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Yokoyama S, Shikano A, Chiba H, Murakami T, Kawamorita T, Murayama T, Ito D, Ichikura K. Machine learning judged neutral facial expressions as key factors for a "good therapist" within the first five minutes: An experiment to simulate online video counselling. PEC INNOVATION 2024; 4:100302. [PMID: 38966314 PMCID: PMC11222811 DOI: 10.1016/j.pecinn.2024.100302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/15/2024] [Accepted: 06/04/2024] [Indexed: 07/06/2024]
Abstract
Objective Machine learning models were employed to discern patients' impressions from the therapists' facial expressions during a virtual online video counselling session. Methods Eight therapists simulated an online video counselling session for the same patient. The facial emotions of the therapists were extracted from the session videos; we then utilized a random forest model to determine the therapist's impression as perceived by the patients. Results The therapists' neutral facial expressions were important controlling factors for patients' impressions. A predictive model with three neutral facial features achieved an accuracy of 83% in identifying patients' impressions. Conclusions Neutral facial expressions may contribute to patient impressions in an online video counselling environment with spatiotemporal disconnection. Innovation Expression recognition techniques were applied innovatively to an online counselling setting where therapists' expressions are limited. Our findings have the potential to enhance psychiatric clinical practice using Information and Communication Technology.
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Affiliation(s)
- Satoshi Yokoyama
- Faculty of Humanities, Niigata University, 8050 Ikarashi 2-no-cho, Nishi-ku, Niigata, Niigata, 9502181, Japan
| | - Asuna Shikano
- Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 2520373, Japan
| | - Hiroki Chiba
- Department of Medical Education, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 2520374, Japan
| | - Takeshi Murakami
- Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 2520373, Japan
- Kitasato University School of Allied Health Sciences, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 2520373, Japan
| | - Takushi Kawamorita
- Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 2520373, Japan
- Kitasato University School of Allied Health Sciences, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 2520373, Japan
| | - Takayuki Murayama
- Kanazawa University Graduate School Human and Socio-Environmental Studies, Kakuma-machi, Kanazawa, Ishikawa 9201192, Japan
| | - Daisuke Ito
- Graduate School of Education, Hyogo University of Teacher Education, 1-5-7 Higashikawasaki, Kobe, Hyogo 6500044, Japan
| | - Kanako Ichikura
- Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 2520373, Japan
- Kitasato University School of Allied Health Sciences, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 2520373, Japan
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Vila A, Romero‐Moreno R, Nogales‐Gonzalez C, Ritchey AJ, Ardoy‐Cuadros J. Sexual Interventions in the Metaverse: Attitudes Towards Novel Therapeutic Approaches, a Qualitative Study. Health Expect 2024; 27:e70004. [PMID: 39207250 PMCID: PMC11360517 DOI: 10.1111/hex.70004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 05/27/2024] [Accepted: 08/07/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Mental health treatment for psychosexual problems is effective, but treatment rates are low. Metaverse-based therapy offers one solution to increase overall treatment rates. Understanding attitudes towards this novel approach could lead to wider adoption of metaverse-based therapy, resulting in higher treatment rates for psychosexual problems. METHODS Twenty-one participants across three focus groups of different ages shared their perceptions and attitudes about metaverse-based therapy broadly and for treating sexual disorders. A content analysis of the transcribed text from the focus groups using qualitative data analysis software was conducted. RESULTS Participants identified several perceived benefits of metaverse-based intervention, including avoiding the perceived embarrassment of going to a clinic and accessing patients (a) with diverse physical or mental functionality, (b) living in remote areas and/or (c) balancing different family/work obligations or duties. The two main concerns with metaverse-based therapy were the fear of online therapy being less personal than traditional therapy and the technological fluency needed. Clarifying their acceptance of the therapy, participants reported that they would be more likely to engage in metaverse-based therapy if they trusted their therapist. Also, although it might be effective for mild and moderate disorders, participants were more reluctant about its use for severe mental illness. CONCLUSIONS Results suggest that attitudes towards metaverse-based intervention are mainly positive, since it removes some barriers that hinder access to psychological treatment in general and, specifically, for problems of a sexual nature. PATIENT AND PUBLIC CONTRIBUTION During the design stage, a person with sexual difficulties was consulted to understand the patient's perspective. Members of the public advised the implementation of the focus groups. Three potential service users were involved in the coding of the text during the content analysis.
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Affiliation(s)
- Ariana Vila
- Psychology Department, Faculty of Health SciencesRey Juan Carlos UniversityMadridSpain
| | - Rosa Romero‐Moreno
- Psychology Department, Faculty of Health SciencesRey Juan Carlos UniversityMadridSpain
| | | | - Andrew J. Ritchey
- Department of Sociology and CriminologyPennsylvania State UniversityUniversity ParkPennsylvaniaUSA
| | - Juan Ardoy‐Cuadros
- Psychology Department, Faculty of Health SciencesRey Juan Carlos UniversityMadridSpain
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Sablone S, Bellino M, Lagona V, Franco TP, Groicher M, Risola R, Violante MG, Grattagliano I. Telepsychology revolution in the mental health care delivery: a global overview of emerging clinical and legal issues. Forensic Sci Res 2024; 9:owae008. [PMID: 39229280 PMCID: PMC11369075 DOI: 10.1093/fsr/owae008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 10/16/2023] [Indexed: 09/05/2024] Open
Abstract
Since the outbreak of the COVID-19 pandemic, remote healthcare delivery by technological devices has become a growing practice. It represented an unprecedented change in personal and professional activities, allowing health specialists to continue working online by assisting their patients from home. Psychological practice greatly benefited from this innovation, guaranteeing diagnostic and therapeutic effectiveness through cyber counseling. However, in many countries there have been no enactments of specific laws nor adaptations of the professional deontological code aimed at regulating this new psychological practice dimension, generally defined as telepsychology. This article aims to briefly review the scientific literature on this tool's effectiveness and especially analyze the legal and operational framework in which telepsychology has been to date practiced in Italy and other national realities, thus providing a global overview that may be useful to understand how to improve this valuable but still immature practice. Key points The coronavirus pandemic exposed to short- and long-term increase in psychological and psychiatric imbalances.Cyber counseling has been proven to be effective to treat a wide range of psychological disorders.Many of the current national and international legislations concerning the telepsychology practice are still immature. Ad hoc legal frameworks are required for each national context to guarantee a safe and effective cyber counseling delivery.
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Affiliation(s)
- Sara Sablone
- Section of Legal Medicine, Department of Interdisciplinary Medicine, Bari Policlinico Hospital, University of Bari, Bari, Italy
| | - Mara Bellino
- Section of Legal Medicine, Department of Interdisciplinary Medicine, Bari Policlinico Hospital, University of Bari, Bari, Italy
| | - Valeria Lagona
- Section of Legal Medicine, Department of Interdisciplinary Medicine, Bari Policlinico Hospital, University of Bari, Bari, Italy
| | - Tamara Patrizia Franco
- Department of Educational Sciences, Psychology, and Communication, University of Bari, Bari, Italy
| | - Matthew Groicher
- Department of Educational Sciences, Psychology, and Communication, University of Bari, Bari, Italy
| | - Roberta Risola
- Department of Educational Sciences, Psychology, and Communication, University of Bari, Bari, Italy
| | - Maria Grazia Violante
- Department of Educational Sciences, Psychology, and Communication, University of Bari, Bari, Italy
| | - Ignazio Grattagliano
- Department of Educational Sciences, Psychology, and Communication, University of Bari, Bari, Italy
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Edelbluth S, Schwartz B, Lutz W. The Effects of Switching to Video Therapy on In-Session Processes in Psychotherapy During the COVID-19 Pandemic. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024; 51:428-438. [PMID: 38483750 PMCID: PMC11196328 DOI: 10.1007/s10488-024-01361-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2024] [Indexed: 06/25/2024]
Abstract
OBJECTIVE AND AIM This study aimed to assess the impact of switching from face-to-face (f2f) psychotherapy to video therapy (VT) due to the COVID-19 pandemic on in-session processes, i.e., the therapeutic alliance, coping skills, and emotional involvement, as rated by both patients and therapists. METHODS A total of N = 454 patients with mood or anxiety disorders were examined. The intervention group (IG) consisted of n = 227 patient-therapist dyads, who switched from f2f to VT, while the control group (CG) consisted of n = 227 patient-therapist dyads, who were treated f2f before the pandemic. To evaluate the effects of switching to VT on in-session processes, three longitudinal piecewise multilevel models, one per process variable, were fitted. Each process variable was regressed on the session number with a slope for the three sessions before switching to VT and a second slope for up to six VT sessions afterwards. RESULTS The therapeutic alliance significantly increased after switching from f2f to VT across the two groups (IG and CG) and raters (patients and therapists) with no differences between IG and CG. On average, patients rated the therapeutic alliance better than therapists. Coping skills significantly increased after switching from f2f to VT across the two groups and raters, but the CG rated coping skills higher than the IG after the switch. Overall, therapists rated coping skills higher than patients. Emotional involvement did not significantly increase after switching to VT across the two groups and raters and there was no significant difference between patient and therapist ratings. DISCUSSION In conclusion, the switch to VT had no negative impact on the therapeutic alliance and emotional involvement. However, more coping skills were reported in the CG than in the IG after the switch to VT, which was mainly due to a stagnation in patient-rated coping skills in the IG.
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Affiliation(s)
- Susanne Edelbluth
- Department of Clinical Psychology and Psychotherapy, University of Trier, 54286, Trier, Germany.
| | - Brian Schwartz
- Department of Clinical Psychology and Psychotherapy, University of Trier, 54286, Trier, Germany
| | - Wolfgang Lutz
- Department of Clinical Psychology and Psychotherapy, University of Trier, 54286, Trier, Germany
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Schoenenberg K, Martin A. Empathy, working alliance, treatment expectancy and credibility in video and face-to-face psychotherapeutic first contact. Psychother Res 2024; 34:626-637. [PMID: 37436800 DOI: 10.1080/10503307.2023.2233685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 07/01/2023] [Indexed: 07/13/2023] Open
Abstract
Objective Video-based therapy has been used increasingly since the onset of the COVID-19 pandemic. Yet, video-based initial psychotherapeutic contact can be problematic due to the limitations of computer-mediated communication. At present, little is known about the effects of video first contact on important psychotherapeutic processes. Method: Forty-three individuals (nvideo = 18, nface-to-face = 25) were recruited via an outpatient clinic waiting list and were randomly assigned to video or face-to-face initial psychotherapeutic sessions. Participants rated treatment expectancy before and after the session, and the therapist's empathy, working alliance, and credibility after the session and several days later. Results: Empathy and working alliance ratings of patients and therapists were high and did not differ between the two communication conditions after the appointment or at follow-up. Treatment expectancy increased to a similar extent for the video and face-to-face modalities from pre to post. Willingness to continue with video-based therapy increased in participants who had video contact, but not in those with face-to-face contact. Conclusion: This study indicates that crucial processes related to the therapeutic relationship can be initiated via video, without prior face-to-face contact. Given the limited nonverbal communication cues in video appointments, it remains unclear as to how such processes evolve.Trial registration: German Clinical Trials Register identifier: DRKS00031262..
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Affiliation(s)
- Katrin Schoenenberg
- Department for Clinical Psychology and Psychotherapy, University Wuppertal, Wuppertal, Germany
| | - Alexandra Martin
- Department for Clinical Psychology and Psychotherapy, University Wuppertal, Wuppertal, Germany
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Miguel-Álvaro A, Estupiñá Puig FJ, Larroy C. Provision of Telepsychological Care Via Email during COVID-19 Confinement: An Exploratory Study. THE SPANISH JOURNAL OF PSYCHOLOGY 2024; 27:e14. [PMID: 38766779 DOI: 10.1017/sjp.2024.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Within teletherapy, email interventions have been studied scarcely. For this reason, this exploratory study aims to characterize the assistance provided by email in a university telepsychology service and to compare the data with the assistance provided by telephone in the same service and period. For this purpose, the records of 81 users assisted via email during the COVID-19 pandemic lockdown in Spain were analyzed. The data were compared with those of the 338 users assisted by telephone in the same period. Despite its many limitations, results indicate high satisfaction with the email modality. Users express that they prefer a preference for using email when they do not feel safe in other ways. We found a lot of variation between the number of emails exchanged and the days that each case was active. Additionally, differences were found with telephone users in aspects such as age (email users being younger) and in a depression screening (email users scoring more positively). This study concludes on the high potential of this channel for the application of certain techniques (e.g., psychoeducation) or for people with certain characteristics.
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Cipolletta S, Tomaino SCM, Bouchard S, Berthiaume M, Manzoni GM. Validation of the Italian Version of the Telepresence in Videoconference Scale (TVS) in a Sample of Psychologists and Psychotherapists During the COVID-19 Pandemic. Clin Psychol Psychother 2024; 31:e3015. [PMID: 38850261 DOI: 10.1002/cpp.3015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 05/07/2024] [Accepted: 05/10/2024] [Indexed: 06/10/2024]
Abstract
OBJECTIVE Telepresence may play a fundamental role in establishing authentic interactions and relationships in online psychological interventions and can be measured by the Telepresence in Videoconference Scale (TVS), which was validated only with patients to date. This post hoc study aimed to validate the Italian version of the TVS with mental health professionals. METHOD The Italian TVS was included in an online survey, whose primary aim was to assess the experiences of Italian psychologists and psychotherapists with online interventions during the first wave of the COVID-19 pandemic and was filled in by 296 participants (83.4% females, mean age = 42 years old). RESULTS Exploratory factor analysis supported the original factor structure only partially because the scale 'Absorption' (i.e., the feeling of losing track of time), as it was formulated, did not measure telepresence. Correlations were also explored between the TVS scales and some survey items pertaining to intimacy and emotional closeness to patients, comfort and positive as well as negative experiences with online interventions. CONCLUSION The TVS may be a useful tool to measure physical and social telepresence in online interventions, both in patients and in professionals.
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Affiliation(s)
| | | | - Stéphane Bouchard
- Department of Psychoeducation and Psychology, Université of Quebec in Outaouais, Gatineau, Quebec, Canada
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
- Research Center of the Outaouais Integrated Health and Social Services Center, Gatineau, Quebec, Canada
| | | | - Gian Mauro Manzoni
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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Schiller B, Kuska M, Becher-Urbaniak S, Wimmer E, Reisinger M, Mörtl K. Online psychotherapy as a first clinical experience during the Covid-19 pandemic: A new generation of psychotherapists in the digital age. Heliyon 2024; 10:e29464. [PMID: 38638950 PMCID: PMC11024621 DOI: 10.1016/j.heliyon.2024.e29464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 03/30/2024] [Accepted: 04/08/2024] [Indexed: 04/20/2024] Open
Abstract
The temporary closure of the Outpatient Psychotherapy Clinic at the Sigmund Freud Private University in Vienna during the Covid-19 pandemic demanded an immediate and unexpected reaction to assure further psychotherapeutic services. Both psychotherapists and patients were forced into a rapid transition to online psychotherapy. While Covid-19 research has comprehensively described challenges of online psychotherapies, we were interested in learning specifically how early stage psychotherapists-in-training, who started their clinical work with patients exclusively in the online setting, experienced this unprecedented clinical situation. Sixteen in-depth interviews were conducted with psychotherapists in training. The data were analyzed using a thematic analysis. The analysis revealed how psychotherapists in training were able to cultivate a set of early-training resources and competencies in the online therapy setting without evidence-based guidelines from supervisors and the institution. This study highlighted the necessity of incorporating specific and novel educational input that is necessary for achieving specific online skills in the early training phase. Recognizing that the therapeutic landscape has undergone an irreversible transformation, the data suggest that distinct techniques are necessary to equip early-training psychotherapists for the now commonly practiced alternation between online setting and in-person setting in psychotherapeutic processes.
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Affiliation(s)
- Birgitta Schiller
- Institute for Qualitative Research, Sigmund Freud Private University Vienna, Austria
| | - Martin Kuska
- Faculty of Psychotherapy Science, Sigmund Freud Private University Vienna, Austria
| | - Stella Becher-Urbaniak
- Research Department University Outpatient Clinic for Adults, Sigmund Freud Private University Vienna, Austria
| | - Eva Wimmer
- Institute for Qualitative Research, Sigmund Freud Private University Vienna, Austria
| | - Manfred Reisinger
- Institute for Qualitative Research, Sigmund Freud Private University Vienna, Austria
| | - Kathrin Mörtl
- Institute for Qualitative Research, Sigmund Freud Private University Vienna, Austria
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Blair M, Tweedlie L, Minnis H, Cronin I, Turner F. Online therapy with families - what can families tell us about how to do this well? A qualitative study assessing families' experience of remote Dyadic Developmental Psychotherapy compared to face-to-face therapy. PLoS One 2024; 19:e0301640. [PMID: 38626223 PMCID: PMC11020366 DOI: 10.1371/journal.pone.0301640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 03/19/2024] [Indexed: 04/18/2024] Open
Abstract
Dyadic Developmental Psychotherapy (DDP) is a family-based therapy for adopted children aiming to achieve secure attachment between the child and parent. Due to restrictions under the COVID-19 pandemic, delivery of DDP transitioned from face-to-face to online methods. This study aimed to explore families experience of online DDP compared to face-to-face DDP, looking at the advantages and disadvantages of remote delivery methods and the implications this has on future service delivery for clinicians. Semi-structured interviews with 6 families were conducted online. Analysis of transcripts using Interpretative Phenomenological Analysis (IPA) revealed four superordinate themes: environment and child engagement, non-verbal communication, travel and familiarity with remote interactions. Parents recognised the influence the physical and online environment had on their child's engagement levels, however, varied in their experience and hence preference of delivery method. All families emphasised the importance of non-verbal communication within DDP sessions and majority highlighted this may be lost online. For families who travelled to face-to-face DDP, car journeys provided a unique opportunity to decompress and reflect after sessions. For families where travel is unfeasible, online DDP was a lifeline, demonstrating the ability of remote therapy to widen access to specialist healthcare. Familiarity with online work emerged as a strong indicator of positive attitudes towards remote DDP, especially if the previous experience is positive and the child is confident using technology. Overall, families differed greatly in their experience of remote and face-to-face DDP indicating a new approach must be undertaken with each family beginning therapy, ensuring it is unique and individual to their needs.
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Affiliation(s)
- Monica Blair
- College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Leigh Tweedlie
- College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Helen Minnis
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Irene Cronin
- Academic Child and Mental Health Services, University of Glasgow, Glasgow, United Kingdom
| | - Fiona Turner
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom
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Finley BA, Shea KD, Gallagher SP, Taylor-Piliae R. Psychiatric mental health nurse practitioners experiencing therapeutic alliance while using tele-mental health: A phenomenological study. Arch Psychiatr Nurs 2024; 49:56-66. [PMID: 38734456 DOI: 10.1016/j.apnu.2024.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/08/2023] [Accepted: 01/28/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Psychiatric mental health nurse practitioners have rapidly adopted and implemented tele-mental health in their practice; however it is unclear how this modality of care affects the experiential quality of therapeutic alliance, simply defined as the interpersonal working bond between provider and patient. OBJECTIVE This study is the first to explore how psychiatric mental health nurse practitioners experience therapeutic alliance while using tele-mental health. DESIGN Husserlian phenomenological qualitative study. PARTICIPANTS A purposive, convenience sample of 17 American psychiatric mental health nurse practitioners who engaged in tele-mental health care were recruited online and interviewed. METHODS Phenomenological interview transcripts recorded and later thematically coded in the qualitative software MaxQDA. RESULTS From 1426 individual codes, five major themes and 16 subthemes were discovered. Overall, themes illuminated that psychiatric mental health nurse practitioners could build therapeutic alliance over tele-mental health using inherent interpersonal skills that had to be adapted to the technology. Adaptions included working with patient environmental factors, individual patient considerations, provider ambivalence, and technological observation shifting awareness and communication patterns. CONCLUSIONS When adapting for the tele-mental health environment, psychiatric mental health nurse practitioners experienced building and sustaining therapeutic alliance with most patients. Unparalleled aspects of tele-mental health allowed for a fuller clinical picture and logistical convenience to see patients more often with ease for both the provider and patient. However, experiential aspects of therapeutic alliance created during in-person care could not be replaced with tele-mental health. In conclusion, participants concluded that a hybrid care model would enhance therapeutic alliance for most patients.
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Affiliation(s)
- Brooke A Finley
- Owner & Provider, Finley Psychiatric Nurse Practitioner, PLLC, Canandaigua, NY, USA.
| | - Kimberly D Shea
- The University of Arizona College of Nursing, Tucson, AZ, USA
| | - Shawn P Gallagher
- The University of Arizona College of Nursing, Tucson, AZ, USA; International Society of Psychiatric-Mental Health Nurses (ISPN), USA
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AshaRani PV, Tan YWB, Samari E, Wang P, Cetty L, Satghare P, Verma SK, Tang C, Subramaniam M. The relationship between therapeutic alliance, frequency of consultation and uptake of telemedicine among patients seeking treatment for early psychosis: A moderated mediation model. Digit Health 2024; 10:20552076241247194. [PMID: 38698830 PMCID: PMC11064748 DOI: 10.1177/20552076241247194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2024] [Indexed: 05/05/2024] Open
Abstract
Background Telehealth services ensure the delivery of healthcare services to a wider range of consumers through online platforms. Nonetheless, the acceptance and uptake of telehealth remain elusive. This study aims to understand the (a) uptake and (b) acceptability of telemedicine, (c) if therapeutic alliance mediates the relationship between the frequency of consultations with clinicians and the uptake of telemedicine in patients with early psychosis, and (d) role of education in moderating the relationship between therapeutic alliance and the uptake of telemedicine for their mental healthcare. Methods A convenience sample of outpatients (n = 109) seeking treatment for early psychosis and their care providers (n = 106) were recruited from a tertiary psychiatric care centre. Sociodemographic and clinical characteristics, therapeutic alliance (Working Alliance Inventory), and telemedicine use were captured through self-administered surveys. The moderated mediation analysis was performed using PROCESS macro 3.4.1 with therapeutic alliance and level of education as the mediating and moderating factors, respectively. Results The acceptance of telemedicine was high (possibly will use: 47.7%; definitely will use: 26.6%) whilst the uptake was low (11%). Therapeutic alliance mediated the relationship between the frequency of consultation and the uptake of telemedicine (β: 0.326; CI: 0.042, 0.637). This effect was moderated by the level of education (β: -0.058; p < 0.05). Conclusion Therapeutic alliance mediates the relationship between the frequency of consultations and the uptake of telemedicine services with the level of education moderating this mediation. Focusing on the patients with lower education to improve their telemedicine knowledge and therapeutic alliance might increase the uptake.
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Affiliation(s)
- PV AshaRani
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Ellaisha Samari
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Peizhi Wang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Laxman Cetty
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Pratika Satghare
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Swapna K Verma
- Department of Psychosis, Duke-NUS Medical School, Singapore, Singapore
- Early Psychosis Intervention Programme, Department of Psychosis, Institute of Mental Health, Singapore, Singapore
| | - Charmaine Tang
- Early Psychosis Intervention Programme, Department of Psychosis, Institute of Mental Health, Singapore, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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Özgen MH, Vos CMD, Yağmur Ö, Sevelius J. Online Group Psychotherapy to Increase Self-acceptance and Reduce Shame Among Transgender Migrants: An Observational Report. TURK PSIKIYATRI DERGISI = TURKISH JOURNAL OF PSYCHIATRY 2024; 35:8-13. [PMID: 38556932 PMCID: PMC11003373 DOI: 10.5080/u27170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 06/19/2023] [Indexed: 04/02/2024]
Abstract
OBJECTIVE Transgender and gender diverse (TGD) people experience higher levels of stigma, discrimination, and interpersonal violence due to their gender identity and/or expression, particularly TGD people with a migration background. This study aimed to conduct and evaluate group psychotherapy for TGD migrants to provide opportunities for exploring and developing interpersonal skills and relationships. METHOD The group therapy included five individuals who identified as TGD and originated from the Middle East. The TGD group therapy consisted of 12 weekly sessions of 90 minutes each and was facilitated by a psychiatrist. All sessions were conducted online and in Turkish. The sessions were guided by the group process and discussions. RESULTS After completing 12 group therapy sessions, members of the group reported benefiting from observing and emulating others who shared their problem constellation. Through the interpersonal skills that they built up throughout the sessions, they became more open to share their feelings experiencing fewer social barriers, and reduced anxiety. CONCLUSION This observational study indicates the significance of offering group-based psychotherapy to enhance affirmation and social connection within gender minority groups and emphasizes the need to empirically evaluate the effectiveness of group psychotherapy with TGD individuals, with special attention to the unique needs of TGD migrants.
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Affiliation(s)
- Mihriban Heval Özgen
- Psychiatrist, Intercultural Psychiatry, Parnassia Academy, Den Haag, Netherlands
| | | | - Özgün Yağmur
- Psychiatrist, Brown University, Department of Psychiatry, Boston, USA
| | - Jae Sevelius
- Prof., Department of Clinical Psychology, UCSF, San Francisco, USA
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Schuster L, Führes H, Wandke S, Thomas M, Scholl I. Psycho-oncologists' experiences with video consultations during the Covid-19 pandemic and implications for the future-a multi-methods study. Psychooncology 2024; 33:e6257. [PMID: 38078678 DOI: 10.1002/pon.6257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 11/09/2023] [Accepted: 11/11/2023] [Indexed: 01/30/2024]
Abstract
OBJECTIVE During the Covid-19 pandemic, there has been a substantial uptake of telemental health interventions. Consequently, the objective of this study was to assess psycho-oncologists' attitudes toward and experiences with video consultations (VC) since the beginning of the Covid-19 pandemic. Additionally, we sought to investigate psycho-oncologists' perspectives on the benefits and drawbacks of VC and its' potential implementation beyond the pandemic. METHODS We used a multi-methods study design. First, semi-structured interviews with psycho-oncologists (N = 6) were conducted to inform the development of a cross-sectional online survey, which represented the quantitative part of our study. We invited psycho-oncologists, working in different settings, from all over Germany to participate. RESULTS Data of N = 217 participants (88% female, 49% over 10 years work experience) of the online survey was analyzed. Psycho-oncologists' acceptance toward VC was average to high. In their daily practice, they preferred in-person consultations. Improved access to care and enhanced flexibility were seen as main advantages. The most significant disadvantages included technical issues, privacy concerns at home, loss of non-verbal cues and absence of physical presence for emotional support. Nevertheless, on average, psycho-oncologists wanted to continue seeing approximately 25% of their patients via VC in the future. CONCLUSIONS Given the average to high acceptance of VC among psycho-oncologists and their desire to continue using VC flexibly even after the pandemic, it may be beneficial to implement VC into future psycho-oncology services. Still, future research should focus on the patients' perspective and the effectiveness of VC in psycho-oncology services.
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Affiliation(s)
- Lara Schuster
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hannah Führes
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Svenja Wandke
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- II. Department of Medicine (Hematology/Oncology), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mareike Thomas
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Isabelle Scholl
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Goldfarb Y, Grayzman A, Meir LG, Grundman SH, Rabinian M, Lachman M, Epstein PG, Ben-Dor IA, Naaman A, Puschner B, Moran GS. UPSIDES Mental Health Peer Support in Face of the COVID-19 Pandemic: Actions and Insights. Community Ment Health J 2024; 60:5-13. [PMID: 36508063 PMCID: PMC9743118 DOI: 10.1007/s10597-022-01030-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 09/12/2022] [Indexed: 12/14/2022]
Abstract
The outburst of the COVID-19 pandemic challenged vulnerable populations such as individuals with significant mental illness. In this fresh focus, we describe the innovative development of the UPSIDES mental health peer support intervention, in face of the COVID-19 pandemic in Israel. While the research program is still ongoing, in this paper we focus on the processes and lessons learned from dealing with the rapidly changing circumstances of the pandemic. We portray additional activities conducted above and beyond the UPSIDES protocol in order to maintain continuation and prevent dropout. We learned that an essential combination of keeping a close adherence with the core peer principles and UPSIDES' systematic program and the use of flexible telecommunication means, helped to maintain social connection and service users' participation throughout these times. The sudden pandemic challenges appeared to level out power imbalances and accelerated the formation of reciprocal and supportive relational interactions within the intervention. These processes highlight experiential knowledge as a unique asset, and peer support services as useful in supporting individuals with significant mental illness throughout COVID-19.
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Affiliation(s)
- Yael Goldfarb
- Department of Social Work, Ben Gurion University of the Negev, Be'er Sheva, Israel
| | - Alina Grayzman
- Department of Social Work, Ben Gurion University of the Negev, Be'er Sheva, Israel
| | - Lion Gai Meir
- Enosh the Israeli Mental Health Association, Kfar Saba, Israel
| | | | | | - Max Lachman
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | | | - Inbar Adler Ben-Dor
- Department of Social Work, Ben Gurion University of the Negev, Be'er Sheva, Israel
| | - Adi Naaman
- Mental Health Department, Ministry of Health, Jerusalem, Israel
| | - Bernd Puschner
- Department of Psychiatry II, Ulm University, Ulm, Germany.
| | - Galia S Moran
- Department of Social Work, Ben Gurion University of the Negev, Be'er Sheva, Israel.
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15
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Hagen MH, Hartvigsen G, Jaccheri L, Papavlasopoulou S. Digital Psychosocial Follow-up for Childhood Critical Illness Survivors: A Qualitative Interview Study on Health Professionals' Perspectives. Scand J Child Adolesc Psychiatr Psychol 2024; 12:50-62. [PMID: 39027413 PMCID: PMC11255782 DOI: 10.2478/sjcapp-2024-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Abstract
Background Digital solutions have been reported to provide positive psychological and social outcomes to childhood critical illness survivors, a group with an increased risk for long-term adverse psychosocial effects. Objective To explore health professionals' perspectives on the potential of digital psychosocial follow-up for childhood critical illness survivors. Methods Using a qualitative approach, expert interviews with six health professionals working at a Norwegian hospital were conducted. Transcribed interviews were analyzed using Braun and Clarke's six-phase thematic analysis framework. Concurrent data collection and analysis using inductive coding was also employed, and a model of codes was constructed. Results The interview yielded thirteen unique codes regarding the health professionals' perspectives on the potential for digital psychosocial follow-up for childhood critical illness survivors, organized in a model comprising the two main themes: Affecting Factors and Digital Usage. Demographic factors (the child's medical condition, age, gender, and residence) and environmental factors (the child's family and health professionals) tended to affect the current psychosocial follow-up. Hospital limitations concerning a lack of digital solutions, worse relationship building with video communication, and children's already high screen time reflected the current state of digital usage. However, ongoing digitalization, existing successful digital solutions, children's good digital skills, and an ongoing process of creating an artifact are also seen as opportunities for digital usage in future psychosocial follow-up for childhood critical illness survivors. Conclusions Researchers can build further on these findings to investigate the potential of digital psychosocial follow-up for childhood critical illness survivors, and clinicians can use it as a starting point for improving psychosocial follow-up.
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Affiliation(s)
- Marte Hoff Hagen
- Department of Computer Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gunnar Hartvigsen
- Department of Computer Science, University of Tromsø – The Arctic University of Norway, Tromsø, Norway
| | - Letizia Jaccheri
- Department of Computer Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Sofia Papavlasopoulou
- Department of Computer Science, Norwegian University of Science and Technology, Trondheim, Norway
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16
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Lange E, Danielsson L. Reaching for connection: a qualitative study of communication and interaction in video-based physiotherapy. Physiother Theory Pract 2023:1-12. [PMID: 38145499 DOI: 10.1080/09593985.2023.2296574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 12/09/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE Digital technology has become increasingly relevant in physiotherapy, but little is known about communication and interaction in video-based physiotherapy. Therefore, this study aimed to explore the experiences among patients and physiotherapists, of communication and interaction in digital, video-based physiotherapy. METHODS A qualitative interview study with a phenomenological approach was conducted. Participants were purposively recruited from primary health care clinics. Semi-structured, in-depth interviews were conducted with 10 physiotherapists and 6 patients. Interviews were recorded, transcribed, and analyzed using a phenomenological approach. RESULTS The analysis resulted in the overall theme Reaching for connection, which captured the central meaning of the participants' experiences. Four categories emerged from the analysis: 1) Closeness at a distance; 2) Overcoming limited bodily communication; 3) The technology as part of the meeting; and 4) Challenging the physical meeting as a norm. The results suggest that communication and interaction in digital settings differ from physical settings, but there is an ongoing adaptation process to this new paradigm. CONCLUSIONS The results of this study show that video-based physiotherapy, while having several benefits according to both patients and physiotherapists, affects the communication in several ways. Physiotherapists need to acknowledge these limitations and seek strategies to adapt and to compensate for the reduced non-verbal elements and lack of touch. Attention to the physical room and shifting between positions (face/full figure) are suggested practical strategies, but also to practice awareness and embodied communication to improve receptivity in the interaction.
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Affiliation(s)
- Elvira Lange
- Department of General Practice, Institute of Medicine at the Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
- Research, Education, Development and Innovation, Primary Health Care, Region Västra Götaland, FoUUI-centrum Göteborg och Södra Bohuslän, Göteborg, Sweden
| | - Louise Danielsson
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
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Békés V, Ménard CG, Schmitz N, Aafjes-van Doorn K. Therapist-Reported Differences between Teletherapy via Phone and via Videoconferencing. Brain Sci 2023; 13:1714. [PMID: 38137162 PMCID: PMC10742214 DOI: 10.3390/brainsci13121714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/03/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
When therapists provide teletherapy they can choose between teletherapy via phone and teletherapy via videoconferencing, however, little is known about differences between using these two teletherapy formats. We aimed to compare therapists' attitudes, level of professional self-doubt, and experience of the therapeutic relationship in sessions conducted via phone versus via videoconferencing. We administered an online survey to 117 therapists who had experience with sessions both via phone and videoconferencing. The results suggested that therapists' attitudes and perceptions of the therapeutic relationship were similar. However, therapists' level of professional self-doubt was higher in sessions conducted via videoconferencing. Therapists with previous experience of conducting teletherapy via phone perceived phone sessions more positively. Thus, familiarity with videoconferencing technology might be more important in shaping therapists' attitudes and confidence than the type of technology per se. This highlights the importance of practicing with new technologies.
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Affiliation(s)
- Vera Békés
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Ave, Bronx, NY 10461, USA; (V.B.); (N.S.)
| | | | - Natale Schmitz
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Ave, Bronx, NY 10461, USA; (V.B.); (N.S.)
| | - Katie Aafjes-van Doorn
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Ave, Bronx, NY 10461, USA; (V.B.); (N.S.)
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18
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O'Connor P, Donohue G, Morrissey J, Needham M, Hargadon L, O'Toole C. An exploration of patient experiences of transitioning to a remote day programme following inpatient treatment in an adult eating disorder service. J Psychiatr Ment Health Nurs 2023; 30:1192-1202. [PMID: 37392056 DOI: 10.1111/jpm.12949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 01/30/2023] [Accepted: 06/13/2023] [Indexed: 07/02/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Traditionally, treatment for eating disorders (EDs) has been provided on an inpatient or outpatient basis, but more recently other levels of treatment provision to include, day care (DC) and community outreach programmes, have been developed. There is limited research exploring the experience of patients who have transitioned from inpatient ED treatment to a remote DC treatment. This lack of knowledge can impact mental health nurses' understanding of what that experience is like for patients and hence may influence the efficacy of collaboration and inclusion between patients and nurses. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This research addresses this dearth of knowledge and adds to our understanding of patients' experiences of attending a remote DC programme following a period of inpatient treatment for an ED. This is an important study for nurses and other mental health professionals working with people in ED treatment, as it highlights the specific challenges and anxieties of transitioning from inpatient to a remote DC programme and the individualized supports advisable during this process. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This research provides a basis on which nurses can understand and address the challenges experienced by patients after transitioning to a less intensive supportive ED programme. The understanding of these experiences will enhance the therapeutic alliance between the nurse and patient, which will in turn support the patient in increasing agency as they progress through their recovery. This research provides a foundation on which to develop specific supports that need to be in place to help patients manage the anxieties they experience as they transition to a less intense and remote treatment. Findings from these lived experiences can be used to support the development of similar DC programmes for EDs in other settings. ABSTRACT INTRODUCTION: Day care (DC) treatment for people with an eating disorder (ED) provides for an easier transition from hospital to home, along with a treatment milieu where patients can maintain occupational and social functioning and allow for the transfer of newly acquired skills to everyday life. AIM To explore patients' experiences of attending a remote day programme following intense inpatient treatment in an adult ED service. METHOD A qualitative descriptive methodology informed the study. In-depth semi-structured interviews were conducted with 10 consenting patients. A thematic analysis framework was used to guide the process of data analysis. RESULTS Three themes reflected participants' experiences: 'Moving On: Preparing for Change', 'Navigating a New Support System' and 'Increasing Agency'. DISCUSSION An underlying issue for participants was an ongoing but changing experience of anxiety. While anticipatory anxiety is evident in preparing for discharge, this is replaced with a real-time anxiety as they endeavour to negotiate an effective support network. IMPLICATIONS FOR PRACTICE The findings from this study provide a basis on which mental health nurses can develop timely and effective treatment and support systems with patients who are transitioning from a high support inpatient ED programme to a less intensive ED remote DC programme.
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Affiliation(s)
| | | | - Jean Morrissey
- Trinity Centre for Practice and Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Mary Needham
- St. Patricks Mental Health Services, Dublin, Ireland
| | - Leah Hargadon
- St. Patricks Mental Health Services, Dublin, Ireland
| | - Clare O'Toole
- St. Patricks Mental Health Services, Dublin, Ireland
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19
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Keuroghlian AS, Marcus PH, Neufeld J, Phillips E, Grasso C, Wozniak JR. Telehealth for psychiatry and mental healthcare can improve access and patient outcomes. Nat Med 2023; 29:2698-2700. [PMID: 37864061 DOI: 10.1038/s41591-023-02579-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Affiliation(s)
- Alex S Keuroghlian
- Massachusetts General Hospital, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
- The Fenway Institute, Fenway Health, Boston, MA, USA.
| | - Peter H Marcus
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Jonathan Neufeld
- Institute for Health Informatics, University of Minnesota, Minneapolis, MN, USA
| | | | - Chris Grasso
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - Janet R Wozniak
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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20
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Kaur K, Mutanda D, Almond P, Pandey A, Young P, Levitan T, Bibby-Jones AM. A co-produced service evaluation of ethnic minority community service user experiences of a specialist mental health service during the COVID-19 pandemic. BMC Health Serv Res 2023; 23:1107. [PMID: 37848874 PMCID: PMC10583414 DOI: 10.1186/s12913-023-10115-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 10/04/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND For ethnic minority communities in the UK, the COVID-19 pandemic amplified existing health inequalities and created other consequential disadvantages like increased vulnerability to COVID-19, higher rates of hospital admissions, increased mortality and poorer mental health outcomes. While longer-term impacts of COVID-19 are considered, it is crucial for NHS mental health services to understand the specific barriers and needs of ethnic minority communities to provide consistent and equitable access to mental health services. These aspects were the focus of a service evaluation of a Sussex-wide mental health service conducted in co-production with experts-by-experience, public members, health professionals and researchers from ethnic minority communities. METHODS Co-designed creative workshops (n = 13) and semi-structured qualitative interviews (n = 13) were used to explore experiences of accessing specialist mental health services during the COVID-19 pandemic. Participants were: Sussex Partnership NHS Foundation Trust (SPFT) service users recruited between October 2021 and January 2022; aged 16+; from ethnic minority community backgrounds. Data was analysed using Thematic Analysis. RESULTS The analysis yielded five overarching themes contextualising service users' experiences: (1) limited awareness of SPFT mental health services; (2) effects of COVID-19 in gaining access to SPFT; (3) SPFT reaching out to ethnic minorities; (4) being supported, 4a) hiding my mental health status from friends and families, 4b) lack of ethnic diversity in services, and 4c) better provision of information and support services, (5) relationship between childhood experiences and current mental health. These findings led to seven key recommendations for future service developments within SPFT. CONCLUSIONS Although this evaluation was set in the context of COVID-19, findings have highlighted specific mental health service needs for ethnic minorities that are applicable beyond the confines of the pandemic. Many benefited from online sessions seen as more inclusive. Mental health advocates, outreach and joint working with communities could help further reduce stigmatising attitudes and improve engagement with mental health services. Improved service awareness of the impact of childhood or historical traumas experienced by ethnic minority communities on current mental health, the role of cultural awareness training and availability of culturally adapted therapies is also needed. Many service improvement recommendations provided could impact all service users.
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Affiliation(s)
- Kiranpal Kaur
- Sussex Partnership NHS Foundation Trust, Worthing, UK
| | | | - Palo Almond
- Sussex Partnership NHS Foundation Trust, Worthing, UK
| | | | - Paris Young
- Sussex Partnership NHS Foundation Trust, Worthing, UK
| | - Tony Levitan
- Sussex Partnership NHS Foundation Trust, Worthing, UK
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Laczkovics C, Blüml V, Kapusta N, Hoffmann-Lamplmair D, Casini E, Bazan M, Torres MAG, Lendvay J, Normandin L, Nowacki H, Snigur V, Doering S, Yeomans F, Clarkin J, Preti E. Videoconferencing psychotherapy from a psychodynamic point of view. A qualitative analysis. Front Psychiatry 2023; 14:1235478. [PMID: 37779629 PMCID: PMC10540621 DOI: 10.3389/fpsyt.2023.1235478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/28/2023] [Indexed: 10/03/2023] Open
Abstract
There is a growing interest in delivering videoconferencing psychotherapy (VCP) due to the enormous impact of the COVID-19 pandemic on our lives since the beginning of severe restrictions worldwide in March 2020. Scientific literature has provided interesting results about the transition to remote sessions and its implications, considering different psychotherapy orientations. Less is known about whether and how VCP affects psychodynamic psychotherapeutic approaches and reports on remote work with severe and complex mental health problems such as severe personality disorders are still scarce. The aim of the study was to examine the experiences of psychodynamic psychotherapists, mainly delivering Transference-Focused Psychotherapy (TFP), with the transition and delivery of VCP during the first wave of the COVID-19 pandemic. Four hundred seventy-nine licensed psychotherapists completed an online survey during the peak of the pandemic. Survey data were analyzed using qualitative analysis. Results are presented and discussed concerning advantages and disadvantages regarding the access to psychotherapy, the specificity of the online video setting, bodily aspects, the quality of the therapeutic relationship, the therapeutic process including technical aspects and therapist's experience. Furthermore, we analyzed and discussed the statements concerning transference and countertransference reactions differentiating between high-level borderline and neurotic patients and low-level borderline patients. Our results support the importance to identify patients who potentially benefit from VCP. Further research including more prospective randomized controlled trials are needed to investigate the therapeutic implications of the findings.
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Affiliation(s)
- Clarissa Laczkovics
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Victor Blüml
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Nestor Kapusta
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | | | - Erica Casini
- Department of Psychology, University of Milano-Bicocca, Milano, Italy
| | - Maria Bazan
- Polish Society for Psychodynamic Psychotherapy, Cracow Psychodynamic Center, Kraków, Poland
| | - Miguel Angel Gonzalez Torres
- Department of Neuroscience. University of the Basque Country, San Sebastian, Spain
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
- CIBERSAM, Spanish Network of Research in Mental Health, Bilbao, Spain
- Biocruces-Bizkaia Research Institute, Barakaldo, Spain
| | - Judit Lendvay
- Personality Disorders Institute, Weill Cornell Medical College, White Plains, NY, United States
- Columbia Center for Psychoanalytic Training and Research, New York, NY, United States
| | - Lina Normandin
- École de Psychologie, Université Laval (Québec), Québec, QC, Canada
| | - Henryk Nowacki
- Polish Society for Psychodynamic Psychotherapy, Cracow Psychodynamic Center, Kraków, Poland
| | - Vladimir Snigur
- Russophone Society for the Transference Focused Psychotherapy, Moscow, Russia
| | - Stephan Doering
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Frank Yeomans
- Personality Disorders Institute, Weill Cornell Medical College, White Plains, NY, United States
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States
| | - John Clarkin
- Personality Disorders Institute, Weill Cornell Medical College, White Plains, NY, United States
| | - Emanuele Preti
- Department of Psychology, University of Milano-Bicocca, Milano, Italy
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Krane V, Kaasbøll J, Kaspersen SL, Ådnanes M. 'It's not like real therapy': young people receiving child welfare services' experiences of video consultations in mental healthcare in Norway: a mixed methods approach. BMC Health Serv Res 2023; 23:949. [PMID: 37670314 PMCID: PMC10481608 DOI: 10.1186/s12913-023-09939-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 08/18/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Video consultations has been suggested to lower the threshold for child and adolescent mental healthcare treatment. This study explores how young people receiving child welfare services experience video consultations in child and adolescent mental healthcare. The study is part of a larger Norwegian study of access to health services for this target group. METHODS The study has a mixed methods design including qualitative interviews and a quantitative survey, with young people receiving child welfare services. The qualitative interviews included 10 participants aged 15-19. The survey included 232 participants aged 16-24 of which 36 reported having received video consultations in mental healthcare. The interviews were analysed using thematic analysis. The survey data was presented as frequencies to clarify the distribution of positive and negative perceptions of video consultation. RESULTS The results show that the participants experienced video consultations as more superficial and less binding, compared to in-person sessions. They raised concerns of the therapeutic relationship, however some found it easier to regulate closeness and distance. In the survey several reported that their relationship with the therapist got worse, and that it was much more difficult to talk on screen. Moreover, a large proportion (42%) claimed that video consultations did not fit their treatment needs overall. However, a minority of the participants found it easier to talk to the therapist on screen. CONCLUSIONS The study reveals important weaknesses and disadvantages of online therapy as experienced by young people receiving child welfare services. It is particularly worrying that their criticism involves the relational aspects of treatment, as children receiving child welfare services often have relational experiences which make them particularly sensitive to challenges in relationships. This study shows that youth involvement in decision making of video consultations in therapy has been rare. Clinicians should be aware of these young people's doubts regarding the quality of video consultations in child and adolescent mental health care. Further studies should examine how user involvement can be incorporated in video consultations in therapy and how this could improve experiences and the quality of video consultations.
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Affiliation(s)
- Vibeke Krane
- Faculty of Health and Social Sciences, Department of Health, Social and Welfare Studies, University of South-Eastern Norway, Drammen, 3007, Norway.
| | - Jannike Kaasbøll
- Department of Mental Health, Faculty of Medicine and Health Sciences, Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Norwegian University of Science and Technology, Trondheim, Norway
- Department of Health Research, SINTEF Digital, Trondheim, Norway
| | | | - Marian Ådnanes
- Department of Health Research, SINTEF Digital, Trondheim, Norway
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Büscher R, Teismann T, Hartleitner P, Klein JP, Baumeister H, Sander LB. Remote blended treatment for individuals with suicidal ideation: A single-arm proof-of-concept trial. Clin Psychol Psychother 2023. [PMID: 37658710 DOI: 10.1002/cpp.2905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/09/2023] [Accepted: 08/21/2023] [Indexed: 09/03/2023]
Abstract
INTRODUCTION New digital treatment formats may reduce barriers to treatment for individuals with suicidal ideation. This study aimed to investigate the feasibility of a remote blended care programme for this population, defined as acceptability, demand, practicality, adaptation, indications of efficacy and safety. METHODS We conducted a mixed-methods single-arm trial for proof-of-concept. Participants were eligible if they were at least 18 years old, had sufficient German proficiency, a Beck Scale for Suicidal Ideation score ≥2, internet access and lived near the outpatient clinic. The treatment consisted of 12 sessions of cognitive-behavioural videotherapy combined with online modules over 6 weeks. RESULTS We included 10 participants. All patients were satisfied with the treatment; most patients (80%) reported unpleasant memories resurfacing. All patients completed all therapy sessions and a mean of 13.7 modules (SD = 5.7); three patients switched to face-to-face treatment, in one case due to safety concerns. All patients and most therapists (83.3%) found the treatment overall practicable. Most patients (66.7%) and therapists (66.7%) considered remote treatment equivalent to face-to-face therapy. There were no serious adverse events. CONCLUSION While promising, the results suggest changes to the programme might be needed, particularly for patients' safety. A controlled feasibility trial should investigate temporary deteriorations.
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Affiliation(s)
- Rebekka Büscher
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Tobias Teismann
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Germany
| | - Paula Hartleitner
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jan Philipp Klein
- Department of Psychiatry, Psychosomatics and Psychotherapy, Luebeck University, Luebeck, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Lasse B Sander
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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24
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Marotta N, de Sire A, Calafiore D, Agostini F, Lippi L, Curci C, Ferraro F, Bernetti A, Invernizzi M, Ammendolia A. Impact of COVID-19 Era on the Anterior Cruciate Ligament Injury Rehabilitation: A Scoping Review. J Clin Med 2023; 12:5655. [PMID: 37685722 PMCID: PMC10488473 DOI: 10.3390/jcm12175655] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/22/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
The surgical intervention rate and the subsequent rehabilitation plan for anterior cruciate ligament (ACL) injury was crucially affected by the COVID-19 pandemic due to the necessity in the face of the emergency. This review aimed to evaluate potential persistent and residual symptoms after COVID-19 disease, including fatigue and neuromuscular disorders. A scoping review design and methodology were used due to the exploratory nature of the research question, according to literature searches on PubMed/Medline, Scopus, Web of Science (WoS), and Physiotherapy Evidence Database (PEDro) electronic databases using the following keywords: "Anterior Cruciate Ligament", "ACL", "SARS-CoV-2", and "COVID-19". Undertraining and muscular knee imbalance might cause inefficient movement strategies, lack of knee stability, and increasing load with negative implications in ACL injuries. In the post-surgery period, during COVID-19, telerehabilitation approaches appeared to be successfully applied to maintain strength and range of motion in this condition. However, no definitive data are available regarding the most effective interventions. This scoping review showed the influence of the COVID-19 pandemic and associated restrictions on postoperative and rehabilitative care of ACL injuries.
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Affiliation(s)
- Nicola Marotta
- Department of Experimental and Clinical Medicine, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy;
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy;
| | - Alessandro de Sire
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy;
- Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
| | - Dario Calafiore
- Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, 46100 Mantova, Italy; (D.C.); (F.F.)
| | - Francesco Agostini
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
- Department of Neurological and Rehabilitation Science, IRCCS San Raffaele, 00163 Rome, Italy
| | - Lorenzo Lippi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (M.I.)
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS, Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Claudio Curci
- Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, 46100 Mantova, Italy; (D.C.); (F.F.)
| | - Francesco Ferraro
- Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, 46100 Mantova, Italy; (D.C.); (F.F.)
| | - Andrea Bernetti
- Department of Biological and Environmental Sciences and Technologies (DiSTeBA), University of Salento, 73100 Lecce, Italy;
| | - Marco Invernizzi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (M.I.)
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS, Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Antonio Ammendolia
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy;
- Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
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Rutkowska E, Furmańska J, Lane H, Marques CC, Martins MJ, Sahar NU, Meixner J, Tullio V, Argo A, Bermeo Barros DM. Determinants of psychotherapists' attitudes to online psychotherapy. Front Psychiatry 2023; 14:1196907. [PMID: 37426099 PMCID: PMC10324565 DOI: 10.3389/fpsyt.2023.1196907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction Online psychotherapy is a form of work that is becoming more and more popular. Public health problems, such as COVID-19, forced mental health professionals and patients to incorporate new methodologies such as the use of electronic media and internet to provide follow-up, treatment and also supervision. The aim of this study was to investigate which factors shape the therapists' attitudes toward online psychotherapy during a pandemic taking into account: (1) attitudes toward the COVID-19 pandemic (fear of contagion, pandemic fatigue, etc.), (2) personal characteristics of the psychotherapists (age, gender, feeling of efficacy, anxiety, depression, etc.), and (3) characteristics of the psychotherapeutic practice (guideline procedure, client age group, professional experience, etc). Materials and methods Study participants were 177 psychotherapists from four European countries: Poland (n = 48), Germany (n = 44), Sweden (n = 49), and Portugal (n = 36). Data were collected by means of an individual online survey through the original questionnaire and the standardized scales: a modified version of the Attitudes toward Psychological Online Interventions Scale (APOI), Fear of Contagion by COVID-19 Scale (FCS COVID-19), Pandemic Fatigue Scale (PFS), Hospital Anxiety and Depression Scale (HADS), Social Support Questionnaire (F-SozU K-14), and the Sense of Efficiency Test (SET). Results Determinants that impacted psychotherapists' attitudes toward online therapy were: COVID-19 belief in prevention-keeping distance and hand disinfection, pandemic behavioral fatigue, previous online therapy experience (including voice call), working with youth and adults. Our study showed that belief in the sense of prevention in the form of taking care of hand disinfection before the session, pandemic behavioral fatigue and experience in working with adults were significant predictors of negative attitudes of therapists toward online psychological interventions. On the other hand, belief in the sense of prevention in the form of keeping distance during the session had a positive effect on general attitudes toward therapy conducted via the internet. Discussion The online therapy boom during the COVID-19 pandemic has spawned a powerful tool for psychotherapists. More research in this area and training of psychotherapists are needed for online psychological interventions to become an effective therapy format that is accepted by patients and therapists alike.
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Affiliation(s)
- Emilia Rutkowska
- Institute of Psychology, University of Szczecin, Szczecin, Poland
| | - Joanna Furmańska
- Institute of Psychology, University of Szczecin, Szczecin, Poland
| | - Hakan Lane
- Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Brandenburg, Germany
| | - Cristiana C. Marques
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Maria João Martins
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
- University of Coimbra Health Services, University of Coimbra, Coimbra, Portugal
| | - Najam us Sahar
- Fatima Jinnah Women University, Rawalpindi, Punjab, Pakistan
| | - Johannes Meixner
- Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Brandenburg, Germany
| | - Valeria Tullio
- Department of Health Promotion, Maternal and Child Care, “G. D’Alessandro”, University of Palermo, Palermo, Sicily, Italy
| | - Antonina Argo
- Department of Health Promotion, Maternal and Child Care, “G. D’Alessandro”, University of Palermo, Palermo, Italy, University of Palermo, Palermo, Sicily, Italy
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Galvin E, Desselle S, Gavin B, Quigley E, Flear M, Kilbride K, McNicholas F, Cullinan S, Hayden J. Stakeholder perspectives and experiences of the implementation of remote mental health consultations during the COVID-19 pandemic: a qualitative study. BMC Health Serv Res 2023; 23:623. [PMID: 37312119 DOI: 10.1186/s12913-023-09529-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 05/10/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Remote mental health consultations were swiftly implemented across mental health services during the COVID-19 pandemic. Research has begun to inform future design and delivery of telemental health services. Exploring the in-depth experiences of those involved is important to understand the complex, multi-level factors that influence the implementation of remote mental health consultations. The aim of this study was to explore stakeholder perspectives and experiences of the implementation of remote mental health consultations during the COVID-19 pandemic in Ireland. METHODS A qualitative study was conducted whereby semi-structured, individual interviews were undertaken with mental health providers, service users, and managers (n = 19) to acquire rich information. Interviews were conducted between November 2021 and July 2022. The interview guide was informed by the Consolidated Framework for Implementation Research (CFIR). Data were analysed thematically using a deductive and inductive approach. RESULTS Six themes were identified. The advantages of remote mental health consultations were described, including convenience and increased accessibility to care. Providers and managers described varying levels of success with implementation, citing complexity and incompatibility with existing workflows as barriers to adoption. Providers' access to resources, guidance, and training were notable facilitators. Participants perceived remote mental health consultations to be satisfactory but not equivalent to in-person care in terms of quality. Views about the inferior quality of remote consultations stemmed from beliefs about the inhibited therapeutic relationship and a possible reduction in effectiveness compared to in-person care. Whilst a return to in-person services was mostly preferred, participants acknowledged a potential adjunct role for remote consultations in certain circumstances. CONCLUSIONS Remote mental health consultations were welcomed as a means to continue care during the COVID-19 pandemic. Their swift and necessary adoption placed pressure on providers and organisations to adapt quickly, navigating challenges and adjusting to a new way of working. This implementation created changes to workflows and dynamics that disrupted the traditional method of mental health care delivery. Further consideration of the importance of the therapeutic relationship and fostering positive provider beliefs and feelings of competence are needed to ensure satisfactory and effective implementation of remote mental health consultations going forward.
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Affiliation(s)
- Emer Galvin
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.
| | | | - Blánaid Gavin
- School of Medicine, University College Dublin, Dublin, Ireland
| | | | | | | | - Fiona McNicholas
- School of Medicine, University College Dublin, Dublin, Ireland
- Children's Health Ireland, Crumlin, Dublin, Ireland
- Lucena Child and Adolescent Mental Health Service (CAMHS), Rathgar, Dublin, Ireland
| | - Shane Cullinan
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - John Hayden
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
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Seidman AJ, Vogel DL, Lannin DG. Examining between- and within-person effects of the self-stigma of seeking psychological help on the therapeutic working alliance: The moderating role of psychological distress. Psychotherapy (Chic) 2023; 60:206-211. [PMID: 36951720 PMCID: PMC10238642 DOI: 10.1037/pst0000482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
The self-stigma (i.e., shame) associated with psychotherapy is a prominent barrier to seeking psychological help, but less is known about its effects after treatment begins. Evidence suggests that self-stigma may interfere with the formation of the therapeutic alliance, but no studies have examined this throughout the course of psychotherapy. Self-stigma's erosion of the alliance may be most pronounced when clients experience heightened psychological distress, but this also has not been examined. Therefore, the present study addresses these omissions among 37 clients who completed at least three therapy sessions for research credit. Participants completed measures of self-stigma and past-week symptoms of distress before each session and ratings of the working alliance after. Predictor variables were disaggregated into between-person (time-invariant or average levels) and within-person (time-variant or session-by-session changes) components to enable investigation of for whom (and under what conditions) self-stigma was associated with the therapeutic alliance. Results indicated that higher levels of self-stigma (between and within persons) predicted a worse alliance. When examined as an interaction effect alongside distress in a multilevel moderation model, higher between-person ratings of self-stigma predicted a weaker therapist-client alliance across levels (M ± 1 SD) of within-person distress. Notably, its effects became more pronounced as symptoms of distress increased, indicating a period in which clients are simultaneously most likely to need help yet least likely to feel allied with their therapist. Findings highlight the importance for therapists to simultaneously monitor and consider both average and session-by-session fluctuations in self-stigma and distress to develop and maintain the working alliance. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Aghakhani N, Delirrad M, Jafari E. When Home Is Not a Safe Place: Confronting Domestic Violence During the COVID-19 Era. Galen Med J 2023; 12:1-2. [PMID: 38974132 PMCID: PMC11227642 DOI: 10.31661/gmj.v12i.2814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Indexed: 07/09/2024] Open
Affiliation(s)
- Nader Aghakhani
- Food and Beverages Safety Research Center, Urmia University of Medical Sciences,
Urmia, Iran
| | - Mohammad Delirrad
- Department of Forensic Medicine, School of Medicine, Food and Beverages Safety
Research Center, Taleghani Hospital, Imam Khomeini Hospital, Urmia University of
Medical Sciences, Urmia, Iran
| | - Elham Jafari
- Food and Beverages Safety Research Center, Urmia University of Medical Sciences,
Urmia, Iran
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Weinberg H. Online Training Process Groups for Therapists: A Proposed Model. Int J Group Psychother 2023; 73:141-165. [PMID: 38446564 DOI: 10.1080/00207284.2023.2170236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
The article proposes a new model for online experiential training groups for therapists. Experiential groups are an essential part of training for group therapists. The article summarizes the requirements for becoming a group therapist, reviews the literature about training-process groups for therapists, and discusses the dilemmas that are part of these groups. Ethical questions and the difference between training-process groups and therapy groups are presented. This training model uses weekly online process group sessions that include a 10-minute didactic discussion at the end of each session, combined with an annual in-person intensive meeting. Group vignettes are included to illustrate group processes. The advantages and disadvantages of the model are discussed, as well as important areas for future research.
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Griffith B, Archbold H, Sáez Berruga I, Smith S, Deakin K, Cogan N, Tanner G, Flowers P. Frontline experiences of delivering remote mental health supports during the COVID-19 pandemic in Scotland: innovations, insights and lessons learned from mental health workers. PSYCHOL HEALTH MED 2023; 28:964-979. [PMID: 36408950 DOI: 10.1080/13548506.2022.2148698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
COVID-19 restrictions drove rapid adaptations to service delivery and new ways of working within Scotland's mental health sector. This study explores mental health workers' (MHWs') experiences of delivering their services remotely. Twenty participants, who had worked in mental health professions in the National Health Service (NHS) in Scotland throughout the COVID-19 pandemic, took part in online semi-structured interviews. Data was transcribed then analysed using an inductive thematic analysis. Two major themes are reported: (1) 'Improved Flexibility for both MHWs and Service Users' and (2) 'Teletherapies Challenge Therapeutic Boundaries'. In relation to (1) virtual platforms were seen as vital in maintaining patient care throughout the COVID-19 pandemic and a valuable resource for service users (SUs) who had previously struggled with mobility or social anxieties when accessing face-to-face services. Some MHWs' also noted benefits for their productivity and comfort. Regarding (2) MHWs highlighted that whilst conducting teletherapies from home, work-life boundaries became blurred and, in some instances, typically comforting spaces became associated with the traumatic content discussed by SUs. These stressors seemed to be compounded by MHWs' isolation, as they were less able to draw upon their colleagues for support. Further, confidentiality could not be assured, as MHWs and SUs alike had to accommodate their family members. These findings highlight important insights from MHWs in adapting to rapid changes in mental health working practices, particularly in relation to the challenges of delivering quality, safe and equitable services and the increased use of teletherapies. Such insights are vital in informing service developments and supporting future pandemic preparedness across a range of healthcare contexts and countries seeking to adopt hybrid models of mental health service delivery.
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Affiliation(s)
- Bethany Griffith
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Heather Archbold
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Isabel Sáez Berruga
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Samantha Smith
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Karen Deakin
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Nicola Cogan
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Gary Tanner
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Paul Flowers
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
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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). CLINICAL PSYCHOLOGY IN EUROPE 2023; 5:e8109. [PMID: 37064999 PMCID: PMC10103154 DOI: 10.32872/cpe.8109] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [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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Wathen CC, Andrade Vargas E. Applying the 10 Principles of Anti-Oppression to Online Psychoeducational Groups: Steps to Intentional Changes in Emerging Technologies. JOURNAL FOR SPECIALISTS IN GROUP WORK 2023. [DOI: 10.1080/01933922.2023.2190783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
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Werkmeister BJ, Haase AM, Fleming T, Officer TN. Experiences of the COVID-19 Lockdown and Telehealth in Aotearoa New Zealand: Lessons and Insights from Mental Health Clinicians. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4791. [PMID: 36981699 PMCID: PMC10049248 DOI: 10.3390/ijerph20064791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/06/2023] [Accepted: 03/06/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE The COVID-19 pandemic rapidly changed health service delivery and daily life. There is limited research exploring health professional experiences with these changes. This research explores mental health clinicians' experiences over the first COVID-19 lockdown in New Zealand to inform future pandemic responses and improve usual business practices. METHOD Thirty-three outpatient mental health clinicians in three Aotearoa New Zealand regions took part in semi-structured interviews. Interviews were analysed thematically applying an interpretive description methodology. RESULTS Three key themes emerged: (1) life in lockdown, (2) collegial support, and (3) maintaining well-being. Clinicians, fearful of contracting COVID-19, struggled to adapt to working from home while maintaining their well-being, due to a lack of resources, inadequate pandemic planning, and poor communication between management and clinicians. They were uncomfortable bringing clients notionally into their own homes, and found it difficult to separate home and work spheres. Māori clinicians reported feeling displaced from their clients and community. CONCLUSION Rapid changes in service delivery negatively impacted clinician well-being. This impact is not lessened by a return to normal work conditions. Additional support is required to improve clinician work conditions and ensure adequate resourcing and supervision to enable clinicians to work effectively within a pandemic context.
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Affiliation(s)
- Benjamin J. Werkmeister
- School of Health, Te Herenga Waka-Victoria University of Wellington, Wellington 6012, New Zealand
- Te Whatu Ora-Health New Zealand, Psychological Medicine, Wellington 6021, New Zealand
- Department of Psychological Medicine, University of Otago-Wellington, Wellington 6242, New Zealand
| | - Anne M. Haase
- School of Health, Te Herenga Waka-Victoria University of Wellington, Wellington 6012, New Zealand
| | - Theresa Fleming
- School of Health, Te Herenga Waka-Victoria University of Wellington, Wellington 6012, New Zealand
| | - Tara N. Officer
- School of Nursing, Midwifery, and Health Practice, Te Herenga Waka-Victoria University of Wellington, Wellington 6021, New Zealand
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Van Lieshout RJ, Layton H, Savoy CD, Xie F, Brown JSL, Huh K, Bieling PJ, Streiner DL, Ferro MA, Haber-Evans E. In-person 1-day cognitive behavioral therapy-based workshops for postpartum depression: a randomized controlled trial. Psychol Med 2023; 53:1-11. [PMID: 36878891 PMCID: PMC10600825 DOI: 10.1017/s0033291723000454] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 01/29/2023] [Accepted: 02/06/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND Postpartum depression (PPD) affects up to one in five mothers and birthing parents, yet as few as 10% access evidence-based treatment. One-day cognitive behavioral therapy (CBT)-based workshops for PPD have the potential to reach large numbers of sufferers and be integrated into stepped models of care. METHODS This randomized controlled trial of 461 mothers and birthing parents in Ontario, Canada with Edinburgh Postnatal Depression Scale (EPDS) scores ⩾10, age ⩾18 years, and an infant <12 months of age compared the effects of a 1-day CBT-based workshop plus treatment as usual (TAU; i.e. care from any provider(s) they wished) to TAU alone at 12-weeks post-intervention on PPD, anxiety, the mother-infant relationship, offspring behavior, health-related quality of life, and cost-effectiveness. Data were collected via REDCap. RESULTS Workshops led to meaningful reductions in EPDS scores (m = 15.77 to 11.22; b = -4.6, p < 0.01) and were associated with three times higher odds of a clinically significant decrease in PPD [odds ratio (OR) 3.00, 95% confidence interval (CI) 1.93-4.67]. Anxiety also decreased and participants had three times the odds of clinically significant improvement (OR 3.20, 95% CI 2.03-5.04). Participants reported improvements in mother-infant bonding, infant-focused rejection and anger, and effortful control in their toddlers. The workshop plus TAU achieved similar quality-adjusted life-years at lower costs than TAU alone. CONCLUSIONS One-day CBT-based workshops for PPD can lead to improvements in depression, anxiety, and the mother-infant relationship and are cost-saving. This intervention could represent a perinatal-specific option that can treat larger numbers of individuals and be integrated into stepped care approaches at reasonable cost.
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Affiliation(s)
- Ryan J. Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Haley Layton
- Health Research Methodology Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Calan D. Savoy
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Feng Xie
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - June S. L. Brown
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Kathryn Huh
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Peter J. Bieling
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - David L. Streiner
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Mark A. Ferro
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Erika Haber-Evans
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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Leung T, Ranheim A, Mattelin E, Eriksson H, Mazaheri M. Distance in Distant Care: Qualitative Content Analysis of Providers' Experiences in Tele-Mental Care. J Med Internet Res 2023; 25:e38568. [PMID: 36800225 PMCID: PMC9984997 DOI: 10.2196/38568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 12/21/2022] [Accepted: 01/24/2023] [Indexed: 02/18/2023] Open
Affiliation(s)
| | - Albertine Ranheim
- Division of Nursing, Department of Neurobiology, Care Sciences, and Society, Karolinska Institute, Huddinge, Sweden
| | - Erica Mattelin
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Barnafrid, Swedish National Center on Violence Against Children, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Henrik Eriksson
- Section for Health Promotion and Care Sciences, University West, Trollhättan, Sweden
| | - Monir Mazaheri
- Division of Nursing, Department of Neurobiology, Care Sciences, and Society, Karolinska Institute, Huddinge, Sweden.,Department of Nursing Sciences, Sophiahemmet University, Stockholm, Sweden
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Atkinson L. “In my own comfort zone”: Clients' experiences of relational aspects of online therapy for alcohol problems. COUNSELLING & PSYCHOTHERAPY RESEARCH 2023. [DOI: 10.1002/capr.12621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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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] [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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38
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Aviram A, Nadan Y. "I miss not being able to offer my couples a box of tissues…": Couples' and Therapists' perspectives on the therapeutic Alliance with the transition to online couple therapy. FAMILY PROCESS 2023. [PMID: 36709951 DOI: 10.1111/famp.12853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/13/2022] [Accepted: 12/26/2022] [Indexed: 06/18/2023]
Abstract
The purpose of this study is to advance theory concerning the experiences of couples and therapists involved in online couple therapy and the meanings they assign to them, with a particular focus on the therapeutic alliance. Using constructivist grounded theory methodology, in-depth semi-structured online interviews were conducted with 36 individuals, including 18 couples who had participated in online couple therapy via videoconference. Additionally, 15 couple and family therapists were interviewed in four online focus groups. Our analysis indicates three dimensions that impact the formation of the therapeutic alliance in online couple therapy: (1) emotional closeness, as a conduit for establishing physical or emotional space; (2) limited care, due to the therapist's difficulty providing comfort and security; and (3) body language, as reflected in the lack of physical presence and the close inspection of the face, at two opposite ends of a continuum. We discuss our findings through the lens of the closeness-distance dynamic, which posits that therapists' ability to regulate themselves depends on their clients' emotional needs. We conclude with implications for clinical practice.
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Affiliation(s)
- Alon Aviram
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yochay Nadan
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Jerusalem, Israel
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Ivey G, Denmeade L. Trainee psychologists’ experiences of learning and conducting psychodynamic therapy via telepsychology. PSYCHOANALYTIC PSYCHOTHERAPY 2023. [DOI: 10.1080/02668734.2022.2158210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Gavin Ivey
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Lesley Denmeade
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
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40
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Tomaino SCM, Manzoni GM, Brotto G, Cipolletta S. Breaking Down the Screen: Italian Psychologists' and Psychotherapists' Experiences of the Therapeutic Relationship in Online Interventions during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1037. [PMID: 36673792 PMCID: PMC9859036 DOI: 10.3390/ijerph20021037] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/29/2022] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
(1) Background: The COVID-19 pandemic posed new challenges to clinical practice and delineated future directions for online interventions in psychological care. The present study aimed to explore Italian psychologists' and psychotherapists' experiences of online interventions during the pandemic, focusing on the strategies they used to develop and maintain therapeutic relationships with their patients. (2) Methods: Between February and July 2021, 368 Italian psychologists and/or psychotherapists completed an online survey. A mixed-methods analysis was conducted, using Jamovi to analyze quantitative data and ATLAS.ti 9 to analyze qualitative data. (3) Results: Of the participants, 62% had never delivered online interventions before the pandemic; though 95.4% were delivering online interventions at the time of the survey, many reported facing technical disruptions (77.1%) and having little confidence in the online setting (45.3%). Feeling present in online sessions-facilitated by emotional attunement, active listening, and conversational spontaneity-was reported as "very important" by 93.6%. (4) Conclusions: Overall, the COVID-19 pandemic allowed a great leap forward in the use of online interventions by Italian psychologists and psychotherapists. This period of upheaval generated not only a positive change in their attitudes toward and intention to use online interventions but also revealed associated technical and relational issues that must be properly addressed.
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Affiliation(s)
| | | | - Giada Brotto
- Department of General Psychology, University of Padua, 35131 Padova, Italy
| | - Sabrina Cipolletta
- Department of General Psychology, University of Padua, 35131 Padova, Italy
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41
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Paige SR, Ong T, Wilczewski H, Barrera JF, Welch BM, Bunnell BE. Clinical and Information Services Needed by Telemental Health Providers. Telemed J E Health 2023; 29:141-145. [PMID: 35617706 PMCID: PMC9918345 DOI: 10.1089/tmj.2021.0457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 04/12/2022] [Accepted: 04/15/2022] [Indexed: 01/12/2023] Open
Abstract
Purpose: To identify clinical and informational services that telemental health (TMH) providers need to be more successful in their practice. Methods: In February-March 2021, 472 TMH providers completed a cross-sectional survey. Providers indicated the degree to which they need clinical (e.g., build therapeutic alliances) and informational (e.g., learn about regulatory changes) services. Independent samples t-tests were conducted to examine differences in needs according to when telemedicine was adopted. Results: TMH providers neutrally-to-somewhat agreed they could benefit from clinical (M = 3.24; standard deviation [SD] = 0.78) and informational (M = 3.66; SD = 0.82) services. Prepandemic TMH providers reported a greater need for services that help them cultivate relationships with patients, monitor health conditions, and to remain updated about reimbursement processes. Conclusion: All TMH providers could benefit from information about the latest trends and best practices in telemedicine. Prepandemic providers could benefit most from policy-related updates and patient-engagement services.
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Affiliation(s)
| | - Triton Ong
- Doxy.me Research, Doxy.me, Inc., Rochester, New York, USA
| | | | - Janelle F. Barrera
- Doxy.me Research, Doxy.me, Inc., Rochester, New York, USA
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, Florida, USA
| | - Brandon M. Welch
- Doxy.me Research, Doxy.me, Inc., Rochester, New York, USA
- Medical University of South Carolina, Charleston, South Carolina, USA
| | - Brian E. Bunnell
- Doxy.me Research, Doxy.me, Inc., Rochester, New York, USA
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, Florida, USA
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Cassity-Caywood W, Griffiths A, Woodward M, Hatfield A. The Benefits and Challenges of Shifting to Telehealth During COVID-19: Qualitative Feedback from Kentucky's Sexual Violence Resource Centers and Children's Advocacy Centers. JOURNAL OF TECHNOLOGY IN BEHAVIORAL SCIENCE 2023; 8:87-99. [PMID: 36597503 PMCID: PMC9801142 DOI: 10.1007/s41347-022-00296-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 12/06/2022] [Accepted: 12/12/2022] [Indexed: 12/31/2022]
Abstract
The onset of the COVID-19 pandemic presented novel challenges for service providers addressing mental health issues with a large shift to the utilization of telehealth. While previous research has examined the benefits and challenges of providing mental health and crisis services remotely through telehealth, little research exists examining the use of telehealth in children's advocacy centers (CACs) and sexual violence resource centers (SVRCs). CACs and SVRCs are multi-disciplinary agencies taking a holistic approach to addressing interpersonal violence, making them unique in that they provide a range of direct services beyond mental health counseling (e.g., legal advocacy, medical exams, and prevention education) but all geared toward public health and safety. The current study explored the experiences of direct service providers in Kentucky CACs and SVRCs and their opinions about the most significant challenges and benefits of adapting their practices at the onset of the COVID-19 pandemic. A total of 118 providers participated in the study, and 88 reported using telehealth (defined as communicating with clients via technology such as videoconferencing, phone calls, or email) since the onset of COVID-19. Qualitative data from those 88 respondents regarding the challenges and benefits of using telehealth were collected and coded using a thematic content analysis. 78.6% of the sample indicated that they served primarily rural areas. Benefits noted included increasing treatment access, increasing treatment flexibility, and advancing continuity of care, while challenges included difficulties with technology, client engagement, privacy, and logistical challenges. Responses highlighted that telehealth presented both a number of advantages and difficulties and that more formal guidance for providers at CACs and SVRCs was desired.
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Affiliation(s)
- Whitney Cassity-Caywood
- Department of Community Leadership and Human Services, Murray State University, Murray, KY USA.,Lifeskills Center for Child Welfare Education and Research, Western Kentucky University, Bowling Green, KY USA.,Paducah Regional Campus, Murray State University, 4430 Sunset Ave, Paducah, KY 42001 USA
| | - Austin Griffiths
- The Department of Social Work Program, Western Kentucky University, Bowling Green, KY USA.,Lifeskills Center for Child Welfare Education and Research, Western Kentucky University, Bowling Green, KY USA
| | - Matthew Woodward
- Department of Psychological Sciences, Western Kentucky University, Bowling Green, KY USA.,Lifeskills Center for Child Welfare Education and Research, Western Kentucky University, Bowling Green, KY USA
| | - Alecia Hatfield
- Department of Psychology, Western Kentucky University, Bowling Green, KY USA.,Lifeskills Center for Child Welfare Education and Research, Western Kentucky University, Bowling Green, KY USA
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43
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Metacognitive Reflection and Insight Therapy (MERIT) Delivered Virtually During the COVID-19 Pandemic: An Illustration of Two Cases. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2023; 53:71-79. [PMID: 35968267 PMCID: PMC9364285 DOI: 10.1007/s10879-022-09557-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 07/10/2022] [Accepted: 07/22/2022] [Indexed: 02/07/2023]
Abstract
Alternative platform offerings for psychotherapy have become a necessity in the age of the novel coronavirus (COVID-19) pandemic. The current study describes the virtual adaptation of Metacognitive Reflection and Insight Therapy (MERIT) for people with psychosis. MERIT is a recovery-oriented psychotherapy that has shown promise in increasing metacognition and allowing individuals to make meaning of their psychiatric challenges and direct their own recovery efforts. MERIT delivery requires the assumption that metacognitive reflection is an intersubjective act where individuals make meaning with others instead of in isolation. As such, considering the current COVID-19 pandemic, research is needed to understand how intersubjectivity and the therapeutic alliance may differ in a virtual environment rather than in-person. The present study addresses this question by illustrating two case examples of MERIT's adaptation to a virtual delivery telehealth format. Moreover, this study expands on Lysaker and colleagues' (2020) investigation of virtual adaptations of MERIT by exploring how MERIT is adapted in a virtual environment, how intersubjectivity changes in a virtual environment, and, what opportunities virtual platforms allow for metacognitive reflection. Overall, we found that MERIT can be successfully delivered in a virtual telehealth platform. We discuss opportunities and considerations for MERIT and other psychotherapy virtual delivery.
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44
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Aviram A, Nadan Y. Online clinical supervision in couple and family therapy: A scoping review. FAMILY PROCESS 2022; 61:1417-1436. [PMID: 36000250 PMCID: PMC10086939 DOI: 10.1111/famp.12809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 07/10/2022] [Accepted: 07/20/2022] [Indexed: 06/15/2023]
Abstract
Online clinical supervision, or telesupervision, is a growing practice in couple and family therapy. This scoping review aims to identify and synthesize the existing body of knowledge regarding the utilization, experiences, and perceptions of telesupervision among the couple and family therapists and to highlight gaps in the literature. The review followed the five-step approach proposed by Arksey et al. (2005). Fifteen articles were included and their analysis yielded four themes: 1. telesupervision competence; 2. setting and boundary management; 3. advantages of telesupervision; and 4. challenges of telesupervision. Our review clearly demonstrates the dearth of available conceptual and empirical work. The rapidly growing use of online therapy and telesupervision in couple and family therapy has created a critical need to expand this body of knowledge by collecting evidence that can later be translated into practice. Moreover, we identified several gaps in the existing body of knowledge, including a lack of reports on the efficacy of telesupervision and on the experiences, processes, and ascribed meanings of the supervisors and supervisees. We also noted a lack of practice and ethical guidelines for telesupervision. We conclude our analysis by suggesting areas and directions for further investigation.
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Affiliation(s)
- Alon Aviram
- The Paul Baerwald School of Social Work and Social WelfareThe Hebrew University of JerusalemJerusalemIsrael
| | - Yochay Nadan
- The Paul Baerwald School of Social Work and Social WelfareThe Hebrew University of JerusalemJerusalemIsrael
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45
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Carretier E, Bastide M, Lachal J, Moro MR. Evaluation of the rapid implementation of telehealth during the COVID-19 pandemic: a qualitative study among adolescents and their parents. Eur Child Adolesc Psychiatry 2022; 32:963-973. [PMID: 36370315 PMCID: PMC9652600 DOI: 10.1007/s00787-022-02108-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 10/26/2022] [Indexed: 11/15/2022]
Abstract
The Coronavirus Disease 2019 (COVID-19) pandemic catalysed an abrupt explosion in the use telepsychiatry for the delivery of mental health services. We aimed to explore the experience of telemedicine use during this period among adolescent outpatients and inpatients and their parents. This qualitative study took place in a French adolescent medicine and psychiatry department during the first lockdown. Data collection by purposive sampling continued until we reached theoretical sufficiency. The interviews were analysed by applying Interpretative Phenomenological Analysis which is based on an iterative, inductive process. It included 20 participants: 10 adolescents and 10 parents. The analysis showed three themes: (1) facilitators of a switch from face-to-face to tele-consultation: (a) the context of health emergency, (b) the integration of parents in the treatment, (c) the choice between telephone or video consultation; (2) distance from the therapist's gaze and its consequences: (a) an obstacle to decrypting clinical nonverbal communication, (b) effectiveness depends on the severity of the adolescent's symptoms, (c) and on the previous quality of the therapeutic relationship; (3) awareness of the value of the face-to-face therapeutic space. In the post-COVID era, practitioners would benefit from combining both approaches, face-to-face and remote, based on the quality of the therapeutic alliance, the pathology, the parents' availability for in-person participation, and the patient's age. Future quantitative research will also be necessary to establish the extent to which the experiences described by the participants in this study reflect those of a broader population.
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Affiliation(s)
- Emilie Carretier
- Paris Cité University, PCPP, 92100, Boulogne-Billancourt, France. .,Paris-Saclay University, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France.
| | | | - Jonathan Lachal
- Paris-Saclay University, UVSQ, Inserm, CESP, Team DevPsy, 94807 Villejuif, France ,CHU de Clermont-Ferrand, Service de Psychiatrie de l’Enfant et de l’Adolescent, 63000 Clermont-Ferrand, France ,Université Clermont Auvergne, 63000 Clermont-Ferrand, France
| | - Marie Rose Moro
- Paris Cité University, PCPP, 92100 Boulogne-Billancourt, France ,Paris-Saclay University, UVSQ, Inserm, CESP, Team DevPsy, 94807 Villejuif, France ,APHP, Cochin Hospital, Maison de Solenn, 75014 Paris, France
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46
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Giordano C, Ambrosiano I, Graffeo MT, Di Caro A, Gullo S. The transition to online psychotherapy during the pandemic: a qualitative study on patients' perspectives. RESEARCH IN PSYCHOTHERAPY (MILANO) 2022; 25:638. [PMID: 36373388 PMCID: PMC9893047 DOI: 10.4081/ripppo.2022.638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 09/19/2022] [Indexed: 11/09/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has substantially increased online psychotherapies due to the impossibility of participating in vis-a-vis settings. In the last years, research about online therapy has been quickly growing. However, until now, few studies investigated patients' perspective about the transition to online psychotherapy and, specifically, no qualitative research in group therapy has been done on this topic. This study aimed to explore the experience of 51 patients (39 group patients and 12 from individual psychotherapies) who continued psychotherapy in the online setting during the COVID-19 outbreak. A structured online questionnaire with open answers investigated the following topics: setting online, effectiveness, psychotherapy relationship, specific dynamics of online psychotherapy. Patients' answers were analysed by means of Consensual Qualitative Research, modified version (CQRM), an inductive method that allows analysing a large sample and relatively brief written answers. The results show the impact of shift to online platforms on patients and explore how easy or difficult it is for them to adapt to therapeutic processes are in online therapy (vs in-person therapy), by highlighting potential barriers and resources to practice implementation. Participants' responses have been arranged into three main domains: setting online, content/effectiveness of online therapy and therapeutic relationship. A fourth domain, specific for online group therapy, collected responses referred to the changes perceived regarding the group dynamics. From the patient's perspective, online therapy is effective and satisfying. Patients perceived a positive quality of therapeutic relationship in online setting, whereas produced more controversial judgments concerned the changes due to the online setting. Finally, patients in group therapy gave more attention and importance in showing and seeing private personal spaces than the ones in individual therapy.
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Affiliation(s)
- Cecilia Giordano
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy,Department of Psychology, Educational Sciences and Human Movement, University of Palermo, viale delle Scienze, Edificio 15, 90128 Palermo, Italy. +39.091.23897718.
| | | | - Maria Teresa Graffeo
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - Alessandro Di Caro
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - Salvatore Gullo
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
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47
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Harvey E, Mutanda D, Jones AM, Hayward M. How should psychological interventions for distressing voices be delivered: a comparison of outcomes for patients who received interventions remotely or face-to-face within routine clinical practice? PSYCHOSIS 2022. [DOI: 10.1080/17522439.2022.2128860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Edward Harvey
- School of Psychology, University of Sussex, Brighton, UK
| | | | | | - Mark Hayward
- Research and Development Department, University of Sussex and Sussex Partnership NHS Foundation Trust, Hove, UK
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48
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Bertuzzi V, Semonella M, Andersson G, Manzoni GM, Castelnuovo G, Molinari E, Pietrabissa G. Study protocol for a randomized controlled trial evaluating the effectiveness of an internet-based self-help intervention to cope with psychological distress due to COVID-19 in the Italian general population: the RinasciMENTE project. Trials 2022; 23:801. [PMID: 36153586 PMCID: PMC9509606 DOI: 10.1186/s13063-022-06714-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 09/04/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND This study aims to evaluate the feasibility and effectiveness of the RinasciMENTE program, an Internet-based self-help intervention based on cognitive behavioral therapy (CBT) principles and techniques in supporting individuals experiencing psychological impairments during the COVID-19 pandemic. A randomized controlled trial (RCT) design with random allocation at the level of individual will be conducted to compare the impact of the RinasciMENTE program with a waiting list control in improving the psychological functioning of the general population during the COVID-19 pandemic. METHODS A minimum sample of 128 participants experiencing mild/subthreshold levels of psychological symptoms during the COVID-19 pandemic will be recruited. After the initial screening, participants will be randomly assigned to either the experimental group or the control condition. The program will last 2 months, during which participants will receive 8 weekly CBT treatment modules. The impact of the RinasciMENTE program on selected primary and secondary psychological outcomes will be tested at the end of the intervention (2 months) and 6- and 12-month follow-ups. DISCUSSION We expect people to show an increased level of psychological functioning and to acquire the skills and self-confidence necessary to deal with the psychological consequences of the COVID-19 outbreak and its related social isolation during and following the pandemic. TRIAL REGISTRATION ClinicalTrials.gov NCT0497903 Registered on 28 May 2021.
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Affiliation(s)
- Vanessa Bertuzzi
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy
| | | | - Gerhard Andersson
- Department of Behavioural Science and Learning, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Solna, Sweden
| | - Gian Mauro Manzoni
- Department of Psychology, Faculty of Psychology, eCampus University, 22100 Como, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Enrico Molinari
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Giada Pietrabissa
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Milan, Italy
- Università Cattolica del DSacro Cuore, Via Largo Gemelli, 1, 20123 Milan, Italy
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Okorie CO, Ogba FN, Amujiri BA, Nwankwo FM, Oforka TO, Igu NCN, Arua CC, Nwamuo BN, Okolie CN, Ogbu EO, Okoro KN, Solomon KC, Nwamuo BE, Akudolu LO, Ukaogo VO, Orabueze FO, Ibenekwu IE, Ani CKC, Iwuala HO. Zoom-based GROW coaching intervention for improving subjective well-being in a sample of school administrators: A randomized control trial. Internet Interv 2022; 29:100549. [PMID: 36092992 PMCID: PMC9452042 DOI: 10.1016/j.invent.2022.100549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 05/13/2022] [Accepted: 05/19/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND/OBJECTIVE Poor subjective well-being is a risk factor for poor health; and threatens school administrators' leadership roles and overall occupational and personal outcomes. Online digital care and coaching such as Zoom-delivered GROW (Z-GROW) coaching may be an invaluable approach to building resilience and improving well-being. This study investigated the effectiveness of the Z-GROW coaching model in enhancing self-reported well-being in a sample of school administrators in South-East Nigeria. METHOD A randomized control trial was conducted with a sample of 109 school administrators who met the inclusion criteria. Participants were allocated into Z-GROW (N = 55) and waitlist control (N = 54) groups. A 2-hour Z-GROW programme was delivered to the Z-GROW intervention group weekly for 9 weeks. Subjective well-being was measured using the Satisfaction with Life Scale (SWLS), the Scale of Positive and Negative Experience (SPANE), and the Flourishing Scale (FS). Data were collected on three occasions: pre-intervention, post-intervention, and follow-up using the same measures. All data were analyzed using descriptive and inferential statistics. The presentation of data was supported by figures and charts. RESULTS Results revealed that school administrators' three dimensions of subjective well-being significantly improved following the Z-GROW intervention. It was further shown that the improved state of participants was sustained through a 3-monthfollow-up assessment. CONCLUSION Based on the findings, it can be concluded that intervention using GROW coaching in the zoom platform improves the self-reported well-being of school administrators. The outcomes of this study present the Z-GROW model as a viable intervention for subjective well-being and other mental health conditions among school administrators. Through the Z-GROW model, employees can access occupational health coaching from the comfort of their homes.
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Key Words
- FS, flourishing scale
- GROW, Goal setting, Reality, Option, and Will
- Online intervention
- SD, standard deviation
- SPANE, Scale of positive and negative affect
- SWB, subjective well-being
- SWLS, Satisfaction with life scale
- School administrators
- Subjective well-being
- WL, waitlist
- Well-being
- Z-GROW, Zoom-based GROW
- Zoom-based GROW model
- p, p-value
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Affiliation(s)
- Cornelius O Okorie
- Department of Political Science, Alex Ekwueme Federal University, Ndufu Alike, Ikwo, Ebonyi State, Nigeria
| | - Francisca N Ogba
- Department Educational Foundations, Alex Ekwueme Federal University, Ndufu Alike, Ikwo, Ebonyi State, Nigeria
| | - Benjamin A Amujiri
- Department of Public Administration and Local Government, University of Nigeria, Nsukka, Nigeria
| | - Felix M Nwankwo
- Department of Political Science, Alex Ekwueme Federal University, Ndufu Alike, Ikwo, Ebonyi State, Nigeria
| | - Theresa O Oforka
- Department of Educational Foundations, University of Nigeria, Nsukka, Nigeria
| | - Ntasiobi C N Igu
- Department Educational Foundations, Alex Ekwueme Federal University, Ndufu Alike, Ikwo, Ebonyi State, Nigeria
| | - Christopher C Arua
- Department of Political Science, Alex Ekwueme Federal University, Ndufu Alike, Ikwo, Ebonyi State, Nigeria
| | - Basil N Nwamuo
- Ebonyi State College of Education, Ebonyi State, Nigeria
| | - Charles N Okolie
- Department of Philisophy/Religion, Alex Ekwueme Federal University, Ndufu Alike, Ikwo, Ebonyi State, Nigeria
| | - Esther O Ogbu
- Department of Philisophy/Religion, Alex Ekwueme Federal University, Ndufu Alike, Ikwo, Ebonyi State, Nigeria
| | - Kingsley N Okoro
- Department of Philisophy/Religion, Alex Ekwueme Federal University, Ndufu Alike, Ikwo, Ebonyi State, Nigeria
| | - Kingsley C Solomon
- Department of Philisophy/Religion, Alex Ekwueme Federal University, Ndufu Alike, Ikwo, Ebonyi State, Nigeria
| | - Bright E Nwamuo
- Department of History and Strategic Studies, Alex Ekwueme Federal University, Ndufu Alike, Ikwo, Ebonyi State, Nigeria
| | - Livinus O Akudolu
- Department of Philisophy/Religion, Alex Ekwueme Federal University, Ndufu Alike, Ikwo, Ebonyi State, Nigeria
| | - Victor O Ukaogo
- Department of History and International Studies, University of Nigeria, Nsukka, Nigeria
| | - Florence O Orabueze
- Department of English and Literary Studies, University of Nigeria, Nsukka, Nigeria
| | | | - Casimir K C Ani
- Strategic Contact Ethics and Publications, University of Nigeria, Nsukka, Nigeria
| | - Harrison O Iwuala
- Department of Political Science, Alex Ekwueme Federal University, Ndufu Alike, Ikwo, Ebonyi State, Nigeria
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Eichenberg C, Aranyi G, Rach P, Winter L. Therapeutic alliance in psychotherapy across online and face-to-face settings: A quantitative analysis. Internet Interv 2022; 29:100556. [PMID: 35942217 PMCID: PMC9350857 DOI: 10.1016/j.invent.2022.100556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 06/30/2022] [Accepted: 07/04/2022] [Indexed: 11/23/2022] Open
Abstract
Lockdown enacted by government in response to the Covid-19 pandemic in Austria forced psychotherapy practice into an online-only setting for several months in 2020. Although there is evidence supporting the effectiveness of psychotherapy in remote settings, research investigating therapeutic alliance in online psychotherapy is still limited, with a specific need for research in assessing possible effects of changes in therapeutic setting from face-to-face to online and vice versa. We measured therapeutic alliance in client-therapist dyads using the Helping Alliance Questionnaire (HAQ) at the Adult Outpatient Clinic of Sigmund Freud University, Vienna. Eighty-seven dyads completed HAQ twice, assessing three time-points: after switching from face-to-face to online therapy, providing a retrospective assessment of their alliance before the setting change as well as a concurrent account of their experience during online therapy, then another assessment after switching back to face-to-face setting after lockdown restrictions were lifted. Data were analysed by fitting a multilevel linear model, where the variables person (client/therapist) and time (before online therapy; online therapy; back to face-to-face) were nested within the client-therapist dyad. We found a statistically significant small improvement in the quality of therapeutic alliance over time, but no differences due to change in therapeutic setting. Separate analysis of HAQ sub-scales revealed that clients rated their relationship statistically significantly higher than their therapists with medium effect size, while there were no differences in success ratings over time and settings, nor between clients and therapists. The findings support the feasibility of online therapy in terms of therapeutic alliance in general, and alternating between face-to-face and online therapy settings in particular.
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Affiliation(s)
- Christiane Eichenberg
- Sigmund Freud Private University, Institute of Psychosomatic, Faculty of Medicine, Vienna, Austria
| | - Gabor Aranyi
- Institute of Education and Psychology at Szombathely, Faculty of Education and Psychology, Eotvos Lorand University, Hungary
- Sigmund Freud Private University, Faculty of Psychotherapy Science, Vienna, Austria
| | - Paul Rach
- Sigmund Freud Private University, Faculty of Psychotherapy Science, Vienna, Austria
| | - Lisa Winter
- Sigmund Freud Private University, Faculty of Psychotherapy Science, Vienna, Austria
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