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Cavallo M, Pedroli E, Cantoia M, McGrath B, Cecchetti S. Attitudes of Mental Health Professionals towards Telepsychology during the Pandemic: A Pilot Study. Healthcare (Basel) 2023; 11:healthcare11111542. [PMID: 37297682 DOI: 10.3390/healthcare11111542] [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: 03/27/2023] [Revised: 05/21/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
OBJECTIVE This pilot study investigated mental health professionals' attitudes towards remote psychological consultations and internet-based interventions. METHODS An online survey in Italian and English was administered to a sample of 191 psychologists and psychotherapists to collect detailed information about their professional experience providing online psychological interventions a year and a half after the beginning of the SARS-CoV-2 pandemic. RESULTS The results did not reveal a statistically significant association between the participants' theoretical approaches and the number of patients treated via the online modality. Overall, most of the participants found advantages to the online setting but also noted critical issues regarding privacy and the ease of integrating new technology into their clinical practice. CONCLUSIONS According to the participants, despite the challenges that must be addressed, telehealth is a viable psychological therapeutic option that is destined to grow in importance in the near future.
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Affiliation(s)
- Marco Cavallo
- Faculty of Psychology, eCampus University, 22060 Novedrate, CO, Italy
- Clinical Psychology Service, Saint George Foundation, 12030 Cavallermaggiore, CN, Italy
| | - Elisa Pedroli
- Faculty of Psychology, eCampus University, 22060 Novedrate, CO, Italy
- Applied Technology for Neuropsychology Lab, IRCCS Istituto Auxologico Italiano, 20135 Milan, MI, Italy
| | - Manuela Cantoia
- Faculty of Psychology, eCampus University, 22060 Novedrate, CO, Italy
| | - Breeda McGrath
- The Chicago School of Professional Psychology, Chicago, IL 60601, USA
| | - Sonja Cecchetti
- Faculty of Psychology, eCampus University, 22060 Novedrate, CO, Italy
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2
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Duquette CL, Morgan SM. Experiences of psychotherapists transitioning to private practice during
COVID
‐19. COUNSELLING & PSYCHOTHERAPY RESEARCH 2023. [DOI: 10.1002/capr.12643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
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3
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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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4
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Seow LSE, Chang S, Sambasivam R, Subramaniam M, Lu SH, Assudani H, Tan CYG, Vaingankar JA. Psychotherapists’ perspective of the use of eHealth services to enhance positive mental health promotion. Digit Health 2023. [DOI: 10.1177/20552076221147411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Objective Keyes’s two-continua model of mental health proposes that mental illness and positive mental health are two separate, correlated, unipolar dimensions. eHealth services have been used to deliver mental health care, though the focus remained largely on symptom reduction and management of negative aspects of mental health. The potential of eHealth services to promote positive mental well-being, however, has not been tapped sufficiently. The present study aims to explore psychotherapists’ perspective on the feasibility of eHealth services to enhance positive mental health promotion. Methods Seven focus group discussions were conducted among professionals ( n = 38) who delivered psychotherapy to examine positive mental health in their practice. Responses related to the use of e-psychotherapy to promote mental well-being were extracted for use in a secondary analysis of data in this study. Thematic analysis of data via inductive approach was conducted to allow emergence of common themes. Results Three main themes related to psychotherapists’ perspective on the feasibility of eHealth intervention in enhancing positive mental health were identified: (1) use of eHealth to educate and improve positive mental health; (2) concerns on incorporating psychotherapy into online services; (3) other factors that affect uptake or effectiveness of eHealth intervention for positive mental health. Conclusions The study generally found support among psychotherapists for the feasibility of eHealth intervention in promoting positive mental health among clients. Potential difficulties in implementation and practicality concerns were discussed.
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Affiliation(s)
| | - Sherilyn Chang
- Research Division, Institute of Mental Health, Singapore
| | | | | | | | - Hanita Assudani
- Department of Psychology, Institute of Mental Health, Singapore
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Schlief M, Saunders KRK, Appleton R, Barnett P, Vera San Juan N, Foye U, Olive RR, Machin K, Shah P, Chipp B, Lyons N, Tamworth C, Persaud K, Badhan M, Black CA, Sin J, Riches S, Graham T, Greening J, Pirani F, Griffiths R, Jeynes T, McCabe R, Lloyd-Evans B, Simpson A, Needle JJ, Trevillion K, Johnson S. Synthesis of the Evidence on What Works for Whom in Telemental Health: Rapid Realist Review. Interact J Med Res 2022; 11:e38239. [PMID: 35767691 PMCID: PMC9524537 DOI: 10.2196/38239] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/20/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Telemental health (delivering mental health care via video calls, telephone calls, or SMS text messages) is becoming increasingly widespread. Telemental health appears to be useful and effective in providing care to some service users in some settings, especially during an emergency restricting face-to-face contact, such as the COVID-19 pandemic. However, important limitations have been reported, and telemental health implementation risks the reinforcement of pre-existing inequalities in service provision. If it is to be widely incorporated into routine care, a clear understanding is needed of when and for whom it is an acceptable and effective approach and when face-to-face care is needed. OBJECTIVE This rapid realist review aims to develop a theory about which telemental health approaches work (or do not work), for whom, in which contexts, and through what mechanisms. METHODS Rapid realist reviewing involves synthesizing relevant evidence and stakeholder expertise to allow timely development of context-mechanism-outcome (CMO) configurations in areas where evidence is urgently needed to inform policy and practice. The CMO configurations encapsulate theories about what works for whom and by what mechanisms. Sources included eligible papers from 2 previous systematic reviews conducted by our team on telemental health; an updated search using the strategy from these reviews; a call for relevant evidence, including "gray literature," to the public and key experts; and website searches of relevant voluntary and statutory organizations. CMO configurations formulated from these sources were iteratively refined, including through discussions with an expert reference group, including researchers with relevant lived experience and frontline clinicians, and consultation with experts focused on three priority groups: children and young people, users of inpatient and crisis care services, and digitally excluded groups. RESULTS A total of 108 scientific and gray literature sources were included. From our initial CMO configurations, we derived 30 overarching CMO configurations within four domains: connecting effectively; flexibility and personalization; safety, privacy, and confidentiality; and therapeutic quality and relationship. Reports and stakeholder input emphasized the importance of personal choice, privacy and safety, and therapeutic relationships in telemental health care. The review also identified particular service users likely to be disadvantaged by telemental health implementation and a need to ensure that face-to-face care of equivalent timeliness remains available. Mechanisms underlying the successful and unsuccessful application of telemental health are discussed. CONCLUSIONS Service user choice, privacy and safety, the ability to connect effectively, and fostering strong therapeutic relationships need to be prioritized in delivering telemental health care. Guidelines and strategies coproduced with service users and frontline staff are needed to optimize telemental health implementation in real-world settings. TRIAL REGISTRATION International Prospective Register of Systematic Reviews (PROSPERO); CRD42021260910; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021260910.
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Affiliation(s)
- Merle Schlief
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Katherine R K Saunders
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Rebecca Appleton
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, 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
| | - Norha Vera San Juan
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Una Foye
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Rachel Rowan Olive
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Karen Machin
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Prisha Shah
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Beverley Chipp
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Natasha Lyons
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Camilla Tamworth
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Karen Persaud
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Monika Badhan
- Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Carrie-Ann Black
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Jacqueline Sin
- Centre for Mental Health Research, City, University of London, London, United Kingdom
| | - Simon Riches
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Tom Graham
- Centre for Anxiety Disorders & Trauma, South London & Maudsley NHS Foundation Trust, London, United Kingdom
| | - Jeremy Greening
- Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Farida Pirani
- Psychological Medicine & Older Adult Directorate, South London & Maudsley NHS Foundation Trust, London, United Kingdom
| | - Raza Griffiths
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Tamar Jeynes
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Rose McCabe
- Centre for Mental Health Research, City, University of 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, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Justin J Needle
- Centre for Health Services Research, City, University of London, London, United Kingdom
| | - Kylee Trevillion
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 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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Chen H, Ma Q, Du B, Huang Y, Zhu SG, Li SL, Geng DQ, Xu XS. Psychotherapy and Follow-Up in Health Care Workers After the COVID-19 Epidemic: A Single Center's Experience. Psychol Res Behav Manag 2022; 15:2245-2258. [PMID: 36003831 PMCID: PMC9394520 DOI: 10.2147/prbm.s371787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/26/2022] [Indexed: 11/23/2022] Open
Abstract
Objective The present study aims to analysis the mental health of high-risk health care workers (HHCWs) and low-risk HCWs (LHCWs) who were respectively exposed to COVID-19 wards and non-COVID-19 wards by following up on mental disorders in HCWs in China for 6 months. Methods A multi-psychological assessment questionnaire was used to follow up on the psychological status of HCWs in the Affiliated Hospital of Xuzhou Medical University in Xuzhou City (a non-core epidemic area) at 6 months after the first evaluation conducted during the COVID-19 epidemic. Based on the risk of exposure to COVID-19 patients, the HCWs were divided into two groups: high-risk HCWs, who worked in COVID-19 wards, and low-risk HCWs, who worked in non-COVID-19 wards. Results A total of 198 HCWs participated in the study, and 168 questionnaires were selected for evaluation. Among them, 93 (55.4%) were in the HHCW group and 75 (44.5%) were in the LHCW group. Significant differences were observed in salary, profession, and altruistic behavior between the two groups (P < 0.05). There were no significant differences in the anxiety, depression, insomnia, or posttraumatic stress disorder (PTSD) scores between the two groups. Logistic regression revealed that work stress was a major joint risk factor for mental disorders in HCWs. Among all the HCWs, a total of 58 voluntarily participated in psychotherapy; the analysis showed a significant decrease in anxiety, depression, PTSD, work stress, and work risk after attending psychotherapy. There were also significant differences in positive and negative coping styles before and after psychotherapy. Conclusion In the present follow-up, work stress was the major contributing factor to mental disorders in HCWs. Psychotherapy is helpful in terms of stress management and should be provided to first-line COVID-19 HCWs.
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Affiliation(s)
- Hao Chen
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, People's Republic of China.,Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, 215000, People's Republic of China
| | - Qing Ma
- Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, People's Republic of China
| | - Bo Du
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, People's Republic of China
| | - Yan Huang
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, People's Republic of China
| | - Shi-Guang Zhu
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, People's Republic of China
| | - Sheng-Li Li
- Department of Medical Records and Statistics, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, People's Republic of China
| | - De-Qin Geng
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, People's Republic of China
| | - Xing-Shun Xu
- Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, 215000, People's Republic of China.,Institute of Neuroscience, Soochow University, Suzhou, 215000, People's Republic of China.,Jiangsu Key Laboratory of Neuropsychiatric Diseases, Soochow University, Suzhou, 215000, People's Republic of China
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7
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Mendes-Santos C, Nunes F, Weiderpass E, Santana R, Andersson G. Understanding Mental Health Professionals' Perspectives and Practices Regarding the Implementation of Digital Mental Health: Qualitative Study. JMIR Form Res 2022; 6:e32558. [PMID: 35412459 PMCID: PMC9044148 DOI: 10.2196/32558] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 01/26/2022] [Accepted: 02/08/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Despite the potential of digital mental health to provide cost-effective mental health care, its adoption in clinical settings is limited, and little is known about the perspectives and practices of mental health professionals regarding its implementation or the factors influencing these perspectives and practices. OBJECTIVE This study aims to characterize in depth the perspectives and practices of mental health professionals regarding the implementation of digital mental health and explore the factors affecting such perspectives and practices. METHODS A qualitative study using in-depth semistructured interviews with Portuguese mental health professionals (N=13)-psychologists and psychiatrists-was conducted. The transcribed interviews were thematically analyzed. RESULTS Mental health professionals deemed important or engaged in the following practices during the implementation of digital mental health: indication evaluation, therapeutic contract negotiation, digital psychological assessment, technology setup and management, and intervention delivery and follow-up. Low-threshold accessibility and professionals' perceived duty to provide support to their clients facilitated the implementation of digital mental health. Conversely, the lack of structured intervention frameworks; the unavailability of usable, validated, and affordable technology; and the absence of structured training programs inhibited digital mental health implementation by mental health professionals. CONCLUSIONS The publication of practice frameworks, development of evidence-based technology, and delivery of structured training seem key to expediting implementation and encouraging the sustained adoption of digital mental health by mental health professionals.
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Affiliation(s)
- Cristina Mendes-Santos
- Department of Culture and Society, Linköping University, Linköping, Sweden
- NOVA National School of Public Health, Public Health Research Centre, Universidade Nova de Lisboa, Lisbon, Portugal
- Fraunhofer Portugal AICOS, Porto, Portugal
- Experimental Pathology and Therapeutics Group, Portuguese Institute of Oncology, Porto, Portugal
| | | | | | - Rui Santana
- NOVA National School of Public Health, Public Health Research Centre, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden
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8
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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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9
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Legerer-Bratengeyer A. Zoom-Fatigue managen. PSYCHOTHERAPIE FORUM 2021. [PMCID: PMC8647510 DOI: 10.1007/s00729-021-00183-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Im März 2020, bedingt durch die Corona-Pandemie, hat sich die Berufsgruppe der Psychotherapeut_innen flexibel und spontan auf die Anforderung des Online-Settings als Behandlungsformat eingelassen. Es galt die Versorgung der Klient_innen unbedingt aufrecht zu halten und einen Anteil an der Gesamtgesundheit der Bevölkerung zu leisten. Durch digitale Kommunikation im Online-Video-Setting ergeben sich für Psychotherapeut_innen bisher wenig beachtete, zusätzliche Belastungen. Insbesondere Arbeitsplatzsicherheit (Bildschirmarbeitsverordnung), Achtsamkeit und Sorgsamkeit für Augen, Binokularsystem, Rücken, Schultern und Nacken sowie der Umgang mit einer neuen Form der Erschöpfung, der Zoom-Fatigue, sind von Bedeutung. Die Arbeitswelt 4.0 hat Einzug in die psychotherapeutischen Praxen gehalten und bringt neue Aspekte und Anforderungen an Selbstfürsorge und Psychohygiene.
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10
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Stefan R, Mantl G, Höfner C, Stammer J, Hochgerner M, Petersdorfer K. Remote Psychotherapy During the COVID-19 Pandemic. Experiences With the Transition and the Therapeutic Relationship. A Longitudinal Mixed-Methods Study. Front Psychol 2021; 12:743430. [PMID: 34899484 PMCID: PMC8651537 DOI: 10.3389/fpsyg.2021.743430] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 11/02/2021] [Indexed: 11/13/2022] Open
Abstract
Aims: Research conducted prior to the onset of the COVID-19 pandemic indicates that remote psychotherapy is as effective as in-person treatment. At that time, it usually was the therapist's individual choice to work remotely, whereas the pandemic pushed psychotherapists, including previous skeptics, to incorporate remote work methods into their routine due to limited face-to-face contact. There is little knowledge of the way therapists experienced this sudden and forced transition to remote psychotherapy as the only treatment option. The present study aims to assess psychotherapists' experience and proficiency delivering remote psychotherapy as well as to investigate perceived changes in the psychotherapeutic relationship. Methods: An online survey was administered to psychotherapists of the Austrian Association for Group Therapy and Group Dynamics (ÖAGG). Three test periods (t) were set (t1: April, 2020 with N = 175; t2: May-June, 2020 with N = 177; t3: November-December, 2020 with N = 113). Research was conducted longitudinally using a mixed-methods research design. Results: While psychotherapists' levels of experience with telephone-based psychotherapy remained similar across all test periods, they became slightly more experienced using video therapy over the test period observed. However, they continued to feel less experienced compared to the use of telephone-based psychotherapy. The therapeutic relationship appeared to improve over the course of the first two test periods, while the third period showed a slight decline. No general deterioration of the psychotherapeutic relationship was found in the timespan studied. Conclusion: Despite many challenges and concerns, psychotherapists seem to adapt and enhance their skills in remote psychotherapy over time. The present paper confirms and enhances previous findings in the field due to its longitudinal approach. Remote psychotherapy can be a credible and trustworthy alternative to in-person treatment to be adopted and implemented on principle by a majority of psychotherapists regardless of their orientation. Furthermore, it sheds light on chances, problems und general observations regarding the comprehensive provision of remote psychotherapy in a pandemic situation.
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Affiliation(s)
- Robert Stefan
- Österreichischer Arbeitskreis für Gruppentherapie und Gruppendynamik, Vienna, Austria
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11
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Sarlon J, Doll JPK, Schmassmann A, Brand S, Ferreira N, Muehlhauser M, Urech-Meyer S, Schweinfurth N, Lang UE, Bruehl AB. Effectiveness of a mindfulness-based mobile application for the treatment of depression in ambulatory care: study protocol for a randomized controlled trial (Preprint). JMIR Res Protoc 2021; 11:e33423. [PMID: 35357325 PMCID: PMC9015747 DOI: 10.2196/33423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/13/2022] [Accepted: 01/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background Patients with major depressive disorder (MDD) often experience relapses despite regular treatment with pharmacotherapy and psychotherapy. Further, long waiting lists and more demand than treatment capacity characterize ambulatory settings. Mindfulness-based interventions proved to be effective in relapse prevention in MDD. Next, mindfulness-based interventions in the form of free mobile applications can be an effective augmentation of the treatment as usual and can fill a gap in ambulatory care. Objective Given this background, the aim of this randomized controlled study is to assess the effectiveness of additional MBI via a mobile app on the symptom severity and stress levels, compared to treatment as usual. Methods A total of 140 individuals with MDD will be randomly allocated to the intervention or control condition. The intervention consists of the daily use of the mindfulness mobile application Headspace for thirty days (up to 10 minutes a day). The control condition will be treatment as usual. At baseline and four weeks later, the following key outcome dimensions will be assessed: self-rated (Beck Depression Inventory) and experts’ rated symptoms of MDD (Hamilton Depression Rating Scale); secondary outcome variables will be blood pressure, heart rate, and respiratory rate and changes in tobacco and alcohol consumption and medication as a proxy of perceived stress. Results This study was funded in February 2021 and approved by the institutional review board on April 15, 2021, and it started in May 2021. As of December 2021, we enrolled 30 participants. The findings are expected to be published in spring 2023. Conclusions We hypothesize that compared to the control conditions, individuals with MDD of the mobile app-condition will have both lower self- and experts’ rated symptoms of MDD and more favorable stress-related levels. While the risk for medical events is low, the immediate benefit for participants could be a decrease in symptom severity and reduction of the stress level. Trial Registration Clinical Trials.gov NCT05060393; https://clinicaltrials.gov/ct2/show/NCT05060393. International Registered Report Identifier (IRRID) DERR1-10.2196/33423
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Affiliation(s)
- Jan Sarlon
- University Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Jessica P K Doll
- University Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Aline Schmassmann
- University Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Serge Brand
- University Psychiatric Clinics, University of Basel, Basel, Switzerland
- Department of Sport, Exercise and Health, Faculty of Medicine, University of Basel, Basel, Switzerland
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Naomi Ferreira
- University Psychiatric Clinics, University of Basel, Basel, Switzerland
| | | | | | - Nina Schweinfurth
- University Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Undine Emmi Lang
- University Psychiatric Clinics, University of Basel, Basel, Switzerland
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12
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Höfner C, Hochgerner M, Mantl G, Stefan R, Stammer J. Telepsychotherapie als Chance und Herausforderung: Eine longitudinale Mixed-Methods Studie. PSYCHOTHERAPIE FORUM 2021. [PMCID: PMC8078091 DOI: 10.1007/s00729-021-00169-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Seit Beginn der COVID-19 Krise und der sukzessiven Lockdowns sind Psychotherapeut*innen plötzlich gefordert, auf Telepsychotherapie (TEP) umzustellen. Die vorliegende Studie untersucht, wie dieser Umstieg bewältigt wird und wie erfahren sich Psychotherapeut*innen im Umgang mit TEP fühlen, welche Veränderungen in der therapeutischen Beziehung wahrgenommen werden und welche Behandlungstechniken in der TEP als besonders geeignet erscheinen. Die Untersuchungen wurden longitudinal mit zwei Erhebungszeitpunkten mit einem Mixed-Methods Forschungsdesign durchgeführt. Es zeigt sich, dass der Umstieg auf TEP gut bewältigt wird und die Erfahrung mit speziellen Apps und Videotelefonie signifikant zunimmt. Die Ergebnisse der Untersuchung legen für die vorliegende Stichprobe eine gewisse Adaptierungsfähigkeit der Psychotherapeut*innen nahe und zeigen, dass durch TEP keine allgemeine Tendenz zur Verschlechterung der Qualität der therapeutischen Beziehung wahrgenommen wird und dass mit der Zeit eine Adaptierung der therapeutischen Techniken aus der Face-to-Face Situation für die TEP vollzogen wird.
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Affiliation(s)
- Claudia Höfner
- Österreichischer Arbeitskreis für Gruppentherapie und Gruppendynamik, Lenaugasse 3, 1080 Wien, Österreich
| | - Markus Hochgerner
- Österreichischer Arbeitskreis für Gruppentherapie und Gruppendynamik, Lenaugasse 3, 1080 Wien, Österreich
| | - Gerd Mantl
- Österreichischer Arbeitskreis für Gruppentherapie und Gruppendynamik, Lenaugasse 3, 1080 Wien, Österreich
| | - Robert Stefan
- Österreichischer Arbeitskreis für Gruppentherapie und Gruppendynamik, Lenaugasse 3, 1080 Wien, Österreich
| | - Julia Stammer
- Österreichischer Arbeitskreis für Gruppentherapie und Gruppendynamik, Lenaugasse 3, 1080 Wien, Österreich
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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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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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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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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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