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McCoy K, Moreland-Johnson A, Wade S, Quinones K, Swiecicki C, Hanson R. Therapist Participation in a Learning Collaborative on Trauma-Focused Cognitive Behavioral Therapy: Impact of COVID-related Stressors and Challenges. Community Ment Health J 2024; 60:1006-1016. [PMID: 38619697 DOI: 10.1007/s10597-024-01256-9] [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: 06/22/2023] [Accepted: 02/17/2024] [Indexed: 04/16/2024]
Abstract
The rise in mental health problems during the COVID-19 pandemic amplified the need to improve access to evidence-based treatments (EBT) and necessitated changes in treatment delivery and training of mental health providers (MHPs). There is limited information on how the pandemic may have impacted MHPs' participation in training and treatment delivery. This study included 269 MHPs who participated in a Learning Collaborative (LC) focused on an EBT. Qualitative interviews conducted with 15 MHPs who participated in the LC during the pandemic identified facilitators and barriers to training participation and EBT delivery that included social support, technology challenges, and difficulty completing cases following the transition to telehealth. Quantitative results showed that MHPs in the peri-COVID cohorts completed significantly fewer cases and fewer consultation calls compared to those prior to the pandemic. Findings suggest that providing support to train MHPs and promote EBT delivery may be beneficial during times of heightened stress.
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Affiliation(s)
- Kelsey McCoy
- Department of Psychiatry, Medical University of South Carolina, South Carolina, USA.
- Present Address: Milestones Psychology, 28 W. 25th Street 10th Floor, New York, NY, 10010, USA.
| | | | - Shelby Wade
- Department of Psychiatry, Medical University of South Carolina, South Carolina, USA
| | - Kathy Quinones
- Department of Psychiatry, Medical University of South Carolina, South Carolina, USA
| | - Carole Swiecicki
- Department of Psychiatry, Medical University of South Carolina, South Carolina, USA
| | - Rochelle Hanson
- Department of Psychiatry, Medical University of South Carolina, South Carolina, USA
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2
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Kaier K, Knecht J, Nalbach L, Körner M. The impact of the Covid-19 pandemic on the effectiveness of psychosomatic rehabilitation in Germany. BMC Health Serv Res 2024; 24:719. [PMID: 38862923 PMCID: PMC11165732 DOI: 10.1186/s12913-024-11170-1] [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: 08/03/2023] [Accepted: 06/04/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND The aim of the present study is to investigate the impact of the Covid-19 pandemic on the effectiveness of psychosomatic rehabilitation. METHODS Between April 2019 and March 2022, a total of 18,388 patients from 7 rehabilitation centres could be included in the study. For each patient, score values from the HEALTH-49 and ICF AT-50 Psych questionnaires were calculated at the beginning and at the end of rehabilitation and the effectiveness of the rehabilitation program was determined by comparing the scores at the beginning and at the end of the rehabilitation programme. Using risk adjusted linear mixed models, three time intervals were compared: a pre-pandemic episode (April 2019 to March 2020), the first year of the pandemic (April 2020 to March 2021) and the second year of the pandemic (April 2021 to March 2022). RESULTS Overall, it can be stated that the pandemic has substantially impaired the effectiveness of psychosomatic rehabilitation measures. This phenomenon can be observed across a wide range of psychosocial markers and even two years after the start of the pandemic there is no end to the limited effectiveness. With regard to 'psychological and somatoform disorders', for example, there was a relative decrease in the effectiveness of the rehabilitation measure by 11.29% in the first year of the pandemic compared to the pre-pandemic episode, p < 0.001. In the second year of the pandemic, the effectiveness of the rehabilitation measure was still decreased by 8.8% compared to the pre-pandemic episode, p < 0.001. In addition, the evaluations show that a division of the pandemic effect into direct effects (on the individual) and indirect effects (via further complication of the occupational problem environment) can be made and that the pandemic-related complication of the occupational problem environment are still prevalent more than two years after the start of the pandemic. DISCUSSION The Covid-19 pandemic has had a significant impact on the psychosomatic rehabilitation programs reducing the effectiveness of treatment not only for a short period of time but constantly until March 2022. TRIAL REGISTRATION NUMBER DRKS00029669; Date of registration: 02/08/2022.
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Affiliation(s)
- Klaus Kaier
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Hugstetter Str. 49, 79106, Germany, Freiburg, Germany.
| | - Jakob Knecht
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Hugstetter Str. 49, 79106, Germany, Freiburg, Germany
| | - Lukas Nalbach
- Medical Psychology and Medical Sociology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Mirjam Körner
- Medical Psychology and Medical Sociology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
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3
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Cencetti G, Lucchini L, Santin G, Battiston F, Moro E, Pentland A, Lepri B. Temporal clustering of social interactions trades-off disease spreading and knowledge diffusion. J R Soc Interface 2024; 21:20230471. [PMID: 38166491 PMCID: PMC10761286 DOI: 10.1098/rsif.2023.0471] [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: 08/14/2023] [Accepted: 11/23/2023] [Indexed: 01/04/2024] Open
Abstract
Non-pharmaceutical measures such as preventive quarantines, remote working, school and workplace closures, lockdowns, etc. have shown effectiveness from an epidemic control perspective; however, they have also significant negative consequences on social life and relationships, work routines and community engagement. In particular, complex ideas, work and school collaborations, innovative discoveries and resilient norms formation and maintenance, which often require face-to-face interactions of two or more parties to be developed and synergically coordinated, are particularly affected. In this study, we propose an alternative hybrid solution that balances the slowdown of epidemic diffusion with the preservation of face-to-face interactions, that we test simulating a disease and a knowledge spreading simultaneously on a network of contacts. Our approach involves a two-step partitioning of the population. First, we tune the level of node clustering, creating 'social bubbles' with increased contacts within each bubble and fewer outside, while maintaining the average number of contacts in each network. Second, we tune the level of temporal clustering by pairing, for a certain time interval, nodes from specific social bubbles. Our results demonstrate that a hybrid approach can achieve better trade-offs between epidemic control and complex knowledge diffusion. The versatility of our model enables tuning and refining clustering levels to optimally achieve the desired trade-off, based on the potentially changing characteristics of a disease or knowledge diffusion process.
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Affiliation(s)
- Giulia Cencetti
- Digital Society Center, Fondazione Bruno Kessler, Trento, Italy
- Centre de Physique Théorique, CNRS, Aix-Marseille Univ, Université de Toulon, Marseille, France
| | - Lorenzo Lucchini
- DONDENA and BIDSA Research Centres—Bocconi University, Milan, Italy
| | - Gabriele Santin
- Digital Society Center, Fondazione Bruno Kessler, Trento, Italy
- Department of Environmental Sciences, Informatics and Statistics, University of Venice, Venezia, Italy
| | - Federico Battiston
- Department of Network and Data Science, Central European University, Vienna, Austria
| | - Esteban Moro
- Media Lab, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Mathematics & GISC, Universidad Carlos III de Madrid, Leganes, Spain
| | - Alex Pentland
- Media Lab, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Bruno Lepri
- Digital Society Center, Fondazione Bruno Kessler, Trento, Italy
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4
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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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5
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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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6
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Andreas S, Gablonski TC, Tschacher W, Gebhardt A, Rabung S, Schulz H, Kadur J. Long-term psychodynamic psychotherapy in a face-to-face versus videoconferencing setting: A single case study. J Clin Psychol 2023; 79:277-295. [PMID: 35819447 PMCID: PMC10084227 DOI: 10.1002/jclp.23411] [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: 10/05/2021] [Revised: 06/07/2022] [Accepted: 06/26/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Due to the coronavirus pandemic and crisis, psychotherapists around the world were forced to switch to video- or tele-based treatments overnight. To date, only a few studies on the effectiveness of video-based psychodynamic psychotherapy via the Internet exist. Therefore, the goal of the present study was to examine symptom improvement, therapeutic relationship, nonverbal synchrony processes, and intersession processes within a systematic single case design and compare face-to-face to video-based approaches in long-term psychodynamic-oriented psychotherapy. METHODS We examined 85 sessions of a client with major depression whose psychodynamic psychotherapy changed from a face-to-face setting to a video-based setting. Video recordings were analyzed using motion energy analysis, and nonverbal synchrony was computed using a surrogate synchrony approach. Time series analyses were performed to analyze changes in symptom severity, therapeutic relationship, and intersession processes. RESULTS The results showed that symptom severity improved descriptively, but not significantly, across the entire course of psychotherapy. There were significant differences, however, in the therapeutic relationship, intersession experiences, and synchronous behavior between the face-to-face and video-based settings. CONCLUSION The results indicate that the presented methodology is well situated to investigate the question whether psychodynamic psychotherapy in video-based setting works in the sameway as in a face-to-face setting.
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Affiliation(s)
- Sylke Andreas
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
| | - Thorsten-Christian Gablonski
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
| | - Wolfgang Tschacher
- University Hospital of Psychiatry and Psychotherapy, Experimental Psychology Division, University of Bern, Bern, Switzerland
| | - Albrecht Gebhardt
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
| | - Sven Rabung
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
| | - Holger Schulz
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jennifer Kadur
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
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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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8
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Winter S, Jesser A, Probst T, Schaffler Y, Kisler IM, Haid B, Pieh C, Humer E. How the COVID-19 Pandemic Affects the Provision of Psychotherapy: Results from Three Online Surveys on Austrian Psychotherapists. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1961. [PMID: 36767327 PMCID: PMC9915415 DOI: 10.3390/ijerph20031961] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
This study aimed to assess patient numbers and the format in which psychotherapy was delivered by Austrian psychotherapists during different time points of the COVID-19 pandemic and to explore psychotherapists` experiences on pandemic-associated changes in their psychotherapeutic work as well as their wishes for support in their professional activities. Three cross-sectional online surveys were conducted between March 2020 and May 2022. The total number of participating psychotherapists was n = 1547 in 2020, n = 238 in 2021, and n = 510 in 2022. The number of patients treated was highest in 2022 and lowest at the beginning of the pandemic (p < 0.001). During the lockdown in 2020, only 25.0% of patients were treated in personal contact. This proportion increased in the following years, reaching 86.9% in 2022 (p < 0.001). After a substantial increase in the proportion of patients treated via the telephone and internet during the first lockdown, both proportions decreased during the pandemics' second and third year (p < 0.001). However, a larger proportion of patients were treated via the internet in 2022 compared to pre-pandemic times (p < 0.001). Psychotherapists reported that the pandemic affected mainly the setting in which psychotherapy was provided (29.6%), the working conditions and workload (27.1%), as well as the demand for psychotherapy (26.9%). About one-third of psychotherapists expressed support wishes for their psychotherapeutic work. Results suggest that the pandemic went along with a partial shift in the provision of psychotherapy towards psychotherapy via the internet but not the telephone. The increase in patient numbers and psychotherapists` reports of increased workload suggest a rise in the demand for mental health care during and in the aftermath of the pandemic.
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Affiliation(s)
- Stefanie Winter
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
| | - Andrea Jesser
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
| | - Thomas Probst
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
| | - Yvonne Schaffler
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
| | | | - Barbara Haid
- Austrian Federal Association for Psychotherapy, 1030 Vienna, Austria
| | - Christoph Pieh
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
| | - Elke Humer
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
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9
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Fiala-Baumann B, Ploner H, Witzmann D, Jesser A. Säuglings‑, Kinder- und Jugendlichen- (SKJ) Psychotherapien während der Covid-19 Pandemie: Ergebnisse einer Studie unter psychodynamischen Psychotherapeut*innen in Österreich. PSYCHOTHERAPIE FORUM 2022. [PMCID: PMC9746562 DOI: 10.1007/s00729-022-00213-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Zusammenfassung
Fragestellung
Diese explorative Studie untersucht die Situation der Säuglings‑, Kinder- und Jugendlichen- (SKJ) Psychotherapien während der Covid-19 Pandemie in Österreich.
Methodik
23 psychodynamisch arbeitende Psychotherapeut*innen nahmen an einer Online-Umfrage teil, die quantitative und qualitative Daten generierte. Offene Fragen zu subjektiv wahrgenommenen Veränderungen wurden mithilfe der qualitativen Inhaltsanalyse ausgewertet.
Ergebnisse
Insgesamt sank die Anzahl an Psychotherapien insbesondere bei den Säuglings- und Kleinkind-Psychotherapien. Die Zahl der Kinder und Jugendlichen-Psychotherapien nahm zunächst ab, stieg nach dem ersten Lockdown aber an. Große Nachfrage wurde zuletzt vor allem bei Jugendlichenpsychotherapien wahrgenommen. Anpassungsleistungen an sich ändernde Bedingungen und Settings erforderten große Flexibilität der Psychotherapeut*innen, die mit Fortschreiten der Pandemie zunehmend an ihre Belastungsgrenzen kamen. Befragte beobachteten eine Zunahme an Symptomen sowie einen gestiegenen Bedarf an Eltern- und Vernetzungsarbeit mit Institutionen.
Schlussfolgerungen
Tele-Psychotherapie kann vor allem mit jüngeren Kindern Präsenztherapie nicht ersetzen. Ergebnisse deuten auf eine Unterversorgung dieser Zielgruppe hin. Dies, sowie die beobachtete Zunahme an Symptomen bei älteren Kindern und Jugendlichen, ist gesellschaftspolitisch und gesundheitsökonomisch ein großes Thema und erfordert dringend einen weiteren Ausbau der Versorgungsnetzwerke.
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Affiliation(s)
| | | | | | - Andrea Jesser
- Wissenschaftliche Arbeitsgruppe, D.O.T. – Die offene Tür, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Dr. Karl-Dorrek-Straße 30, 3500 Krems, Österreich
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10
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Schaffler Y, Kaltschik S, Probst T, Jesser A, Pieh C, Humer E. Mental health in Austrian psychotherapists during the COVID-19 pandemic. Front Public Health 2022; 10:1011539. [PMID: 36424964 PMCID: PMC9679414 DOI: 10.3389/fpubh.2022.1011539] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 10/20/2022] [Indexed: 11/09/2022] Open
Abstract
Although the impact of the COVID-19 pandemic on mental health has been reported in different communities, little is known about the mental health of psychotherapists during the COVID-19 pandemic. This study aimed to assess mental health during the COVID-19 pandemic in Austrian psychotherapists and compare it with the general population. A total of n = 513 psychotherapists (80.5% women; mean age: 53.06 ± 9.94 years) took part in an online survey conducted from April to June 2022. At the same time, a representative sample (N = 1,031) of the Austrian general population was surveyed online. Indicators of mental health were mental wellbeing (WHO-5), depression (PHQ-2), anxiety (GAD-2), insomnia (ISI-2), and stress (PSS-10). The general population sample was matched according to age and gender with the psychotherapist's data using propensity scores, yielding a final sample of n = 513 (80.5% women; mean age: 52.33 ± 13.39 years). Psychotherapists showed lower odds for exceeding cut-offs for clinically relevant depressive, anxiety, insomnia and stress symptoms (0.34-0.58) compared to the general population. Further studies should elucidate the protective factors underlying these findings.
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Affiliation(s)
| | | | | | | | | | - Elke Humer
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, Krems, Austria
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11
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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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12
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Zangani C, Ostinelli EG, Smith KA, Hong JSW, Macdonald O, Reen G, Reid K, Vincent C, Syed Sheriff R, Harrison PJ, Hawton K, Pitman A, Bale R, Fazel S, Geddes JR, Cipriani A. Impact of the COVID-19 Pandemic on the Global Delivery of Mental Health Services and Telemental Health: Systematic Review. JMIR Ment Health 2022; 9:e38600. [PMID: 35994310 PMCID: PMC9400843 DOI: 10.2196/38600] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/05/2022] [Accepted: 07/21/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic required mental health services around the world to adapt quickly to the new restrictions and regulations put in place to reduce the risk of transmission. As face-to-face contact became difficult, virtual methods were implemented to continue to safely provide mental health care. However, it is unclear to what extent service provision transitioned to telemental health worldwide. OBJECTIVE We aimed to systematically review the global research literature on how mental health service provision adapted during the first year of the pandemic. METHODS We searched systematically for quantitative papers focusing on the impact of the COVID-19 pandemic on mental health services published until April 13, 2021, in the PubMed, Embase, medRxiv, and bioXriv electronic bibliographic databases, using the COVID-19 Open Access Project online platform. The screening process and data extraction were independently completed by at least two authors, and any disagreement was resolved by discussion with a senior member of the team. The findings were summarized narratively in the context of each country's COVID-19 Stringency Index, which reflects the stringency of a government's response to COVID-19 restrictions at a specific time. RESULTS Of the identified 24,339 records, 101 papers were included after the screening process. Reports on general services (n=72) showed that several countries' face-to-face services reduced their activities at the start of the pandemic, with reductions in the total number of delivered visits and with some services forced to close. In contrast, telemental health use rapidly increased in many countries across the world at the beginning of the pandemic (n=55), with almost complete virtualization of general and specialistic care services by the end of the first year. Considering the reported COVID-19 Stringency Index values, the increased use of virtual means seems to correspond to periods when the Stringency Index values were at their highest in several countries. However, due to specific care requirements, telemental health could not be used in certain subgroups of patients, such as those on clozapine or depot treatments and those who continued to need face-to-face visits. CONCLUSIONS During the pandemic, mental health services had to adapt quickly in the short term, implementing or increasing the use of telemental health services across the globe. Limited access to digital means, poor digital skills, and patients' preferences and individual needs may have contributed to differences in implementing and accessing telemental health services during the pandemic. In the long term, a blended approach, combining in-person and virtual modalities, that takes into consideration the needs, preferences, and digital skills of patients may better support the future development of mental health services. It will be required to improve confidence with digital device use, training, and experience in all modalities for both clinicians and service users.
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Affiliation(s)
- Caroline Zangani
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | | | - Katharine A Smith
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - James S W Hong
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Orla Macdonald
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, United Kingdom
| | - Gurpreet Reen
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - Katherine Reid
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, United Kingdom
| | - Charles Vincent
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | | | - Paul J Harrison
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Keith Hawton
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Alexandra Pitman
- Division of Psychiatry, University College London, London, United Kingdom
| | - Rob Bale
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, United Kingdom
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - John R Geddes
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Andrea Cipriani
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, United Kingdom
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13
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A Large-Scale Dataset of Twitter Chatter about Online Learning during the Current COVID-19 Omicron Wave. DATA 2022. [DOI: 10.3390/data7080109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
The COVID-19 Omicron variant, reported to be the most immune-evasive variant of COVID-19, is resulting in a surge of COVID-19 cases globally. This has caused schools, colleges, and universities in different parts of the world to transition to online learning. As a result, social media platforms such as Twitter are seeing an increase in conversations related to online learning in the form of tweets. Mining such tweets to develop a dataset can serve as a data resource for different applications and use-cases related to the analysis of interest, views, opinions, perspectives, attitudes, and feedback towards online learning during the current surge of COVID-19 cases caused by the Omicron variant. Therefore, this work presents a large-scale, open-access Twitter dataset of conversations about online learning from different parts of the world since the first detected case of the COVID-19 Omicron variant in November 2021. The dataset is compliant with the privacy policy, developer agreement, and guidelines for content redistribution of Twitter, as well as with the FAIR principles (Findability, Accessibility, Interoperability, and Reusability) principles for scientific data management. The paper also briefly outlines some potential applications in the fields of Big Data, Data Mining, Natural Language Processing, and their related disciplines, with a specific focus on online learning during this Omicron wave that may be studied, explored, and investigated by using this dataset.
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A web-survey assessed attitudes toward evidence-based practice among psychotherapists in Austria. Sci Rep 2022; 12:9374. [PMID: 35672342 PMCID: PMC9172095 DOI: 10.1038/s41598-022-13266-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 05/23/2022] [Indexed: 01/05/2023] Open
Abstract
Evidence-based practice (EBP) means integrating the best available scientific evidence with clinical experience and patient values. Although perceived as important by many psychotherapists, there still seems to be reluctance to use empirically supported therapies in clinical practice. We aimed to assess the attitudes of psychotherapists in Austria toward EBP in psychotherapy as well as factors influencing the implementation of EBP. We conducted an online survey. To investigate attitudes toward EBP, we used two subscales (“Limitations” and “Balance”) of a translated and validated short version of the Evidence-Based Practice Attitude Scale-36 (EBPAS-36). Participants provided perceived barriers and facilitators as answers to open-ended questions. We analyzed the responses mainly using descriptive statistics. Open answers were analyzed using a thematic analysis. In total, 238 psychotherapists completed our survey (mean age 51.0 years, standard deviation [SD] = 9.9, 76.9% female). Psychotherapists scored on average 2.62 (SD = 0.89) on the reversed EBPAS-36 subscale “Limitations,” indicating that the majority do not perceive EBP as limiting their practice as psychotherapists. They scored 1.43 (SD = 0.69) on the reversed EBPAS-36 subscale “Balance,” indicating that psychotherapists on average put a higher value on the art of psychotherapy than on evidence-based approaches. Organizational factors such as lack of time and access to research studies as well as negative attitudes toward research and a lack of skills and knowledge kept respondents from implementing EBP. Our study highlights that EBP is still not very popular within the psychotherapy community in Austria. The academization of psychotherapy training might change this in the future.
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Schaffler Y, Kuska M, Barke A, Doering BK, Gossmann K, Meier Z, Kascakova N, Tavel P, Humer E, Pieh C, Stippl P, Schimböck W, Haid B, Probst T. Psychotherapists' Reports regarding the Impact of the COVID-19 Pandemic on Their Patients: A Cross-National Descriptive Study Based on the Social-Ecological Model (SEM). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6825. [PMID: 35682406 PMCID: PMC9180390 DOI: 10.3390/ijerph19116825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/29/2022] [Accepted: 05/31/2022] [Indexed: 11/28/2022]
Abstract
The COVID-19 outbreak has raised questions about how vulnerable groups experience the pandemic. Research that focuses on the view of individuals with pre-existing mental health conditions is still limited, and so are cross-country comparative surveys. We gathered our sample of qualitative data during the first lockdown after governmental measures against the spread of the SARS-CoV-2 virus came into force in Austria, Czechia, Germany, and Slovakia. A total of n = 1690 psychotherapists from four middle European countries answered the question of how the COVID-19 pandemic was addressed in sessions by their patients during the early stage of unprecedented public health conditions. We employed a descriptive qualitative methodology to determine themes following levels of the social-ecological model (SEM) regarding how the COVID-19 pandemic affected patients. At the public policy level, stressful environmental conditions concerned the governmental mitigation efforts. At the level of community/society, reported key themes were employment, restricted access to educational and health facilities, socioeconomic consequences, and the pandemic itself. Key themes at the interpersonal level regarded forced proximity, the possibility of infection of loved ones, childcare, and homeschooling. Key themes at the individual level were the possibility of contracting COVID-19, having to stay at home/isolation, and a changing environment. Within the SEM framework, adaptive and maladaptive responses to these stressors were reported, with more similarities than differences between the countries. A quantification of word stems showed that the maladaptive reactions predominated.
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Affiliation(s)
- Yvonne Schaffler
- Department for Psychosomatic Medicine and Psychotherapy, Danube University Krems, 3500 Krems, Austria; (M.K.); (E.H.); (C.P.); (T.P.)
| | - Martin Kuska
- Department for Psychosomatic Medicine and Psychotherapy, Danube University Krems, 3500 Krems, Austria; (M.K.); (E.H.); (C.P.); (T.P.)
- College of Applied Psychology, 41155 Terezin, Czech Republic
| | - Antonia Barke
- Clinical and Biological Psychology, Catholic University of Eichstätt-Ingolstadt, 85072 Eichstätt, Germany; (A.B.); (K.G.)
| | - Bettina K. Doering
- Clinical Psychology and Psychotherapy, Brandenburg Medical School Theodor Fontane, 16861 Neuruppin, Germany;
| | - Katharina Gossmann
- Clinical and Biological Psychology, Catholic University of Eichstätt-Ingolstadt, 85072 Eichstätt, Germany; (A.B.); (K.G.)
| | - Zdenek Meier
- Olomouc University Social Health Institute (OUSHI), Palacky University Olomouc, 77111 Olomouc, Czech Republic; (Z.M.); (N.K.); (P.T.)
| | - Natalia Kascakova
- Olomouc University Social Health Institute (OUSHI), Palacky University Olomouc, 77111 Olomouc, Czech Republic; (Z.M.); (N.K.); (P.T.)
- Psychiatric-Psychotherapeutic Outpatient Clinic, Pro Mente Sana, 81108 Bratislava, Slovakia
| | - Peter Tavel
- Olomouc University Social Health Institute (OUSHI), Palacky University Olomouc, 77111 Olomouc, Czech Republic; (Z.M.); (N.K.); (P.T.)
| | - Elke Humer
- Department for Psychosomatic Medicine and Psychotherapy, Danube University Krems, 3500 Krems, Austria; (M.K.); (E.H.); (C.P.); (T.P.)
| | - Christoph Pieh
- Department for Psychosomatic Medicine and Psychotherapy, Danube University Krems, 3500 Krems, Austria; (M.K.); (E.H.); (C.P.); (T.P.)
| | - Peter Stippl
- Austrian Federal Association for Psychotherapy, 1030 Vienna, Austria; (P.S.); (W.S.); (B.H.)
| | - Wolfgang Schimböck
- Austrian Federal Association for Psychotherapy, 1030 Vienna, Austria; (P.S.); (W.S.); (B.H.)
| | - Barbara Haid
- Austrian Federal Association for Psychotherapy, 1030 Vienna, Austria; (P.S.); (W.S.); (B.H.)
| | - Thomas Probst
- Department for Psychosomatic Medicine and Psychotherapy, Danube University Krems, 3500 Krems, Austria; (M.K.); (E.H.); (C.P.); (T.P.)
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16
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Beurs E, Blankers M, Peen J, Rademacher C, Podgorski A, Dekker J. Impact of COVID‐19 social distancing measures on routine mental health care provision and treatment outcome for common mental disorders in the Netherlands. Clin Psychol Psychother 2022; 29:1342-1354. [PMID: 35068003 PMCID: PMC9015637 DOI: 10.1002/cpp.2713] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 01/13/2022] [Accepted: 01/17/2022] [Indexed: 11/24/2022]
Abstract
Objective The uptake of digital interventions in mental health care (MHC) has been slow, as many therapists and patients believe that in‐person contact is essential for establishing a good working relationship and good outcomes in treatment. The public health policies regarding social distancing during the coronavirus disease‐2019 (COVID‐19) pandemic forced an abrupt transformation of MHC provisions for outpatients: Since mid‐March 2020, nearly all in‐person contact was replaced with videoconferencing. The COVID‐19 crisis offered a unique opportunity to investigate whether MHC with videoconferencing yields inferior results as compared to in‐person interventions. Method In a large urban MHC facility in the Netherlands, measurement‐based care is routine practice. Outcome data are regularly collected to support shared decision making and monitor patient progress. For this study, pretest and post‐test data were used to compare outcomes for three cohorts: treatments performed prior to, partially during and entirely during the COVID‐19 lockdown. Outcomes were compared in two large data sets: Basic MHC (N = 1392) and Specialized MHC (N = 1040). Results Therapeutic outcomes appeared robust for COVID‐19 conditions across the three cohorts: No differences in outcomes were found between treatments that were conducted during lockdown compared to in‐person treatments prior to COVID‐19, or treatments which started in‐person, but needed to be continued by means of videoconferencing. Discussion Videoconferencing care during the COVID‐19 pandemic had similar outcomes compared to traditional in‐person care. These real‐world results corroborate findings of previous randomized controlled studies and meta‐analyses in which videoconferencing and in‐person care has been directly compared in terms of clinical effectiveness.
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Affiliation(s)
- Edwin Beurs
- Arkin Mental Health Care NN Amsterdam Netherlands
- Leiden Universiteit, Department of Clinical Psychology AK Leiden Netherlands
| | - Matthijs Blankers
- Arkin Mental Health Care NN Amsterdam Netherlands
- Amsterdam University Medical Center, Location AMC, Department of Psychiatry AZ Amsterdam The Netherlands
- Trimbos Institute VS Utrecht Netherlands
| | - Jaap Peen
- Arkin Mental Health Care NN Amsterdam Netherlands
| | - Clara Rademacher
- Leiden Universiteit, Department of Clinical Psychology AK Leiden Netherlands
| | - Alicja Podgorski
- Leiden Universiteit, Department of Clinical Psychology AK Leiden Netherlands
| | - Jack Dekker
- Arkin Mental Health Care NN Amsterdam Netherlands
- Vrije Universiteit, Department of Clinical Psychology BT Amsterdam Netherlands
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Jesser A, Muckenhuber J, Lunglmayr B. Psychodynamic Therapist's Subjective Experiences With Remote Psychotherapy During the COVID-19-Pandemic-A Qualitative Study With Therapists Practicing Guided Affective Imagery, Hypnosis and Autogenous Relaxation. Front Psychol 2022; 12:777102. [PMID: 35069358 PMCID: PMC8777098 DOI: 10.3389/fpsyg.2021.777102] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/06/2021] [Indexed: 11/30/2022] Open
Abstract
The COVID-19-pandemic brought massive changes in the provision of psychotherapy. To contain the pandemic, many therapists switched from face-to-face sessions in personal contact to remote settings. This study focused on psychodynamic therapists practicing Guided Affective Imagery, Hypnosis and Autogenous Relaxation and their subjective experiences with psychotherapy via telephone and videoconferencing during the first COVID-19 related lockdown period in March 2020 in Austria. An online survey completed by 161 therapists produced both quantitative and qualitative data with the latter being subject to a qualitative content analysis. Our research suggests that telephone and videoconferencing are considered valuable treatment formats to deliver psychodynamic psychotherapy. However, therapists' experiences with remote psychotherapy are multifaceted and ambiguous. In particular, the findings raise questions concerning the maintenance of the therapeutic alliance, the development of the analytic process, the sensitivity to unconscious communication, and the indication for certain types of patients that still need further investigation. Our research indicates that the long-standing reticence toward remote treatments offers among psychodynamic therapists is becoming more differentiated and partially dissolves as therapists gain experiences in their use. Attitudes are becoming more open. At the same time, the way is being prepared to take a closer look at the specific processes and dynamics of remote psychotherapy and to examine them critically in future studies.
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Affiliation(s)
- Andrea Jesser
- Department for Psychotherapy and Biopsychosocial Health, University for Continuing Education Krems, Danube University, Krems an der Donau, Austria
- Independent Researcher, Vienna, Austria
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18
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Romano V, Ancillotti M, Mascalzoni D, Biasiotto R. Italians locked down: people's responses to early COVID-19 pandemic public health measures. HUMANITIES & SOCIAL SCIENCES COMMUNICATIONS 2022; 9:342. [PMID: 36212915 PMCID: PMC9524326 DOI: 10.1057/s41599-022-01358-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 09/14/2022] [Indexed: 05/14/2023]
Abstract
At the beginning of 2020, the widespread diffusion of SARS-CoV-2 rapidly became a worldwide priority. In Italy, the government implemented a lockdown for more than two months (March 9-May 18). Aware of the uniqueness of such an experience, we designed an online qualitative study focused on three main dimensions: daily life during the lockdown, relationships with others, and public health issues. The aim was to gain insights into people's experiences of, and attitudes toward, the changes caused by public health measures implemented as a response to the COVID-19 pandemic. We conducted 18 semi-structured interviews with Italian residents. The interviewees were recruited through mediators using purposive sampling to obtain a balanced sample with respect to age, gender, education, and geographical residence. Interviews were analyzed through qualitative content analysis. The lockdown affected a variety of aspects of people's life, resulting in a significant re-shaping of daily activities and relationships. These changes, which entailed both positive and negative aspects, were met with resilience. Even though public health measures were generally considered acceptable and adequate, they were also perceived to generate uncertainty and stress as well as to reveal tensions within the public health system. When tasked with imagining a scenario with saturated intensive care units and the need for selection criteria, respondents showed a tendency to dodge the question and struggled to formulate criteria. Media and news were found to be confusing, leading to a renewed critical attitude toward information. The findings shed some light on the impact of the lockdown on people's daily life and its effects on relationships with others. Furthermore, the study contributes to an understanding of people's reasons for, and capacity to respond to, emergency public health measures.
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Affiliation(s)
- Virginia Romano
- Institute for Biomedicine, Eurac Research, Affiliated Institute of the University of Lübeck, Bolzano, Italy
| | - Mirko Ancillotti
- Centre for Research Ethics and Bioethics, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Deborah Mascalzoni
- Institute for Biomedicine, Eurac Research, Affiliated Institute of the University of Lübeck, Bolzano, Italy
- Centre for Research Ethics and Bioethics, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Roberta Biasiotto
- Centre for Research Ethics and Bioethics, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
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Appleton R, Williams J, Vera San Juan N, Needle JJ, Schlief M, Jordan H, Sheridan Rains L, Goulding L, Badhan M, Roxburgh E, Barnett P, Spyridonidis S, Tomaskova M, Mo J, Harju-Seppänen J, Haime Z, Casetta C, Papamichail A, Lloyd-Evans B, Simpson A, Sevdalis N, Gaughran F, Johnson S. Implementation, Adoption, and Perceptions of Telemental Health During the COVID-19 Pandemic: Systematic Review. J Med Internet Res 2021; 23:e31746. [PMID: 34709179 PMCID: PMC8664153 DOI: 10.2196/31746] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/20/2021] [Accepted: 10/01/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Early in 2020, mental health services had to rapidly shift from face-to-face models of care to delivering the majority of treatments remotely (by video or phone call or occasionally messaging) due to the COVID-19 pandemic. This resulted in several challenges for staff and patients, but also in benefits such as convenience or increased access for people with impaired mobility or in rural areas. There is a need to understand the extent and impacts of telemental health implementation, and barriers and facilitators to its effective and acceptable use. This is relevant both to future emergency adoption of telemental health and to debates on its future use in routine mental health care. OBJECTIVE To investigate the adoption and impacts of telemental health approaches during the COVID-19 pandemic, and facilitators and barriers to optimal implementation. METHODS Four databases (PubMed, PsycINFO, CINAHL, and Web of Science) were searched for primary research relating to remote working, mental health care, and the COVID-19 pandemic. Preprint servers were also searched. Results of studies were synthesized using framework synthesis. RESULTS A total of 77 papers met our inclusion criteria. In most studies, the majority of contacts could be transferred to a remote form during the pandemic, and good acceptability to service users and clinicians tended to be reported, at least where the alternative to remote contacts was interrupting care. However, a range of impediments to dealing optimal care by this means were also identified. CONCLUSIONS Implementation of telemental health allowed some continuing support to the majority of service users during the COVID-19 pandemic and has value in an emergency situation. However, not all service users can be reached by this means, and better evidence is now needed on long-term impacts on therapeutic relationships and quality of care, and on impacts on groups at risk of digital exclusion and how to mitigate these. TRIAL REGISTRATION PROSPERO International prospective register of systematic reviews CRD42021211025; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021211025.
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Affiliation(s)
- Rebecca Appleton
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Julie Williams
- Centre for Implementation Science, King's College London, London, United Kingdom
| | - Norha Vera San Juan
- NIHR Mental Health Policy Research Unit, King's College London, London, United Kingdom
| | - Justin J Needle
- Centre for Health Services Research, City, University of London, London, United Kingdom
| | - Merle Schlief
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Harriet Jordan
- Centre for Implementation Science, King's College London, London, United Kingdom
| | - Luke Sheridan Rains
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Lucy Goulding
- King's Improvement Science, King's College London, London, United Kingdom
| | - Monika Badhan
- Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Emily Roxburgh
- Kingston iCope, Camden & Islington NHS Trust, London, United Kingdom
| | - Phoebe Barnett
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Spyros Spyridonidis
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Magdalena Tomaskova
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Jiping Mo
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | | | - Zoë Haime
- Division of Psychiatry, University College London, London, United Kingdom
| | - Cecilia Casetta
- Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Alexandra Papamichail
- NIHR Mental Health Policy Research Unit, King's College London, London, United Kingdom
| | - Brynmor Lloyd-Evans
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Alan Simpson
- NIHR Mental Health Policy Research Unit, King's College London, London, United Kingdom
| | - Nick Sevdalis
- Centre for Implementation Science, King's College London, London, United Kingdom
- NIHR Mental Health Policy Research Unit, King's College London, London, United Kingdom
| | - Fiona Gaughran
- Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Sonia Johnson
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
- Camden and Islington NHS Foundation Trust, London, United Kingdom
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Abraham A, Jithesh A, Doraiswamy S, Al-Khawaga N, Mamtani R, Cheema S. Telemental Health Use in the COVID-19 Pandemic: A Scoping Review and Evidence Gap Mapping. Front Psychiatry 2021; 12:748069. [PMID: 34819885 PMCID: PMC8606591 DOI: 10.3389/fpsyt.2021.748069] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 10/15/2021] [Indexed: 01/07/2023] Open
Abstract
Background: The COVID-19 pandemic has highlighted telemedicine use for mental illness (telemental health). Objective: In the scoping review, we describe the scope and domains of telemental health during the COVID-19 pandemic from the published literature and discuss associated challenges. Methods: PubMed, EMBASE, and the World Health Organization's Global COVID-19 Database were searched up to August 23, 2020 with no restrictions on study design, language, or geographical, following an a priori protocol (https://osf.io/4dxms/). Data were synthesized using descriptive statistics from the peer-reviewed literature and the National Quality Forum's (NQF) framework for telemental health. Sentiment analysis was also used to gauge patient and healthcare provider opinion toward telemental health. Results: After screening, we identified 196 articles, predominantly from high-income countries (36.22%). Most articles were classified as commentaries (51.53%) and discussed telemental health from a management standpoint (86.22%). Conditions commonly treated with telemental health were depression, anxiety, and eating disorders. Where data were available, most articles described telemental health in a home-based setting (use of telemental health at home by patients). Overall sentiment was neutral-to-positive for the individual domains of the NQF framework. Conclusions: Our findings suggest that there was a marked growth in the uptake of telemental health during the pandemic and that telemental health is effective, safe, and will remain in use for the foreseeable future. However, more needs to be done to better understand these findings. Greater investment into human and financial resources, and research should be made by governments, global funding agencies, academia, and other stakeholders, especially in low- and middle- income countries. Uniform guidelines for licensing and credentialing, payment and insurance, and standards of care need to be developed to ensure safe and optimal telemental health delivery. Telemental health education should be incorporated into health professions curricula globally. With rapidly advancing technology and increasing acceptance of interactive online platforms amongst patients and healthcare providers, telemental health can provide sustainable mental healthcare across patient populations. Systematic Review Registration: https://osf.io/4dxms/.
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Affiliation(s)
- Amit Abraham
- Institute for Population Health, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
| | - Anupama Jithesh
- Institute for Population Health, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
| | | | | | - Ravinder Mamtani
- Institute for Population Health, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
| | - Sohaila Cheema
- Institute for Population Health, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
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Weitzer J, Papantoniou K, Seidel S, Klösch G, Caniglia G, Laubichler M, Bertau M, Birmann BM, Jäger CC, Zenk L, Steiner G, Schernhammer E. Working from home, quality of life, and perceived productivity during the first 50-day COVID-19 mitigation measures in Austria: a cross-sectional study. Int Arch Occup Environ Health 2021; 94:1823-1837. [PMID: 33877416 PMCID: PMC8056371 DOI: 10.1007/s00420-021-01692-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 03/06/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To explore changes in quality of life and perceived productivity, focusing on the effects of working from home during the first COVID-19 50-day mitigation period in Austria. METHODS We conducted an Austrian-representative online survey (N = 1010) of self-reported life- and work-related changes during the first COVID-19 50-day mitigation period (March 16 through May 1 2020) compared to the situation before. We used multinominal logistic regression models to identify correlates of improved/decreased quality of life in the entire sample, and of improved/decreased productivity in a subsample of the working population (N = 686). We also calculated age- and multivariable-adjusted ORs and 95% CIs of an improved/decreased quality of life and an improved/decreased productivity by work from home status. RESULTS During the COVID-19 mitigation period, quality of life improved in 17.5%, but decreased in 20.7% of the general Austrian population; perceived productivity at work increased in 12.7%, but decreased in 30.2% of the working population. Working from home during the mitigation period was associated with an increased quality of life (vs. none, partially: OR 2.07, 95% CI 1.09-3.91; all the time: 3.69, 1.86-7.29). In contrast, perceived productivity seemed to decrease when people worked from home (vs. none, partially: 1.42, 0.86-2.35; all the time: 1.48, 0.85-2.58). Working from home and related benefits were not equally distributed among gender, age, and educational attainment. CONCLUSIONS A transition to more flexibility of workplace and working hours for employees could have important positive consequences for family and professional life, for stakeholders, for public health, and ultimately for the environment.
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Affiliation(s)
- Jakob Weitzer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Kyriaki Papantoniou
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Stefan Seidel
- Department of Neurology, Medical University of Vienna, Vienna, Austria
- Institute for Sleep-Wake-Research, Vienna, Austria
| | - Gerhard Klösch
- Department of Neurology, Medical University of Vienna, Vienna, Austria
- Institute for Sleep-Wake-Research, Vienna, Austria
| | - Guido Caniglia
- Konrad Lorenz Institute for Evolution and Cognition Research (KLI), Klosterneuburg, Austria
| | - Manfred Laubichler
- School of Life Sciences, Arizona State University, Tempe, AZ, USA
- Santa Fe Institute, Santa Fe, NM, USA
- Complexity Science Hub, Vienna, Austria
| | - Martin Bertau
- Institut Für Technische Chemie, TU Bergakademie Freiberg, Freiberg, Germany
| | - Brenda M Birmann
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Carlo C Jäger
- Complexity Science Hub, Vienna, Austria
- Academy of Disaster Reduction and Emergency Management, School of Geography, Beijing Normal University, Beijing, 100875, China
- Global Climate Forum, 10178, Berlin, Germany
| | - Lukas Zenk
- Department for Knowledge and Communication Management, Faculty of Business and Globalization, Danube University Krems, Krems, Austria
| | - Gerald Steiner
- Complexity Science Hub, Vienna, Austria
- Department for Knowledge and Communication Management, Faculty of Business and Globalization, Danube University Krems, Krems, Austria
| | - Eva Schernhammer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria.
- Complexity Science Hub, Vienna, Austria.
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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22
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Li H, Luo W, Hou Y, Xia Y, Yao J, Kang N, Deng C, Sun H, Chen C. Factors Affecting Perceived Health Benefits and Use Behaviors in Urban Green Spaces During the COVID-19 Pandemic in Southern China Megacities. Front Public Health 2021; 9:759444. [PMID: 34778190 PMCID: PMC8581461 DOI: 10.3389/fpubh.2021.759444] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/01/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The COVID-19 pandemic has alienated people from urban green spaces (UGSs) that have various health outcomes for humans. However, little is known about the influential factors of perceived health benefits and use behaviors in UGSs during the COVID-19 pandemic. This study aims to explore the key factors that influence perceived health benefits and use behaviors in UGSs and to assess the mediating role of place attachment in relationships during the COVID-19 pandemic in Chinese megacities. Methods: We conducted an online questionnaire survey from December 2020 to March 2021 in Guangzhou and Shenzhen, China. Six multiple regression models were constructed to investigate the main factors by which UGSs influence citizens' perceived health benefits and use behaviors. Four mediation models were established using the structural equation modeling (SEM) method to explore the mediating effect of place attachment. Results: A total of 628 questionnaires were included in the analysis. The results revealed that some UGS components (green space access, maintenance, and soundscape) significantly affected perceived health benefits for citizens (physical, mental, and social health) during the COVID-19 pandemic. Conversely, use behaviors (frequency of visits, duration of visits, and activity intensity) were mainly affected by the sociodemographic context but less affected by UGS components. In addition, UGS components were found to significantly predict place attachment, which in turn influenced the perceived health benefits, frequency, and duration of visits. Conclusions: This study distinguished the key factors that affect perceived health benefits and use behaviors during the COVID-19 pandemic: green space access, maintenance, soundscape, and sociodemographic characteristics. Place attachment still needs to be considered when discussing how to encourage citizens to visit UGSs during the pandemic. These findings provide implications for policymakers and landscape planners regarding design and management measures for UGSs that are conducive to coping with pandemics.
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Affiliation(s)
- Haiwei Li
- College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou, China
| | - Weijing Luo
- College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou, China
| | - Yongqi Hou
- College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou, China
| | - Yu Xia
- College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou, China
| | - Jing Yao
- Urban Big Data Centre, School of Social and Political Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Ning Kang
- School of Architecture, Tsinghua University, Beijing, China
| | - Congshuang Deng
- Guangzhou Sun & Partners Incorporation Design Co., Ltd., Guangzhou, China
| | - Hu Sun
- Guangzhou Sun & Partners Incorporation Design Co., Ltd., Guangzhou, China
| | - Chongxian Chen
- College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou, China
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23
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Jesser A, Muckenhuber J, Lunglmayr B, Dale R, Humer E. Provision of Psychodynamic Psychotherapy in Austria during the COVID-19 Pandemic: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9046. [PMID: 34501635 PMCID: PMC8431203 DOI: 10.3390/ijerph18179046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 12/05/2022]
Abstract
The COVID-19 pandemic has brought massive changes in the provision of psychotherapy. To avoid or reduce the risk of infection, many therapists switched from face-to-face sessions in personal contact to remote psychotherapy, i.e., psychotherapy delivered by telephone or videoconferencing. This study examined the attitudes toward and practice of remote psychotherapy among Austrian therapists with a psychodynamic orientation at the onset of the pandemic as well as changes in the therapeutic process that were experienced by the therapists due to switching to a remote setting. A total of 161 therapists with psychodynamic orientation took part in an online survey. The results show that attitudes toward remote psychotherapy changed positively in psychodynamically orientated therapists and most are willing to switch to remote settings, if necessary. However, many therapists reported negative effects of remote psychotherapy and prefer seeing their patients in-person. The strongest changes were experienced with regard to transference/countertransference, the therapeutic process and the intensity of session. The analysis further revealed an overall decrease in the number of patients treated, indicating an undersupply of psychotherapy, at least during the first wave of COVID-19 infection in Austria. In summary, the experience during the first COVID-19 lockdown has led to an increase in remote psychotherapy and more openness toward these treatment modalities among psychodynamically oriented therapists. However, in-person therapy will remain the first choice for most therapists.
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Affiliation(s)
- Andrea Jesser
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (R.D.); (E.H.)
| | - Johanna Muckenhuber
- Institut für Soziale Arbeit, FH Joanneum University of Applied Science, 8020 Graz, Austria;
| | - Bernd Lunglmayr
- Research Workgroup, Austrian Society for Applied Depth Psychology and Psychotherapy (ÖGATAP), 1150 Vienna, Austria;
- Doctorate in Psychotherapy by Professional Studies Programme, Metanoia Institute, Ealing, London W5 2QB, UK
| | - Rachel Dale
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (R.D.); (E.H.)
| | - Elke Humer
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (R.D.); (E.H.)
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24
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Radanliev P, De Roure D. Alternative mental health therapies in prolonged lockdowns: narratives from Covid-19. HEALTH AND TECHNOLOGY 2021; 11:1101-1107. [PMID: 34395155 PMCID: PMC8349233 DOI: 10.1007/s12553-021-00581-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 07/28/2021] [Indexed: 12/25/2022]
Abstract
Identify and review alternative (home-based) therapies for prolonged lockdowns. Interdisciplinary study using multi-method approach – case study, action research, grounded theory. Only secondary data has been used in this study. Epistemological framework based on a set of digital humanities tools. The set of tools are based on publicly available, open access technological solutions, enabling generalisability of the findings. Alternative therapies can be integrated in healthcare systems as home-based solutions operating on low-cost technologies.
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Affiliation(s)
- Petar Radanliev
- Department of Engineering Sciences, University of Oxford, Oxford, OX1 3QG England, UK
| | - David De Roure
- Department of Engineering Sciences, University of Oxford, Oxford, OX1 3QG England, UK
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25
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Probst T, Haid B, Schimböck W, Reisinger A, Gasser M, Eichberger‐Heckmann H, Stippl P, Jesser A, Humer E, Korecka N, Pieh C. Therapeutic interventions in in-person and remote psychotherapy: Survey with psychotherapists and patients experiencing in-person and remote psychotherapy during COVID-19. Clin Psychol Psychother 2021; 28:988-1000. [PMID: 33448499 PMCID: PMC8013388 DOI: 10.1002/cpp.2553] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 01/04/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE First, to investigate how psychotherapists and patients experience the change from in-person to remote psychotherapy or vice versa during COVID-19 regarding the therapeutic interventions used. Second, to explore the influence of therapeutic orientations on therapeutic interventions in in-person versus remote psychotherapy. METHOD Psychotherapists (N = 217) from Austria were recruited, who in turn recruited their patients (N = 133). The therapeutic orientation of the therapists was psychodynamic (22.6%), humanistic (46.1%), systemic (20.7%) or behavioural (10.6%). All the data were collected remotely via online surveys. Therapists and patients completed two versions of the 'Multitheoretical List of Therapeutic Interventions' (MULTI-30) (version 1: in-person; version 2: remote) to investigate differences between in-person and remote psychotherapy in the following therapeutic interventions: psychodynamic, common factors, person-centred, process-experiential, interpersonal, cognitive, behavioural and dialectical-behavioural. RESULTS Therapists rated all examined therapeutic interventions as more typical for in-person than for remote psychotherapy. For patients, three therapeutic interventions (psychodynamic, process-experiential, cognitive interventions) were more typical for in-person than for remote psychotherapy after correcting for multiple testing. For two therapeutic interventions (behavioural, dialectical-behavioural), differences between the four therapeutic orientations were more consistent for in-person than for remote psychotherapy. CONCLUSIONS Therapeutic interventions differed between in-person and remote psychotherapy and differences between therapeutic orientations in behavioural-oriented interventions become indistinct in remote psychotherapy.
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Affiliation(s)
- Thomas Probst
- Department for Psychotherapy and Biopsychosocial HealthDanube University KremsKrems an der DonauAustria
| | - Barbara Haid
- Austrian Federal Association for PsychotherapyViennaAustria
| | | | | | - Marion Gasser
- Austrian Federal Association for PsychotherapyViennaAustria
| | | | - Peter Stippl
- Austrian Federal Association for PsychotherapyViennaAustria
| | - Andrea Jesser
- Department for Psychotherapy and Biopsychosocial HealthDanube University KremsKrems an der DonauAustria
| | - Elke Humer
- Department for Psychotherapy and Biopsychosocial HealthDanube University KremsKrems an der DonauAustria
| | - Nicole Korecka
- Department for Psychotherapy and Biopsychosocial HealthDanube University KremsKrems an der DonauAustria
| | - Christoph Pieh
- Department for Psychotherapy and Biopsychosocial HealthDanube University KremsKrems an der DonauAustria
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26
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Safieh J, Broughan J, McCombe G, McCarthy N, Frawley T, Guerandel A, Lambert JS, Cullen W. Interventions to Optimise Mental Health Outcomes During the COVID-19 Pandemic: A Scoping Review. Int J Ment Health Addict 2021; 20:2934-2955. [PMID: 34149329 PMCID: PMC8204922 DOI: 10.1007/s11469-021-00558-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/24/2021] [Indexed: 12/23/2022] Open
Abstract
Adverse mental health has been a major consequence of the COVID-19 pandemic. This review examines interventions to enhance mental health outcomes and well-being of populations during COVID-19. Four electronic databases (MEDLINE, PsycINFO, Embase, and CINAHL) were searched following Arskey and O’Malley’s six-staged scoping review process. Twenty studies were included in the review. Various study populations were included to ensure greater generalisability of results. Interventions informing treatment of mental health concerns during COVID-19 were included and classified into (a) prevention of poor mental health, (b) therapeutic interventions, and (c) other interventions. Preventative strategies (n = 16) included public health education, modified social media use, technology-based interventions, physical activity, policy adaptations, and therapeutic interventions. Treatment strategies (n = 7) included adapting existing treatment and the creation new treatment programmes and platforms. While current evidence is promising, future research should focus on novel effective interventions to address mental health issues during the pandemic.
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Affiliation(s)
| | - John Broughan
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Geoff McCombe
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Niamh McCarthy
- School of Medicine, University College Dublin, Dublin, Ireland.,Seanoira Day Hospital, St. Camillus Hospital, Limerick, Ireland.,Department of Psychiatry and Mental Health Research, St. Vincent's University Hospital, Dublin, Ireland
| | - Timothy Frawley
- School of Nursing, Midwifery, and Health Systems, University College Dublin, Dublin, Ireland.,Ireland East Hospital Group, Dublin, Ireland
| | - Allys Guerandel
- School of Medicine, University College Dublin, Dublin, Ireland.,Department of Psychiatry and Mental Health Research, St. Vincent's University Hospital, Dublin, Ireland
| | - John S Lambert
- School of Medicine, University College Dublin, Dublin, Ireland.,Department of Infectious Diseases, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Walter Cullen
- School of Medicine, University College Dublin, Dublin, Ireland
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27
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Psychotherapie auf Distanz in Österreich während COVID‑19. Zusammenfassung der bisher publizierten Ergebnisse von drei Onlinebefragungen. PSYCHOTHERAPIE FORUM 2021. [PMCID: PMC8062842 DOI: 10.1007/s00729-021-00168-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Die Donau-Universität Krems untersuchte in Kooperation mit dem Österreichischen Bundesverband für Psychotherapie mit drei Onlinebefragungen Psychotherapie auf Distanz in Österreich während der COVID-19-Pandemie. Dieser Artikel fasst die bisherigen bereits publizierten Ergebnisse dieser Befragungen zusammen. An der ersten Onlinebefragung, welche in den ersten Wochen des ersten coronabedingten Lockdowns in Österreich stattfand, beteiligten sich insgesamt 1547 Psychotherapeut*innen. Die Ergebnisse zeigen, dass Psychotherapeut*innen während des Lockdowns Psychotherapie im persönlichen Kontakt verstärkt durch Psychotherapie auf Distanz (Telefon oder Internet) ersetzten. Ein erhöhtes Stresserleben sowie jobbezogene Ängste waren v. a. bei Psychotherapeut*innen vorhanden, bei denen Psychotherapie die einzige Einnahmequelle darstellte. Die Erfahrungen mit Psychotherapie auf Distanz wurden als insgesamt positiver beschrieben als sie erwartet wurden. Nichtsdestotrotz wurde Psychotherapie auf Distanz als nicht vollständig vergleichbar mit Psychotherapie im persönlichen Kontakt angesehen. An einer zweiten Onlinebefragung nach dem ersten Lockdown (Sommer 2020) beteiligten sich 222 Psychotherapeut*innen aus Österreich. Ziel dieser Befragung war es den Wechsel des Behandlungsformats (persönlich zu digital oder digital zu persönlich) im Hinblick auf die Anwendung spezifischer therapeutischer Interventionen genauer zu untersuchen. Unter digital wurden verschiede Medien wie z. B. Sprachtelefonie, Videokonferenz, Chats und E‑Mail subsumiert. Zeitgleich mit der zweiten Befragung wurde eine dritte Onlinebefragung durchgeführt, an der 139 Patient*innen der 222 österreichischen Psychotherapeut*innen teilnahmen, um auch die Patient*innen-Perspektive beim Wechsel des Behandlungsformats zu untersuchen. Erste Ergebnisse zeigen, dass Psychotherapeut*innen und Patient*innen beim Wechsel des Behandlungsformats einen Unterschied hinsichtlich der angewandten therapeutischen Interventionen erlebten. So wurden die untersuchten therapeutischen Interventionen als typischer für die Therapie im direkten persönlichen Kontakt als für die Psychotherapie auf Distanz bewertet. Zudem veränderte sich die subjektive Bedeutung verschiedener Bereiche des Lebens während der Corona-Pandemie. Die bisherigen Auswertungen zeigen, dass die COVID-19 Pandemie einen deutlichen Impact auf die Psychotherapiepraxis in Österreich hat. Weitere quantitative und qualitative Auswertungen der Daten werden noch tiefergehende Erkenntnisse liefern.
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28
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Humer E, Haid B, Schimböck W, Reisinger A, Gasser M, Eichberger-Heckmann H, Stippl P, Pieh C, Probst T. Provision of Psychotherapy One Year after the Beginning of the COVID-19 Pandemic in Austria. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5843. [PMID: 34072376 PMCID: PMC8199049 DOI: 10.3390/ijerph18115843] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 11/16/2022]
Abstract
A previous study revealed that the majority of Austrian psychotherapists switched to remote settings during the first months of the COVID-19 pandemic. The current study investigated whether this change in treatment format was maintained after one year of the COVID-19 pandemic. From 16 February until 2 April 2021, a total of 238 Austrian psychotherapists completed an online survey. They were asked about the number of patients currently treated in-person, via telephone and via the internet. Psychotherapists rated three different aspects of psychotherapy (ability to actively listen to patients, ability to understand what is going on in the patients and ability to support patients emotionally) for three different formats (in-person with facemasks, telephone and internet) separately. The results show that, after one year of the pandemic, the majority (78.4%) of patients were treated in-person (compared to 21.7% during the first months of the COVID-19 pandemic; p < 0.001). This change in the treatment format was accompanied by a strong increase in the total number of patients treated by 77.2% on average (p < 0.001). Psychotherapists reported no differences between in-person psychotherapy with facemasks and psychotherapy via the internet with regard to the three investigated aspects of psychotherapy, while the surveyed aspects were rated less favorably for psychotherapy conducted via telephonic communication (p < 0.05). Further studies are needed to investigate the reasons why most psychotherapists switched back to the in-person format with the continuation of the COVID-19 pandemic.
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Affiliation(s)
- Elke Humer
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (C.P.); (T.P.)
| | - Barbara Haid
- Austrian Federal Association for Psychotherapy, 1030 Vienna, Austria; (B.H.); (W.S.); (A.R.); (M.G.); (P.S.)
| | - Wolfgang Schimböck
- Austrian Federal Association for Psychotherapy, 1030 Vienna, Austria; (B.H.); (W.S.); (A.R.); (M.G.); (P.S.)
- ABILE-Viktor Frankl Education Austria, 3390 Melk, Austria
| | - Andrea Reisinger
- Austrian Federal Association for Psychotherapy, 1030 Vienna, Austria; (B.H.); (W.S.); (A.R.); (M.G.); (P.S.)
| | - Marion Gasser
- Austrian Federal Association for Psychotherapy, 1030 Vienna, Austria; (B.H.); (W.S.); (A.R.); (M.G.); (P.S.)
| | | | - Peter Stippl
- Austrian Federal Association for Psychotherapy, 1030 Vienna, Austria; (B.H.); (W.S.); (A.R.); (M.G.); (P.S.)
| | - Christoph Pieh
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (C.P.); (T.P.)
| | - Thomas Probst
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (C.P.); (T.P.)
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Perra N. Non-pharmaceutical interventions during the COVID-19 pandemic: A review. PHYSICS REPORTS 2021; 913:1-52. [PMID: 33612922 PMCID: PMC7881715 DOI: 10.1016/j.physrep.2021.02.001] [Citation(s) in RCA: 224] [Impact Index Per Article: 74.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 02/08/2021] [Indexed: 05/06/2023]
Abstract
Infectious diseases and human behavior are intertwined. On one side, our movements and interactions are the engines of transmission. On the other, the unfolding of viruses might induce changes to our daily activities. While intuitive, our understanding of such feedback loop is still limited. Before COVID-19 the literature on the subject was mainly theoretical and largely missed validation. The main issue was the lack of empirical data capturing behavioral change induced by diseases. Things have dramatically changed in 2020. Non-pharmaceutical interventions (NPIs) have been the key weapon against the SARS-CoV-2 virus and affected virtually any societal process. Travel bans, events cancellation, social distancing, curfews, and lockdowns have become unfortunately very familiar. The scale of the emergency, the ease of survey as well as crowdsourcing deployment guaranteed by the latest technology, several Data for Good programs developed by tech giants, major mobile phone providers, and other companies have allowed unprecedented access to data describing behavioral changes induced by the pandemic. Here, I review some of the vast literature written on the subject of NPIs during the COVID-19 pandemic. In doing so, I analyze 348 articles written by more than 2518 authors in the first 12 months of the emergency. While the large majority of the sample was obtained by querying PubMed, it includes also a hand-curated list. Considering the focus, and methodology I have classified the sample into seven main categories: epidemic models, surveys, comments/perspectives, papers aiming to quantify the effects of NPIs, reviews, articles using data proxies to measure NPIs, and publicly available datasets describing NPIs. I summarize the methodology, data used, findings of the articles in each category and provide an outlook highlighting future challenges as well as opportunities.
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Affiliation(s)
- Nicola Perra
- Networks and Urban Systems Centre, University of Greenwich, London, UK
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30
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Mc Kenny R, Galloghly E, Porter CM, Burbach FR. 'Living in a Zoom world': Survey mapping how COVID-19 is changing family therapy practice in the UK. JOURNAL OF FAMILY THERAPY 2021; 43:272-294. [PMID: 33821064 PMCID: PMC8013560 DOI: 10.1111/1467-6427.12332] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 05/05/2023]
Abstract
UNLABELLED Following the COVID-19 pandemic, psychological therapies rapidly moved online in mid-2020. The Association for Family Therapy and Systemic Practice in the UK (AFT) surveyed the attitudes and practices of systemic therapists in the UK in early October 2020, exploring members' views and gathered information about ongoing needs. A sample of 312 people were included in a mixed methods analysis. In total, 65% of respondents felt their overall experience of using online video technology professionally was positive, further reflected in responses to two open-ended questions. Detailed thematic analysis revealed that many positive comments were related to the practical advantages of online working, whilst many negative comments were related to technique and the therapeutic relationship. Possible respondent biases are discussed, and the implications of this change in practice are explored. It remains to be seen if this marks the beginning of a more permanent shift in our field as we explore the potential of new technologies. PRACTITIONER POINTS The vast majority of UK systemic therapists felt that their experience of online video technology was positive.They noted many practical advantages but also identified many challenges regarding therapeutic techniques and the therapeutic relationship.Therapists developed a range of creative solutions to maximise the therapeutic opportunities of online video.
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31
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Reinstadler V, Ausweger V, Grabher AL, Kreidl M, Huber S, Grander J, Haslacher S, Singer K, Schlapp-Hackl M, Sorg M, Erber H, Oberacher H. Monitoring drug consumption in Innsbruck during coronavirus disease 2019 (COVID-19) lockdown by wastewater analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 757:144006. [PMID: 33310574 PMCID: PMC7681035 DOI: 10.1016/j.scitotenv.2020.144006] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 11/15/2020] [Accepted: 11/15/2020] [Indexed: 05/17/2023]
Abstract
The coronavirus disease 2019 (COVID-19) has developed into a serious pandemic with millions of cases diagnosed worldwide. To fight COVID-19 pandemic, over 100 countries instituted either a full or partial lockdown, affecting billions of people. In Tyrol, first lockdown measures were taken on 10 March 2020. On 16 March 2020, a curfew went into force which ended on 1 May 2020. On 19 March 2020, Tyrol as a whole was placed in quarantine which ended on 7 April 2020. The governmental actions helped reducing the spread of COVID-19 at the cost of significant effects on social life and behaviour. Accordingly, to provide a comprehensive picture of the population health status not only input from medical and biological sciences is required, but also from other sciences able to provide lifestyle information such as drug use. Herein, wastewater-based epidemiology was used for studying temporal trends of licit and illicit drug consumption during lockdown and quarantine in the area of the Tyrolean capital Innsbruck (174,000 inhabitants). On 35 days between 12 March 2020 and 15 April 2020, loads of 23 markers were monitored in wastewater. Loads determined on 292 days between March 2016 and January 2020 served as reference. During lockdown, changes in the consumption patterns of recreational drugs (i.e. cocaine, amphetamine, 3,4-methylenedioxymethamphetamine, methamphetamine, and alcohol) and pharmaceuticals for short-term application (i.e. acetaminophen, codeine, and trimethoprim) were detected. For illicit drugs and alcohol, it is very likely that observed changes were linked to the shutdown of the hospitality industry and event cancelation which led to a reduced demand of these compounds particularly on weekends. For the pharmaceuticals, further work will be necessary to clarify if the observed declines are indicators of improved population health or of some kind of restraining effect that reduced the number of consultations of medical doctors and pharmacies.
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Affiliation(s)
- Vera Reinstadler
- Institute of Legal Medicine and Core Facility Metabolomics, Medical University of Innsbruck, Muellerstrasse 44, 6020 Innsbruck, Austria
| | - Verena Ausweger
- Institute of Legal Medicine and Core Facility Metabolomics, Medical University of Innsbruck, Muellerstrasse 44, 6020 Innsbruck, Austria
| | - Anna-Lena Grabher
- Institute of Legal Medicine and Core Facility Metabolomics, Medical University of Innsbruck, Muellerstrasse 44, 6020 Innsbruck, Austria
| | - Marco Kreidl
- Institute of Legal Medicine and Core Facility Metabolomics, Medical University of Innsbruck, Muellerstrasse 44, 6020 Innsbruck, Austria
| | - Susanne Huber
- Institute of Legal Medicine and Core Facility Metabolomics, Medical University of Innsbruck, Muellerstrasse 44, 6020 Innsbruck, Austria
| | - Julia Grander
- Institute of Legal Medicine and Core Facility Metabolomics, Medical University of Innsbruck, Muellerstrasse 44, 6020 Innsbruck, Austria
| | - Sandra Haslacher
- Institute of Legal Medicine and Core Facility Metabolomics, Medical University of Innsbruck, Muellerstrasse 44, 6020 Innsbruck, Austria
| | - Klaus Singer
- Innsbrucker Kommunalbetriebe AG, Salurner Straße 11, 6020 Innsbruck, Austria
| | | | - Manuel Sorg
- Innsbrucker Kommunalbetriebe AG, Salurner Straße 11, 6020 Innsbruck, Austria
| | - Harald Erber
- Innsbrucker Kommunalbetriebe AG, Salurner Straße 11, 6020 Innsbruck, Austria
| | - Herbert Oberacher
- Institute of Legal Medicine and Core Facility Metabolomics, Medical University of Innsbruck, Muellerstrasse 44, 6020 Innsbruck, Austria.
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Simon J, Helter TM, White RG, van der Boor C, Łaszewska A. Impacts of the Covid-19 lockdown and relevant vulnerabilities on capability well-being, mental health and social support: an Austrian survey study. BMC Public Health 2021. [PMID: 33557816 DOI: 10.1186/s12889-021-10,351-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Abstract
BACKGROUND Impacts of the Covid-19 pandemic and its public health measures go beyond physical and mental health and incorporate wider well-being impacts in terms of what people are free to do or be. We explored the impacts of the Covid-19 lockdown and relevant vulnerabilities on capability well-being, mental health and social support in Austria. METHODS Adult Austrian residents (n = 560) provided responses to a cross-sectional online survey about their experiences during Covid-19 lockdown (15 March-15 April 2020). Instruments measuring capabilities (OxCAP-MH), depression and anxiety (HADS), social support (MSPSS) and mental well-being (WHO-5) were used in association with six pre-defined vulnerabilities using multivariable linear regression. RESULTS 31% of the participants reported low mental well-being and only 30% of those with a history of mental health treatment received treatment during lockdown. Past mental health treatment had a significant negative effect across all outcome measures with an associated capability well-being score reduction of - 6.54 (95%CI, - 9.26, - 3.82). Direct Covid-19 experience and being 'at risk' due to age and/or physical health conditions were also associated with significant capability deprivations. When adjusted for vulnerabilities, significant capability reductions were observed in association with increased levels of depression (- 1.77) and anxiety (- 1.50), and significantly higher capability levels (+ 3.75) were associated with higher levels of social support. Compared to the cohort average, individual capability impacts varied between - 9% for those reporting past mental health treatment and + 5% for those reporting one score higher on the social support scale. CONCLUSIONS Our study is the first to assess the capability limiting aspects of lockdown and relevant vulnerabilities alongside their impacts on mental health and social support. The negative capability well-being, mental health and social support impacts of the Covid-19 lockdown were strongest for people with a history of mental health treatment. Future public health policies concerning lockdowns should pay special attention to improve social support levels in order to increase public resilience.
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Affiliation(s)
- Judit Simon
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria.
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK.
| | - Timea M Helter
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria
| | - Ross G White
- Primary Care and Mental Health, Institute of Population Health, University of Liverpool, School of Psychology, Brownlow Hill, Liverpool, L69 3GB, UK
| | - Catharina van der Boor
- Primary Care and Mental Health, Institute of Population Health, University of Liverpool, School of Psychology, Brownlow Hill, Liverpool, L69 3GB, UK
| | - Agata Łaszewska
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria
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Simon J, Helter TM, White RG, van der Boor C, Łaszewska A. Impacts of the Covid-19 lockdown and relevant vulnerabilities on capability well-being, mental health and social support: an Austrian survey study. BMC Public Health 2021; 21:314. [PMID: 33557816 PMCID: PMC7868863 DOI: 10.1186/s12889-021-10351-5] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 01/11/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Impacts of the Covid-19 pandemic and its public health measures go beyond physical and mental health and incorporate wider well-being impacts in terms of what people are free to do or be. We explored the impacts of the Covid-19 lockdown and relevant vulnerabilities on capability well-being, mental health and social support in Austria. METHODS Adult Austrian residents (n = 560) provided responses to a cross-sectional online survey about their experiences during Covid-19 lockdown (15 March-15 April 2020). Instruments measuring capabilities (OxCAP-MH), depression and anxiety (HADS), social support (MSPSS) and mental well-being (WHO-5) were used in association with six pre-defined vulnerabilities using multivariable linear regression. RESULTS 31% of the participants reported low mental well-being and only 30% of those with a history of mental health treatment received treatment during lockdown. Past mental health treatment had a significant negative effect across all outcome measures with an associated capability well-being score reduction of - 6.54 (95%CI, - 9.26, - 3.82). Direct Covid-19 experience and being 'at risk' due to age and/or physical health conditions were also associated with significant capability deprivations. When adjusted for vulnerabilities, significant capability reductions were observed in association with increased levels of depression (- 1.77) and anxiety (- 1.50), and significantly higher capability levels (+ 3.75) were associated with higher levels of social support. Compared to the cohort average, individual capability impacts varied between - 9% for those reporting past mental health treatment and + 5% for those reporting one score higher on the social support scale. CONCLUSIONS Our study is the first to assess the capability limiting aspects of lockdown and relevant vulnerabilities alongside their impacts on mental health and social support. The negative capability well-being, mental health and social support impacts of the Covid-19 lockdown were strongest for people with a history of mental health treatment. Future public health policies concerning lockdowns should pay special attention to improve social support levels in order to increase public resilience.
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Affiliation(s)
- Judit Simon
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria.
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK.
| | - Timea M Helter
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria
| | - Ross G White
- Primary Care and Mental Health, Institute of Population Health, University of Liverpool, School of Psychology, Brownlow Hill, Liverpool, L69 3GB, UK
| | - Catharina van der Boor
- Primary Care and Mental Health, Institute of Population Health, University of Liverpool, School of Psychology, Brownlow Hill, Liverpool, L69 3GB, UK
| | - Agata Łaszewska
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria
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Peters EMJ, Schedlowski M, Watzl C, Gimsa U. To stress or not to stress: Brain-behavior-immune interaction may weaken or promote the immune response to SARS-CoV-2. Neurobiol Stress 2021; 14:100296. [PMID: 33527083 PMCID: PMC7839386 DOI: 10.1016/j.ynstr.2021.100296] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/29/2020] [Accepted: 01/10/2021] [Indexed: 02/06/2023] Open
Abstract
The COVID-19 pandemic continues to strongly affect people with health disadvantages, creating a heavy burden on medical systems and societies worldwide. Research is growing rapidly and recently revealed that stress-related factors such as socio-economic status, may also play a pivotal role. However, stress research investigating the underlying psychoneuroimmune interactions is missing. Here we address the question whether stress-associated neuroendocrine-immune mechanisms can possibly contribute to an increase in SARS-CoV-2 infections and influence the course of COVID-19 disease. Additionally, we discuss that not all forms of stress (e.g. acute versus chronic) are detrimental and that some types of stress could attenuate infection-risk and -progression. The overall aim of this review is to motivate future research efforts to clarify whether psychosocial interventions have the potential to optimize neuroendocrine-immune responses against respiratory viral infections during and beyond the COVID-19 pandemic. The current state of research on different types of stress is summarized in a comprehensive narrative review to promote a psychoneuroimmune understanding of how stress and its mediators cortisol, (nor)adrenaline, neuropeptides and neurotrophins can shape the immune defense against viral diseases. Based on this understanding, we describe how people with high psychosocial stress can be identified, which behaviors and psychosocial interventions may contribute to optimal stress management, and how psychoneuroimmune knowledge can be used to improve adequate care for COVID-19 and other patients with viral infections.
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Affiliation(s)
- Eva M J Peters
- Psychoneuroimmunology Laboratory, Department of Psychosomatic Medicine and Psychotherapy, Justus-Liebig University Giessen, Giessen and Universitätsmedizin-Charité, Berlin, Germany
| | - Manfred Schedlowski
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, Germany and Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Carsten Watzl
- Department for Immunology, Leibniz Research Centre for Working Environment and Human Factors (IfADo) at TU Dortmund, Dortmund, Germany
| | - Ulrike Gimsa
- Psychophysiology Unit, Institute of Behavioural Physiology, Leibniz Institute for Farm Animal Biology (FBN), Dummerstorf, Germany
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de Vroege L, van den Broek A. UpdatesMental support for health care professionals essential during the COVID-19 pandemic. J Public Health (Oxf) 2021; 42:679-680. [PMID: 32657335 PMCID: PMC7454787 DOI: 10.1093/pubmed/fdaa107] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Lars de Vroege
- Tranzo Scientific Center for Care and Welbeing, Tilburg University, Tilburg, the Netherlands.,Clinical Centre of Excellence for Body, Mind, and Health, GGz Breburg, Tilburg, the Netherlands
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Bäuerle A, Jahre L, Teufel M, Jansen C, Musche V, Schweda A, Fink M, Dinse H, Weismüller B, Dörrie N, Junne F, Graf J, Skoda EM. Evaluation of the E-Mental Health Mindfulness-Based and Skills-Based "CoPE It" Intervention to Reduce Psychological Distress in Times of COVID-19: Results of a Bicentre Longitudinal Study. Front Psychiatry 2021; 12:768132. [PMID: 34803775 PMCID: PMC8599585 DOI: 10.3389/fpsyt.2021.768132] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/11/2021] [Indexed: 01/08/2023] Open
Abstract
Background: The SARS-CoV-2 pandemic poses immense challenges for health care systems and population-wide mental health. The e-mental health intervention "CoPE It" has been developed to offer standardized and manualized support to overcome psychological distress caused by the pandemic. The aim of this study was to assess the effectiveness of "CoPE It" in terms of reducing distress (primary outcome), depression and anxiety symptoms, and improving self-efficacy, and mindfulness (secondary outcomes). Furthermore, the intervention's usability, feasibility, and participants' satisfaction with "CoPE It" was evaluated (tertiary outcome). The study protocol has been published previously. Methods: A bicentre longitudinal study was conducted from April 27th 2020 to May 3rd 2021. N = 110 participants were included in the analyses. The intervention consisted of four modules featuring different media promoting evidence-based methods of cognitive behavioral therapy and mindfulness-based stress reduction. Difference in psychological distress between baseline (T0) and post-intervention (T1) were analyzed by repeated measure analysis of covariance. Mixed linear models were applied to assess moderating effects. Depressive symptoms, generalized anxiety symptoms, self-efficacy, and mindfulness were compared between baseline (T0) and post-intervention (T1) via t-tests. Usability of the "CoPE It" intervention and participants' satisfaction was evaluated by calculation means and frequencies. Results: Primary outcome: A significant effect of time on psychological distress at post-intervention (T1) after controlling for age, gender, education, mental illness and attitudes toward online interventions was found. Depressive and anxiety symptoms, and mindfulness were a significant moderators of the relationship between time and psychological distress for consistent wording. Secondary outcomes: There was a significant decrease in depressive symptoms and generalized anxiety, and a significant increase in self-efficacy and mindfulness between baseline (T0) and post-intervention (T1). Tertiary outcomes: 95.83% of the participants thought the "CoPE It" intervention was easy to use and 87.50% were satisfied with the "CoPE It" intervention in an overall, general sense. Conclusion: The e-mental health "CoPE It" intervention seems to be an effective approach in reducing psychological distress, anxiety and depressive symptoms, and in enhancing self-efficacy and mindfulness during the COVID-19 pandemic. Participants' satisfaction and the program's feasibility, and usability were proven to be high. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: DRKS00021301.
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Affiliation(s)
- Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Lisa Jahre
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Christoph Jansen
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Venja Musche
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Adam Schweda
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Madeleine Fink
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Hannah Dinse
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Benjamin Weismüller
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Nora Dörrie
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany.,Department for Psychosomatic Medicine and Psychotherapy, Otto Von Guericke University Magdeburg, Magdeburg, Germany
| | - Johanna Graf
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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Humer E, Stippl P, Pieh C, Pryss R, Probst T. Experiences of Psychotherapists With Remote Psychotherapy During the COVID-19 Pandemic: Cross-sectional Web-Based Survey Study. J Med Internet Res 2020; 22:e20246. [PMID: 33151896 PMCID: PMC7704121 DOI: 10.2196/20246] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/14/2020] [Accepted: 10/02/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND The current situation around the COVID-19 pandemic and the measures necessary to fight it are creating challenges for psychotherapists, who usually treat patients face-to-face with personal contact. The pandemic is accelerating the use of remote psychotherapy (ie, psychotherapy provided via telephone or the internet). However, some psychotherapists have expressed reservations regarding remote psychotherapy. As psychotherapists are the individuals who determine the frequency of use of remote psychotherapy, the potential of enabling mental health care during the COVID-19 pandemic in line with the protective measures to fight COVID-19 can be realized only if psychotherapists are willing to use remote psychotherapy. OBJECTIVE This study aimed to investigate the experiences of psychotherapists with remote psychotherapy in the first weeks of the COVID-19 lockdown in Austria (between March 24 and April 1, 2020). METHODS Austrian psychotherapists were invited to take part in a web-based survey. The therapeutic orientations of the psychotherapists (behavioral, humanistic, psychodynamic, or systemic), their rating of the comparability of remote psychotherapy (web- or telephone-based) with face-to-face psychotherapy involving personal contact, and potential discrepancies between their actual experiences and previous expectations with remote psychotherapy were assessed. Data from 1162 psychotherapists practicing before and during the COVID-19 lockdown were analyzed. RESULTS Psychotherapy conducted via telephone or the internet was reported to not be totally comparable to psychotherapy with personal contact (P<.001). Psychodynamic (P=.001) and humanistic (P=.005) therapists reported a higher comparability of telephone-based psychotherapy to in-person psychotherapy than behavioral therapists. Experiences with remote therapy (both web- and telephone-based) were more positive than previously expected (P<.001). Psychodynamic therapists reported more positive experiences with telephone-based psychotherapy than expected compared to behavioral (P=.03) and systemic (P=.002) therapists. In general, web-based psychotherapy was rated more positively (regarding comparability to psychotherapy with personal contact and experiences vs expectations) than telephone-based psychotherapy (P<.001); however, psychodynamic therapists reported their previous expectations to be equal to their actual experiences for both telephone- and web-based psychotherapy. CONCLUSIONS Psychotherapists found their experiences with remote psychotherapy (ie, web- or telephone-based psychotherapy) to be better than expected but found that this mode was not totally comparable to face-to-face psychotherapy with personal contact. Especially, behavioral therapists were found to rate telephone-based psychotherapy less favorably than therapists with other theoretical backgrounds.
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Affiliation(s)
- Elke Humer
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems, Austria
| | - Peter Stippl
- Austrian Federal Association for Psychotherapy, Vienna, Austria
| | - Christoph Pieh
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems, Austria
| | - Rüdiger Pryss
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Thomas Probst
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems, Austria
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Humer E, Schimböck W, Kisler IM, Schadenhofer P, Pieh C, Probst T. How the COVID-19 Pandemic Changes the Subjective Perception of Meaning Related to Different Areas of Life in Austrian Psychotherapists and Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8600. [PMID: 33228105 PMCID: PMC7699404 DOI: 10.3390/ijerph17228600] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 11/09/2020] [Accepted: 11/16/2020] [Indexed: 01/26/2023]
Abstract
We assessed psychotherapists' and patients' ratings of their subjective perception of meaning related to different areas of life before the COVID-19 pandemic as compared to the time during the COVID-19 pandemic. In a quantitative cross-sectional study, Austrian psychotherapists (N = 222) were recruited by e-mail, who in turn recruited their patients (N = 139). Therapists and patients were asked to rate the meaning of different areas of life before as well as during the COVID-19 crisis. The psychotherapists showed an overall higher rating of the importance of areas of life compared to their patients (p < 0.001). The rating of the importance of the domains of living was differently affected by the COVID-19 situation (p < 0.001). While the meaning of physical and mental health during COVID-19 was rated higher than before, the opposite was observed for work (p < 0.001). No differences were found for relationships and friends, as well as for hobbies. As no interactions between perspective (therapists vs. patients), area of life, and time point (before vs. during COVID-19) were observed, it can be concluded that the COVID-19 situation changed the subjective attribution of meaning concerning different aspects of life similarly in therapists as well as patients. While mental and physical health gained subjective importance, the opposite was observed for work.
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Affiliation(s)
- Elke Humer
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (E.H.); (C.P.)
| | - Wolfgang Schimböck
- ABILE-Viktor Frankl Education Austria, 3390 Melk, Austria; (W.S.); (I.-M.K.); (P.S.)
| | - Ida-Maria Kisler
- ABILE-Viktor Frankl Education Austria, 3390 Melk, Austria; (W.S.); (I.-M.K.); (P.S.)
| | - Petra Schadenhofer
- ABILE-Viktor Frankl Education Austria, 3390 Melk, Austria; (W.S.); (I.-M.K.); (P.S.)
- Telephone Emergency Service—Lower Austria (TelefonSeelsorge NÖ), Diocese St. Pölten, 3100 St. Pölten, Austria
| | - Christoph Pieh
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (E.H.); (C.P.)
| | - Thomas Probst
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (E.H.); (C.P.)
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Humer E, Stippl P, Pieh C, Schimböck W, Probst T. Psychotherapy via the Internet: What Programs Do Psychotherapists Use, How Well-Informed Do They Feel, and What Are Their Wishes for Continuous Education? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8182. [PMID: 33167478 PMCID: PMC7663907 DOI: 10.3390/ijerph17218182] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/01/2020] [Accepted: 11/04/2020] [Indexed: 11/16/2022]
Abstract
The outbreak of the COVID-19 pandemic has caused changes in the provision of psychotherapy around the world. The common format of delivering in-person psychotherapy is replaced by psychotherapy via the Internet to a great extent. This study examined how well Austrian psychotherapists feel informed about the use of the Internet in psychotherapy, where additional information needs exist, and which software is used. A link to an online survey was sent to all psychotherapists providing a valid email address in the official list of licensed psychotherapists at the start of the COVID-19 lockdown in Austria. A total of 1547 people took part in the survey. The results show that psychotherapy via the Internet was primarily offered via Skype and Zoom during the COVID-19 pandemic and that the majority of the therapists felt well-informed about psychotherapy via the Internet; however, several therapists stated that they wish to have further information on data protection and security. Overall, the study shows that Austrian psychotherapists coped well with the rapid change from the provision of psychotherapy through personal contact to psychotherapy via the Internet. Security and data protection aspects of therapy via the Internet should be addressed in training and further education of psychotherapists. As this study was conducted online, it might have caused some respondent bias towards a higher participation of psychotherapists with higher preference for new technologies.
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Affiliation(s)
- Elke Humer
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (E.H.); (C.P.)
| | - Peter Stippl
- Austrian Federal Association for Psychotherapy, 1030 Vienna, Austria; (P.S.); (W.S.)
| | - Christoph Pieh
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (E.H.); (C.P.)
| | - Wolfgang Schimböck
- Austrian Federal Association for Psychotherapy, 1030 Vienna, Austria; (P.S.); (W.S.)
- Viktor Frankl Education Austria (ABILE), 3390 Melk, Austria
| | - Thomas Probst
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (E.H.); (C.P.)
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Korecka N, Rabenstein R, Pieh C, Stippl P, Barke A, Doering B, Gossmann K, Humer E, Probst T. Psychotherapy by Telephone or Internet in Austria and Germany Which CBT Psychotherapists Rate It more Comparable to Face-to-Face Psychotherapy in Personal Contact and Have more Positive Actual Experiences Compared to Previous Expectations? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7756. [PMID: 33114136 PMCID: PMC7660328 DOI: 10.3390/ijerph17217756] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/19/2020] [Accepted: 10/22/2020] [Indexed: 12/18/2022]
Abstract
Objectives: COVID-19 has led to changes in the provision in mental health services. The current study investigated influencing factors on: (i) the comparability of psychotherapy via internet/telephone with psychotherapy in face-to-face contact as well as (ii) the actual experience with psychotherapy via internet/telephone compared to respective prior expectations in CBT therapists. Methods: A quantitative cross-sectional study was conducted in the form of an online survey. The research samples, registered cognitive-behavioral therapy (CBT) psychotherapists in Austria and Germany, were contacted by e-mail. Results: One hundred and ninety CBT therapists were analyzed in this study. The total number of patients treated via telephone/internet is a decisive factor for the subjective evaluation of the comparability of psychotherapy via telephone/internet and psychotherapy in personal contact. This factor also influences the extent (positive/negative) of the assessment of the actual experience with psychotherapy via internet/telephone compared to previous expectations. Neither age nor gender were associated with comparability of psychotherapy via internet/telephone with psychotherapy in face-to-face contact or the actual experience with psychotherapy via internet/telephone compared to respective prior expectations. Conclusions: Implications of the results are that attitudes towards remote psychotherapy might be increased in CBT therapists when they treat more patients remotely and experiences with remote psychotherapies should be included in psychotherapy training.
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Affiliation(s)
- Nicole Korecka
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (N.K.); (R.R.); (C.P.); (E.H.)
| | - Rafael Rabenstein
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (N.K.); (R.R.); (C.P.); (E.H.)
| | - Christoph Pieh
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (N.K.); (R.R.); (C.P.); (E.H.)
| | - Peter Stippl
- Austrian Federal Association for Psychotherapy, Löwengasse 3, 1030 Vienna, Austria;
| | - Antonia Barke
- Clinical and Biological Psychology, Catholic University of Eichstätt-Ingolstadt, Ostenstraße 26, 85072 Eichstätt, Germany; (A.B.); (B.D.); (K.G.)
| | - Bettina Doering
- Clinical and Biological Psychology, Catholic University of Eichstätt-Ingolstadt, Ostenstraße 26, 85072 Eichstätt, Germany; (A.B.); (B.D.); (K.G.)
| | - Katharina Gossmann
- Clinical and Biological Psychology, Catholic University of Eichstätt-Ingolstadt, Ostenstraße 26, 85072 Eichstätt, Germany; (A.B.); (B.D.); (K.G.)
| | - Elke Humer
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (N.K.); (R.R.); (C.P.); (E.H.)
| | - Thomas Probst
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (N.K.); (R.R.); (C.P.); (E.H.)
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Boldrini T, Schiano Lomoriello A, Del Corno F, Lingiardi V, Salcuni S. Psychotherapy During COVID-19: How the Clinical Practice of Italian Psychotherapists Changed During the Pandemic. Front Psychol 2020; 11:591170. [PMID: 33192932 PMCID: PMC7641613 DOI: 10.3389/fpsyg.2020.591170] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 09/16/2020] [Indexed: 12/17/2022] Open
Abstract
Aims: Italy was one of the first countries to be significantly affected by the coronavirus disease 2019 (COVID-19) pandemic, determining a unique scenario for Italian psychotherapists to consider changing the modality in which they deliver treatment. The present study aimed at studying which factors related to psychotherapists and their clinical practice had a major role in predicting two main outcomes: (1) the rate of interrupted treatments during lockdown and (2) psychotherapists' satisfaction with the telepsychotherapy modality. Methods: An online survey was administered to licensed psychotherapists (n = 306), who worked mainly as private practitioners, between April 5 and May 10, 2020 (i.e., the peak of the pandemic in Italy). Results: Psychotherapists reported that 42.1% (SD = 28.9) of their treatments had been interrupted, suggesting that Italy faced an important undersupply of psychotherapy during the lockdown. Using the Akaike information criterion (AIC) model selection, we identified three predictors of the rate of interrupted treatments: (1) psychotherapists' lack of experience with telepsychotherapy prior to the lockdown, (2) their theoretical orientation (with cognitive behavioral psychotherapists reporting a higher rate of interrupted treatments), and (3) patients' lack of privacy at home, as reported to the psychotherapists. Furthermore, we found four predictors of psychotherapists' satisfaction with the telepsychotherapy modality: (1) the rate of interrupted treatments, (2) psychotherapists' previous experience with telepsychotherapy, (3) their beliefs about the compatibility of telepsychotherapy with their theoretical orientation, and (4) their use of a video-conferencing modality, rather than telephone. Conclusion: The following recommendations can help policy makers, professional associations, and practitioners in promoting the continuity of psychotherapy treatments during the COVID-19 outbreak and in future emergencies: (i) disseminating training programs for practitioners on telepsychotherapy, (ii) supporting patients to pragmatically access a private space at home, (iii) encouraging practitioners to use video-conferencing (instead of telephone) to deliver remote therapy, and (iv) increasing the acceptance of telepsychotherapy among both clinicians and the general public.
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Affiliation(s)
- Tommaso Boldrini
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
| | - Arianna Schiano Lomoriello
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
- Department of Cognitive System, Denmark Technical University (DTU), Copenhagen, Denmark
| | - Franco Del Corno
- Association for Research in Clinical Psychology (ARP), Milan, Italy
| | - Vittorio Lingiardi
- Department of Dynamic and Clinic Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Silvia Salcuni
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
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Probst T, Humer E, Stippl P, Pieh C. Being a Psychotherapist in Times of the Novel Coronavirus Disease: Stress-Level, Job Anxiety, and Fear of Coronavirus Disease Infection in More Than 1,500 Psychotherapists in Austria. Front Psychol 2020; 11:559100. [PMID: 33132965 PMCID: PMC7550677 DOI: 10.3389/fpsyg.2020.559100] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/04/2020] [Indexed: 01/09/2023] Open
Abstract
This study investigated stress-level, degree of job-related anxiety, and fear of coronavirus disease (COVID-19) infection in psychotherapists in the early weeks of the COVID-19 lockdown in Austria. One thousand five hundred and forty-seven psychotherapists participated in an online survey, assessing stress [Perceived Stress Scale-10 (PSS-10)], work-related worries and fears of existence [Job Anxiety Scale (JAS)], fear of COVID-19 infection during face-to-face psychotherapy, and adherence to five protective measures against COVID-19 infection during face-to-face psychotherapy. Stress-levels were higher than in a representative sample (p < 0.001). When psychotherapy was the sole income, stress-level (p = 0.020) and job anxiety (p < 0.001) were higher. Experiences with teletherapy, the psychotherapy format used during COVID-19, as well as reductions in number of patients treated during COVID-19, had no effect on stress-level or job anxiety. Psychotherapists still conducting face-to-face psychotherapy during COVID-19 reported less fear of infection compared to those conducting no face-to-face psychotherapy (p < 0.001), whereby the fear of infection was further reduced when they were more able to adhere to protective measures against COVID-19 (p < 0.01). Mental hygiene is important for psychotherapists to manage stress and job-related anxiety during COVID-19, especially in those whose income relies on psychotherapy.
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Affiliation(s)
- Thomas Probst
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems, Austria
| | - Elke Humer
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems, Austria
| | - Peter Stippl
- Austrian Federal Association for Psychotherapy, Vienna, Austria
| | - Christoph Pieh
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems, Austria
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Abstract
In many parts of the world, concerns about the COVID-19 pandemic and city quarantine policy have led to a general decline in the physical and mental health of residents due to insufficient social interaction. These adverse effects can cause potential public health risks. Ways to alleviate the adverse impact of the pandemic and meet social interaction needs must be widely addressed. This survey was conducted from 1–5 April 2020; it collected 386 responses from residents of Chengdu, China, during the pandemic based on an online survey questionnaire. The results indicate that most of the residents believe their health status is poor, and that they do not experience adequate social contact with others. Most of the respondents indicated no difference in mental health, while a few reported differences in their physical health and social interaction levels. Visiting urban parks can significantly improve overall health and assist in meeting individuals’ social interaction needs. Although residents have reduced the frequency of visits during the pandemic, even once a week can be beneficial. This paper emphasizes the critical role of urban parks during the pandemic period from the perspective of the urban building environment. The conclusion affirms that urban parks and large outdoor, open spaces can provide residents with a place for safe outdoor activities and social interaction in a green environment during a pandemic, as well as serve as a buffer area to maintain favorable health and quality of life.
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Humer E, Pieh C, Kuska M, Barke A, Doering BK, Gossmann K, Trnka R, Meier Z, Kascakova N, Tavel P, Probst T. Provision of Psychotherapy during the COVID-19 Pandemic among Czech, German and Slovak Psychotherapists. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4811. [PMID: 32635422 PMCID: PMC7370023 DOI: 10.3390/ijerph17134811] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 06/24/2020] [Accepted: 07/01/2020] [Indexed: 01/18/2023]
Abstract
Psychotherapists around the world are facing an unprecedented situation with the outbreak of the novel coronavirus disease (COVID-19). To combat the rapid spread of the virus, direct contact with others has to be avoided when possible. Therefore, remote psychotherapy provides a valuable option to continue mental health care during the COVID-19 pandemic. The present study investigated the fear of psychotherapists to become infected with COVID-19 during psychotherapy in personal contact and assessed how the provision of psychotherapy changed due to the COVID-19 situation and whether there were differences with regard to country and gender. Psychotherapists from three European countries: Czech Republic (CZ, n = 112), Germany (DE, n = 130) and Slovakia (SK, n = 96), with on average 77.8% female participants, completed an online survey. Participants rated the fear of COVID-19 infection during face-to-face psychotherapy and reported the number of patients treated on average per week (in personal contact, via telephone, via internet) during the COVID-19 situation as well as (retrospectively) in the months before. Fear of COVID-19 infection was highest in SK and lowest in DE (p < 0.001) and was higher in female compared to male psychotherapists (p = 0.021). In all countries, the number of patients treated on average per week in personal contact decreased (p < 0.001) and remote psychotherapies increased (p < 0.001), with more patients being treated via internet than via telephone during the COVID-19 situation (p < 0.001). Furthermore, female psychotherapists treated less patients in personal contact (p = 0.036), while they treated more patients via telephone than their male colleagues (p = 0.015). Overall, the total number of patients treated did not differ during COVID-19 from the months before (p = 0.133) and psychotherapy in personal contact remained the most common treatment modality. Results imply that the supply of mental health care could be maintained during COVID-19 and that changes in the provision of psychotherapy vary among countries and gender.
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Affiliation(s)
- Elke Humer
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (E.H.); (C.P.); (M.K.)
| | - Christoph Pieh
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (E.H.); (C.P.); (M.K.)
| | - Martin Kuska
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (E.H.); (C.P.); (M.K.)
| | - Antonia Barke
- Clinical and Biological Psychology, Catholic University of Eichstätt-Ingolstadt, 85072 Eichstätt, Germany; (A.B.); (B.K.D.); (K.G.)
| | - Bettina K. Doering
- Clinical and Biological Psychology, Catholic University of Eichstätt-Ingolstadt, 85072 Eichstätt, Germany; (A.B.); (B.K.D.); (K.G.)
| | - Katharina Gossmann
- Clinical and Biological Psychology, Catholic University of Eichstätt-Ingolstadt, 85072 Eichstätt, Germany; (A.B.); (B.K.D.); (K.G.)
| | - Radek Trnka
- Science and Research Department, Prague College of Psychosocial Studies, 14900 Prague, Czech Republic;
- Olomouc University Social Health Institute (OUSHI), Palacky University Olomouc, 77111 Olomouc, Czech Republic; (Z.M.); (N.K.); (P.T.)
| | - Zdenek Meier
- Olomouc University Social Health Institute (OUSHI), Palacky University Olomouc, 77111 Olomouc, Czech Republic; (Z.M.); (N.K.); (P.T.)
| | - Natalia Kascakova
- Olomouc University Social Health Institute (OUSHI), Palacky University Olomouc, 77111 Olomouc, Czech Republic; (Z.M.); (N.K.); (P.T.)
- Psychiatric-Psychotherapeutic Outpatient Clinic, Pro mente sana, 81108 Bratislava, Slovakia
| | - Peter Tavel
- Olomouc University Social Health Institute (OUSHI), Palacky University Olomouc, 77111 Olomouc, Czech Republic; (Z.M.); (N.K.); (P.T.)
| | - Thomas Probst
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (E.H.); (C.P.); (M.K.)
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