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Tajan N, Devès M, Potier R. Tele-psychotherapy during the COVID-19 pandemic: a mini-review. Front Psychiatry 2023; 14:1060961. [PMID: 37476543 PMCID: PMC10354254 DOI: 10.3389/fpsyt.2023.1060961] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 06/14/2023] [Indexed: 07/22/2023] Open
Abstract
The COVID-19 pandemic has dramatically changed psychotherapy practices. Psychotherapy around the world has shifted from predominantly face-to-face settings to overwhelmingly online settings since the beginning of the pandemic. Many studies have been published on this topic, but there has been no review of the literature focused on the experience of psychotherapists. Our goal was to identify the challenging issues of teletherapy, including the efficiency of online consultations and the extent to which they are accepted by therapists and patients. A PubMed literature search using the [("Teletherapy" OR "Telebehavioral health" OR "telepsychotherapy") AND ("COVID-19")] search string retrieved 46 studies focused on mental health professionals, as detailed in a PRISMA flow diagram. Two reviewers independently screened the abstracts and excluded those that were outside the scope of the review. The selection of articles kept for review was discussed by all three authors. Overall, the review contributes to the description and evaluation of tele mental health services, including teletherapy, online counseling, digital mental health tools, and remote monitoring.
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Affiliation(s)
- Nicolas Tajan
- Laboratory of Psychopathology and Psychoanalysis, Graduate School of Human and Environmental Studies, Kyoto University, Kyoto, Japan
| | - Maud Devès
- Institut de Physique du Globe de Paris, CNRS, Université Paris Cité, Paris, France
- Centre de Recherche Psychanalyse Médecine et Société, CNRS, Université Paris Cité, Paris, France
| | - Rémy Potier
- Centre de Recherche en Psychopathologie et Psychologie Clinique, Institut de Psychologie, Université Lumière Lyon 2, Lyon, France
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von Below C, Bergsten J, Midbris T, Philips B, Werbart A. It turned into something else: patients' long-term experiences of transitions to or from telepsychotherapy during the COVID-19 pandemic. Front Psychol 2023; 14:1142233. [PMID: 37251023 PMCID: PMC10213395 DOI: 10.3389/fpsyg.2023.1142233] [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: 01/11/2023] [Accepted: 04/21/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction The shift from in-person therapy to telepsychotherapy during the COVID-19 pandemic was unprepared for, sudden, and inevitable. This study explored patients' long-term experiences of transitions to telepsychotherapy and back to the office. Methods Data were collected approximately two years after the declaration of COVID-19 as a pandemic. Eleven patients were interviewed (nine women and two men, aged 28 to 56, six in psychodynamic psychotherapy, five in CBT). Treatments switched between in-person and video/telephone sessions. Interview transcripts were analyzed applying the qualitative methodology of inductive thematic analysis. Results (1) The patients experienced the process in telepsychotherapy as impeded. Interventions were difficult to understand and lost impact. Routines surrounding the therapy sessions were lost. Conversations were less serious and lost direction. (2) Understanding was made more difficult when the nuances of non-verbal communication were lost. (3) The emotional relationship was altered. Remote therapy was perceived as something different from regular therapy, and once back in the therapy room, the patients felt that therapy started anew. The emotional presence was experienced as weakened, but some of the patients found expressing their feelings easier in the absence of bodily co-presence. According to the patients, in-person presence contributed to their security and trust, whereas they felt that the therapists were different when working remotely, behaving in a more easygoing and familiar way, as well as more solution-focused, supportive and unprofessional, less understanding and less therapeutic. Despite this, (4) telepsychotherapy also gave the patients an opportunity to take therapy with them into their everyday lives. Discussion The results suggest that in the long run, remote psychotherapy was seen as a good enough alternative when needed. The present study indicates that format alternations have an impact on which interventions can be implemented, which can have important implications for psychotherapy training and supervision in an era when telepsychotherapy is becoming increasingly common.
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Bani M, Ardenghi S, Rampoldi G, Russo S, Strepparava MG. Impact of facemasks on psychotherapy: Clinician's confidence and emotion recognition. J Clin Psychol 2023; 79:1178-1191. [PMID: 36459660 PMCID: PMC9877818 DOI: 10.1002/jclp.23468] [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: 05/02/2022] [Revised: 10/04/2022] [Accepted: 11/20/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVES Facial emotion recognition is a key component of human interactions, and in clinical relationships contributes to building and maintaining the therapeutic alliance with patients. The introduction of facemasks has reduced the availability of facial information in private and professional relationships. This study aimed to assess the impact of facemasks on clinicians' perception of clinical interactions as well as their ability to read facial expressions. METHODS In this cross-sectional study, a purposive sample of 342 clinical psychologists or psychotherapists completed an online survey including the assessment of burnout, alexithymia, emotion dysregulation, and self-perceived ability to build effective relationships and communication with patients with/without facemasks. Participants were randomly assigned to the standardized facial emotion recognition task Diagnostic Analysis of Nonverbal Accuracy FACES 2-Adult Faces including 24 faces representing anger, fear, sadness, and happiness. RESULTS Facemasks impaired the self-perceived ability of clinicians to build effective relationships and communicate with patients and reduced satisfaction in clinical encounters. The ability of clinicians to recognize facial emotions is significantly reduced for masked happy and angry faces, but not for sad and afraid ones. The perceived difficulty in building good relationships and communication with patients had a positive correlation with alexithymia and emotion dysregulation; higher levels of discomfort when wearing facemasks had a positive correlation with burnout and emotion dysregulation. CONCLUSION Facemasks reduced clinicians' self-confidence in clinical encounters with patients wearing facemasks, but their facial emotion recognition performance was only partially impaired.
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Affiliation(s)
- Marco Bani
- School of Medicine and Surgery, University of Milano-Bicocca, Monza (MB), Italy
| | - Stefano Ardenghi
- School of Medicine and Surgery, University of Milano-Bicocca, Monza (MB), Italy
| | - Giulia Rampoldi
- School of Medicine and Surgery, University of Milano-Bicocca, Monza (MB), Italy
| | - Selena Russo
- School of Medicine and Surgery, University of Milano-Bicocca, Monza (MB), Italy
| | - Maria Grazia Strepparava
- School of Medicine and Surgery, University of Milano-Bicocca, Monza (MB), Italy.,Department of Mental Health, Clinical Psychology Unit, San Gerardo Hospital, ASST-Monza, Monza (MB), Italy
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Singh J, Karanika-Murray M, Baguley T, Hudson J. Work-related experiences of mental health professionals during COVID-19 pandemic: a qualitative study. COUNSELLING PSYCHOLOGY QUARTERLY 2023. [DOI: 10.1080/09515070.2023.2180618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Affiliation(s)
- Jasmeet Singh
- Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK
| | - Maria Karanika-Murray
- Department of Work, Employment, Management and Organisations, School of Business, University of Leicester, Leicester, UK
| | - Thom Baguley
- Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK
| | - John Hudson
- Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK
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Morgan A, Davies C, Olabi Y, Hope-Stone L, Cherry MG, Fisher P. Therapists' experiences of remote working during the COVID-19 pandemic. Front Psychol 2022; 13:966021. [PMID: 36591020 PMCID: PMC9802664 DOI: 10.3389/fpsyg.2022.966021] [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: 06/10/2022] [Accepted: 11/15/2022] [Indexed: 12/23/2022] Open
Abstract
Objectives To explore the experiences of therapists who delivered remote psychological therapy during the COVID-19 pandemic. Design This was a qualitative, phenomenological study. Interpretative Phenomenological Analysis elicited themes from semi-structured interviews. Methods A purposive sample of eight therapists was recruited from breast cancer services in the United Kingdom. Results Analysis identified three superordinate themes. Participants spoke about how their experience of remote working changed over time from an initial crisis response to a new status quo. They adapted to the specific practical and personal challenges of remote working and struggled to connect with clients as the use of technology fundamentally changed the experience of therapy. Conclusion Consideration should be given to the impact of remote working on therapists and the quality of their practise. Adjustments to ways of working can help to maximize the advantages of remote working while minimizing potential issues.
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Affiliation(s)
- Andrew Morgan
- Primary Care and Mental Health, University of Liverpool, Liverpool, United Kingdom,Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Cari Davies
- Primary Care and Mental Health, University of Liverpool, Liverpool, United Kingdom,Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom,*Correspondence: Cari Davies,
| | - Yasmine Olabi
- Primary Care and Mental Health, University of Liverpool, Liverpool, United Kingdom,Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Laura Hope-Stone
- Primary Care and Mental Health, University of Liverpool, Liverpool, United Kingdom,Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Mary Gemma Cherry
- Primary Care and Mental Health, University of Liverpool, Liverpool, United Kingdom,Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Peter Fisher
- Primary Care and Mental Health, University of Liverpool, Liverpool, United Kingdom,Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom
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Margherita G, Muzii B, Caffieri A, Di Francia A, Somma B. 'Isolated together': online group treatments during the COVID-19 pandemic. A systematic review. RESEARCH IN PSYCHOTHERAPY (MILANO) 2022; 25:639. [PMID: 36373389 PMCID: PMC9893046 DOI: 10.4081/ripppo.2022.639] [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: 06/14/2022] [Accepted: 10/03/2022] [Indexed: 11/09/2022]
Abstract
Considering the emerging need to face the negative impact of the pandemic on mental health, social support, and access to health services, it became a critical issue to adapt to online group settings and create new group interventions to face the developing distress during this time. The aim of the current study is to investigate the main findings on OPGI conducted during the COVID-19 pandemic from March 2020 until March 2022, with a particular focus on: i) the therapeutic group factors; ii) what kind of OPGI works and for whom; iii) settings and emerging dimensions. In accordance with PRISMA guidelines, we performed a systematic review on scientific databases (PsychINFO, PubMed, Web of Science and EBSCO) searching for studies published between March 2020 and March 2022. 'Group intervention' or 'group therapy' or 'group treatment' crossed with 'COVID-19' and synonymous, were used as keywords. Internet based intervention was used as an eligibility criteria during the full-text screening. A total of 1326 articles were identified, of which 24 met the inclusion criteria. Among all studies, with different participants and different orientations, data extracted supported psychological online group interventions as an effective approach to reducing psychological distress and increasing psychological resources in the interpersonal field. Our findings also showed that COVID-19 has led to new needs and issues, that require the investigation of new dimensions for online psychological interventions. Methodological and clinical implications will be discussed through a descriptive table related to setting characteristics. Recommendations are made for future research.
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Affiliation(s)
- Giorgia Margherita
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy,I.I.P.G., Italian Institute of Group Psychoanalysis and European Federation for Psychoanalytic Psychotherapy in the Public Sector, Rome, Italy,Department of Humanistic Studies, University of Naples Federico II, Naples, Italy.
| | - Benedetta Muzii
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
| | - Alessia Caffieri
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
| | - Adriana Di Francia
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
| | - Brenda Somma
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
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Fernández O, Espinosa HD, Krause M, Altimir C, Mantilla C, Paz C, Lozano AG, Argumedo D, De La Cerda C, Juan S, Fernández S, Lancho MP, Fernández-Álvarez J. Personal experience of Latin American therapists on their clinical practice during the COVID-19 pandemic ( Experiencia personal de terapeutas latinoamericanos sobre su práctica clínica durante la pandemia por COVID-19). STUDIES IN PSYCHOLOGY 2022. [DOI: 10.1080/02109395.2022.2133456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
| | | | | | | | | | - Clara Paz
- Universidad de las Américas, Ecuador
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Maresca G, Formica C, De Cola MC, Lo Buono V, Latella D, Cimino V, Carnazza L, Giambò FM, Parasporo N, Bramanti A, Corallo F. Care models for mental health in a population of patients affected by COVID-19. J Int Med Res 2022; 50:3000605221097478. [PMID: 35531918 PMCID: PMC9092593 DOI: 10.1177/03000605221097478] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective Emergency psychological interventions are needed in patients with COVID-19. During the pandemic, psychological counseling services have been provided using online platforms to address adverse psychological impacts and symptoms in patients and the general population. We investigated the effects of telepsychotherapy on emotional well-being and psychological distress in patients affected by COVID-19. Methods Forty-five Sicilian patients who had contracted COVID-19 joined “Telecovid Sicilia” from March to June 2020. Participants completed self-assessment questionnaires and psychological testing to measure levels of anxiety, presence of depressive symptoms, and altered circadian rhythm with consequent sleep disorders and psychological distress. Individual telepsychotherapy services were provided for 1 hour, twice a week, for 16 sessions in total. Results We enrolled 45 patients (42.2% women). We found significant changes between baseline and the end of follow-up in all outcome measures, especially depression (χ2 (1) = 30.1; effect size [ES] = 0.82), anxiety (χ2 (1) = 37.4; ES = 0.91), and paranoid ideation (χ2 (1) = 5.6; ES = 0.35). The proportion of participants with sleep disorders decreased to 84.1% after intervention (χ2 (1) = 58.6; ES = 1.14). Conclusion A telepsychotherapeutic approach showed promising effects on psychological symptoms, with significantly reduced patient anxiety and depression.
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Affiliation(s)
| | | | | | | | | | | | - Lara Carnazza
- IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
| | | | | | - Alessia Bramanti
- Department of Medicine Surgery and Dentistry ‘Salerno Medical School', University of Salerno, Fisciano, Italy
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Stefan R, Mantl G, Höfner C, Stammer J, Hochgerner M, Petersdorfer K. Remote Psychotherapy During the COVID-19 Pandemic. Experiences With the Transition and the Therapeutic Relationship. A Longitudinal Mixed-Methods Study. Front Psychol 2021; 12:743430. [PMID: 34899484 PMCID: PMC8651537 DOI: 10.3389/fpsyg.2021.743430] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 11/02/2021] [Indexed: 11/13/2022] Open
Abstract
Aims: Research conducted prior to the onset of the COVID-19 pandemic indicates that remote psychotherapy is as effective as in-person treatment. At that time, it usually was the therapist's individual choice to work remotely, whereas the pandemic pushed psychotherapists, including previous skeptics, to incorporate remote work methods into their routine due to limited face-to-face contact. There is little knowledge of the way therapists experienced this sudden and forced transition to remote psychotherapy as the only treatment option. The present study aims to assess psychotherapists' experience and proficiency delivering remote psychotherapy as well as to investigate perceived changes in the psychotherapeutic relationship. Methods: An online survey was administered to psychotherapists of the Austrian Association for Group Therapy and Group Dynamics (ÖAGG). Three test periods (t) were set (t1: April, 2020 with N = 175; t2: May-June, 2020 with N = 177; t3: November-December, 2020 with N = 113). Research was conducted longitudinally using a mixed-methods research design. Results: While psychotherapists' levels of experience with telephone-based psychotherapy remained similar across all test periods, they became slightly more experienced using video therapy over the test period observed. However, they continued to feel less experienced compared to the use of telephone-based psychotherapy. The therapeutic relationship appeared to improve over the course of the first two test periods, while the third period showed a slight decline. No general deterioration of the psychotherapeutic relationship was found in the timespan studied. Conclusion: Despite many challenges and concerns, psychotherapists seem to adapt and enhance their skills in remote psychotherapy over time. The present paper confirms and enhances previous findings in the field due to its longitudinal approach. Remote psychotherapy can be a credible and trustworthy alternative to in-person treatment to be adopted and implemented on principle by a majority of psychotherapists regardless of their orientation. Furthermore, it sheds light on chances, problems und general observations regarding the comprehensive provision of remote psychotherapy in a pandemic situation.
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Affiliation(s)
- Robert Stefan
- Österreichischer Arbeitskreis für Gruppentherapie und Gruppendynamik, Vienna, Austria
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