K.G.)
| | - Elke Humer
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (N.K.); (R.R.); (C.P.); (E.H.)
| | - Thomas Probst
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (N.K.); (R.R.); (C.P.); (E.H.)
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Boldrini T, Schiano Lomoriello A, Del Corno F, Lingiardi V, Salcuni S. Psychotherapy During COVID-19: How the Clinical Practice of Italian Psychotherapists Changed During the Pandemic. Front Psychol 2020; 11:591170. [PMID: 33192932 PMCID: PMC7641613 DOI: 10.3389/fpsyg.2020.591170] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 09/16/2020] [Indexed: 12/17/2022] Open
Abstract
Aims: Italy was one of the first countries to be significantly affected by the coronavirus disease 2019 (COVID-19) pandemic, determining a unique scenario for Italian psychotherapists to consider changing the modality in which they deliver treatment. The present study aimed at studying which factors related to psychotherapists and their clinical practice had a major role in predicting two main outcomes: (1) the rate of interrupted treatments during lockdown and (2) psychotherapists' satisfaction with the telepsychotherapy modality. Methods: An online survey was administered to licensed psychotherapists (n = 306), who worked mainly as private practitioners, between April 5 and May 10, 2020 (i.e., the peak of the pandemic in Italy). Results: Psychotherapists reported that 42.1% (SD = 28.9) of their treatments had been interrupted, suggesting that Italy faced an important undersupply of psychotherapy during the lockdown. Using the Akaike information criterion (AIC) model selection, we identified three predictors of the rate of interrupted treatments: (1) psychotherapists' lack of experience with telepsychotherapy prior to the lockdown, (2) their theoretical orientation (with cognitive behavioral psychotherapists reporting a higher rate of interrupted treatments), and (3) patients' lack of privacy at home, as reported to the psychotherapists. Furthermore, we found four predictors of psychotherapists' satisfaction with the telepsychotherapy modality: (1) the rate of interrupted treatments, (2) psychotherapists' previous experience with telepsychotherapy, (3) their beliefs about the compatibility of telepsychotherapy with their theoretical orientation, and (4) their use of a video-conferencing modality, rather than telephone. Conclusion: The following recommendations can help policy makers, professional associations, and practitioners in promoting the continuity of psychotherapy treatments during the COVID-19 outbreak and in future emergencies: (i) disseminating training programs for practitioners on telepsychotherapy, (ii) supporting patients to pragmatically access a private space at home, (iii) encouraging practitioners to use video-conferencing (instead of telephone) to deliver remote therapy, and (iv) increasing the acceptance of telepsychotherapy among both clinicians and the general public.
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Affiliation(s)
- Tommaso Boldrini
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
| | - Arianna Schiano Lomoriello
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
- Department of Cognitive System, Denmark Technical University (DTU), Copenhagen, Denmark
| | - Franco Del Corno
- Association for Research in Clinical Psychology (ARP), Milan, Italy
| | - Vittorio Lingiardi
- Department of Dynamic and Clinic Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Silvia Salcuni
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
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Probst T, Humer E, Stippl P, Pieh C. Being a Psychotherapist in Times of the Novel Coronavirus Disease: Stress-Level, Job Anxiety, and Fear of Coronavirus Disease Infection in More Than 1,500 Psychotherapists in Austria. Front Psychol 2020; 11:559100. [PMID: 33132965 PMCID: PMC7550677 DOI: 10.3389/fpsyg.2020.559100] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/04/2020] [Indexed: 01/09/2023] Open
Abstract
This study investigated stress-level, degree of job-related anxiety, and fear of coronavirus disease (COVID-19) infection in psychotherapists in the early weeks of the COVID-19 lockdown in Austria. One thousand five hundred and forty-seven psychotherapists participated in an online survey, assessing stress [Perceived Stress Scale-10 (PSS-10)], work-related worries and fears of existence [Job Anxiety Scale (JAS)], fear of COVID-19 infection during face-to-face psychotherapy, and adherence to five protective measures against COVID-19 infection during face-to-face psychotherapy. Stress-levels were higher than in a representative sample (p < 0.001). When psychotherapy was the sole income, stress-level (p = 0.020) and job anxiety (p < 0.001) were higher. Experiences with teletherapy, the psychotherapy format used during COVID-19, as well as reductions in number of patients treated during COVID-19, had no effect on stress-level or job anxiety. Psychotherapists still conducting face-to-face psychotherapy during COVID-19 reported less fear of infection compared to those conducting no face-to-face psychotherapy (p < 0.001), whereby the fear of infection was further reduced when they were more able to adhere to protective measures against COVID-19 (p < 0.01). Mental hygiene is important for psychotherapists to manage stress and job-related anxiety during COVID-19, especially in those whose income relies on psychotherapy.
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Affiliation(s)
- Thomas Probst
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems, Austria
| | - Elke Humer
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems, Austria
| | - Peter Stippl
- Austrian Federal Association for Psychotherapy, Vienna, Austria
| | - Christoph Pieh
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems, Austria
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