Tele-Drama Therapy with Community-Dwelling Older Adults: A Field Training Project.

OBJECTIVES: This paper explores a field training project of tele-drama therapy with community-dwelling older adults during COVID19. It merges three perspectives: the older participants' perspective, the students engaged in the field training, who conducted this remote therapy, and social workers. METHODS: Interviews were conducted with 19 older adults. Focus groups were conducted with 10 drama therapy students and 4 social workers. The data were thematically analyzed. RESULTS: Three themes emerged: the role of drama therapy methods in the therapeutic process, attitudes toward psychotherapy for older adults, and the phone as a therapeutic setting. These themes coalesced into a triangular model associating dramatherapy, tele-psychotherapy and psychotherapy with the older population. A number of obstacles were identified. CONCLUSIONS: The field training project made a dual contribution to the older participants and the students. In addition, it promoted more positive attitudes among the students toward psychotherapy with the older population. CLINICAL IMPLICATIONS: Tele-drama therapy methods appear to promote the therapeutic process with older adults. However, the phone session should be planned in advance in terms of time and place to ensure the participants' privacy. Field training of mental health students with older adults can promote more positive attitudes toward working with the older population.

COVID-19 Booster Vaccination Bellwethers: Factors Predictive of Older Adults' Adoption of the Second Booster COVID-19 Vaccine in Israel: A Longitudinal Study.

Israel became the first country to offer the second COVID-19 booster vaccination. The study tested for the first time, the predictive role of booster-related sense of control (SOC_B), trust and vaccination hesitancy (VH) on adoption of the second-booster among older adults, 7 months later. Four hundred Israelis (≥60 years-old), eligible for the first booster, responded online, two weeks into the first booster campaign. They completed demographics, self-reports, and first booster vaccination status (early-adopters or not). Second booster vaccination status was collected for 280 eligible responders: early- and late-adopters, vaccinated four and 75 days into the second booster campaign, respectively, versus non-adopters. Multinomial logistic regression was conducted with pseudo R2 = .385. Higher SOC_B, and first booster early-adoption were predictive of second booster early-vs.-non-adoption, 1.934 [1.148-3.257], 4.861 [1.847-12.791]; and late-vs.-non-adoption, 2.031 [1.294-3.188], 2.092 [0.979-4.472]. Higher trust was only predictive of late-vs.-non-adoption (1.981 [1.03-3.81]), whereas VH was non-predictive. We suggest that older-adult bellwethers, second booster early-adopters, could be predicted by higher SOC_B, and first booster early-adoption, 7 months earlier.

Italian adolescents' perception of tele-psychodrama treatment during the COVID-19 Pandemic.

BACKGROUND: Psychodrama is an experiential group psychotherapy that is used to enhance adolescents' wellbeing. The COVID-19 pandemic forced the adaptation of this method to an online setting. OBJECTIVE: This qualitative study investigated whether and how tele-psychodrama provides psychological support to adolescents, in order to better understand its strengths and weaknesses. PARTICIPANTS: 14 adolescents from Northern and Central Italy. METHOD: 14 interviews were conducted at the end of group tele-psychodrama treatment and were analysed with qualitative thematic analysis. RESULTS: Three themes were identified: (1) contribution of tele-psychodrama to adolescents' well-being; (2) implementation of psychodrama to the online setting; and (3) (the) shortcomings of tele-psychodrama. CONCLUSIONS: Despite the differences between online and in-person psychodrama, all the participants expressed their appreciation of group tele-psychodrama, which contributed to their overall psychological wellbeing and helped them process difficulties that emerged during the lockdowns.

Spirituality During the COVID-19 Pandemic: An Online Creative Arts Intervention With Photocollages for Older Adults in Italy and Israel.

The present study aimed to examine how expressions of spirituality were stimulated and reflected in an online creative arts intervention for older adults during COVID-19 lockdowns. The online process focused on the creation of digital photocollages together with narrative elements of dignity therapy. Twenty-four Israeli and Italian community-dwelling older adults aged 78-92 participated in a three-session online intervention involving the production of three photocollages. The visual and verbal data (participants' chosen photos and photocollages, and transcripts of the sessions) were qualitatively analyzed within an abductive framework. Four themes were generated, representing the four domains of spirituality that were stimulated by and expressed in the process: (1) Connectedness with the self, (2) connectedness with others, (3) connectedness with the environment, and (4) connectedness with the transcendent. The findings show how photographs can serve as projective visual stimuli which elicit personal content through spontaneous thinking, and they reveal the multifaceted nature of spirituality, wherein each domain nourishes the others. Overall, the findings illustrate how creative arts intervention guided by the tenets of dignity therapy can contribute to the spiritual care of older adults during periods of social isolation, or to the spiritual support provided in palliative care.

Loss, adaptation and growth: The experiences of creative arts therapists during the Covid-19 pandemic.

Since the outbreak of the COVID-19 pandemic in March 2020, mental health professionals have been called upon to cope with various challenges, including the shift to telehealth without prior training, overload in the workplace, increased risk of infection, and personal stressors relating to the pandemic. This article presents the qualitative findings of a larger international mixed-method study that explored the experiences of creative arts therapists around the globe during the first year of the pandemic (Feniger-Schaal et al., 2022). Twenty creative arts therapists were interviewed between July 2020 and March 2021. Transcriptions of the interviews were qualitatively analyzed through reflexive thematic analysis. Three main themes were identified: an experience of processing the losses caused by the pandemic, a restorative orientation that focused on adaptations the therapists made, and innovations that lead to personal and professional growth. Artistic engagement and creativity were found to be a resource when coping with losses and helped therapists adapt to the shift to tele-creative arts therapies (tele-CAT). Although this shift can lead to advances in the field of creative arts therapies, it requires further consideration, including the need for ethical guidelines, specific training, the development of digital methods that support the creative process, and dedicated supervision for therapists. The findings also point to the importance of psychological support to mitigate the burden therapists experience during stressful events.

Spirituality During the COVID-19 Pandemic: An Online Creative Arts Intervention With Photocollages for Older Adults in Italy and Israel

The present study aimed to examine how expressions of spirituality were stimulated and reflected in an online creative arts intervention for older adults during COVID-19 lockdowns. The online process focused on the creation of digital photocollages together with narrative elements of dignity therapy. Twenty-four Israeli and Italian community-dwelling older adults aged 78–92 participated in a three-session online intervention involving the production of three photocollages. The visual and verbal data (participants’ chosen photos and photocollages, and transcripts of the sessions) were qualitatively analyzed within an abductive framework. Four themes were generated, representing the four domains of spirituality that were stimulated by and expressed in the process: (1) Connectedness with the self, (2) connectedness with others, (3) connectedness with the environment, and (4) connectedness with the transcendent. The findings show how photographs can serve as projective visual stimuli which elicit personal content through spontaneous thinking, and they reveal the multifaceted nature of spirituality, wherein each domain nourishes the others. Overall, the findings illustrate how creative arts intervention guided by the tenets of dignity therapy can contribute to the spiritual care of older adults during periods of social isolation, or to the spiritual support provided in palliative care.

"Post-lockdown Depression": Adaptation Difficulties, Depressive Symptoms, and the Role of Positive Solitude When Returning to Routine After the Lifting of Nation-Wide COVID-19 Social Restrictions.

Objectives: The aim of the current study was to identify difficulties in adapting to normal life once COVID-19 lockdown has been lifted. Israel was used as a case study, as COVID-19 social restrictions, including a nation-wide lockdown, were lifted almost completely by mid-April 2021, following a large-scale vaccination operation. Methods: A sample of 293 mid-age and older Israeli adults (M age = 61.6 ± 12.8, range 40-85 years old) reported on return-to-routine adaptation difficulties (on a novel index), depression, positive solitude, and several demographic factors. Results: Of the participants, 40.4% met the criteria of (at least) mild depressive symptoms. Higher levels of adaptation difficulties were related to higher ratios of clinical depressive symptoms. This link was moderated by positive solitude. Namely, the association between return-to-routine adaptation difficulties and depression was mainly indicated for individuals with low positive solitude. Conclusions: The current findings are of special interest to public welfare, as adaptation difficulties were associated with higher chance for clinical depressive symptoms, while positive solitude was found to be as an efficient moderator during this period. The large proportion of depressive symptoms that persist despite lifting of social restrictions should be taken into consideration by policy makers when designing return-to-routine plans.

Vaccine and Psychological Booster: Factors Associated With Older Adults' Compliance to the Booster COVID-19 Vaccine in Israel.

Israel became the first country to offer the booster COVID-19 vaccination. The study tested for the first time the role of sense of control (SOC) due to vaccinations, trust and vaccination hesitancy (VH), and their association with compliance to the booster COVID-19 vaccine among older adults, during the first 2 weeks of the campaign. 400 Israeli citizens (≥ 6 years old), eligible for the booster vaccine, responded online. They completed demographics, self-reports, and booster vaccination status (already vaccinated, booked-a-slot, vaccination intent, and vaccination opposers). Multinomial logistic regression was conducted with pseudo R2 = .498. Higher SOC and lower VH were related to the difference between early and delayed vaccination (booked-a-slot, OR = 0.7 [0.49-0.99]; 2.2 [1.32-3.62], intent OR = 0.6 [0.42-0.98]; 2.7 [1.52-4.86]), as well as to rejection (OR = 0.3 [0.11-0.89]; 8.5 [3.39-21.16]). Increased trust was only related to the difference between early vaccinations and vaccine rejection (OR = 0.3 [0.11-0.89]). We suggest that SOC, as well as low VH, can be used as positive motivators, encouraging earlier vaccinations in older age.

Shifting to tele-creative arts therapies during the COVID-19 pandemic: An international study on helpful and challenging factors.

The COVID-19 pandemic has led to an unprecedented shift to online treatment. For the creative arts therapies (CATs) - a healthcare profession that involves the intentional use of the visual art, drama, music, dance, and poetry within a therapeutic relationship - this shift has been highly consequential for practice. This study examined (a) how the COVID-19 pandemic has impacted clinical practice in the CATs, and (b) the features characterizing online practice in an international sample of 1206 creative arts therapists aged 22-86 (92% female). It aimed to identify changes in the use of the arts in therapy, resources that contributed to the delivery of therapy, and the role of therapists' creative self-efficacy in adapting to these changes. Respondents completed close and open-ended questions providing examples of what does and does not work in online practice. The results indicate that creative self-efficacy plays a meaningful role in buffering the impact of therapists' computer comfort on their perceived difference in online clinical practice; confidence in one's abilities positively contributed to their adaptation to online practice. The qualitative analysis yielded four main categories: the challenges of tele-CATs, continuing the therapeutic process through tele-CATs, adaptations for tele-CATs, and future directions. Overall, the results present a timely report on the inevitable transition of the CATs to online practice.

Spirituality during COVID-19 in Northern Italy: The experience of participating in an online prayer group.

Spirituality has ascendant value during times of adversity. Religious activities have beenfound to increase spirituality, and therefore might be considered a coping resource for the individual. The present research aims to explore participants' experience in an online Catholic prayer group in northern Italy that was held throughout the period of COVID-19 social restrictions. The group comprised 16 Catholic individuals aged 34 to 85, who were interviewed in writing following a protocol of four open-ended questions. The results reported four main thematic areas: (1) the benefits of the spiritual journey while coping with the pandemic; (2) the potential of the online setting; (3) the challenges of the online setting; and (4) the bond with God and how it evolved during the pandemic. The findings confirm the valuable contribution of the on-line group religious activity to the participants'    wellbeing, particularly during the time of social distancing.

Crafting Life Stories in Photocollage: An Online Creative Art-Based Intervention for Older Adults.

Creative arts therapies (CAT) provide a safe and creative environment for older adults to process life experiences and maintain personal growth while aging. There is a growing need to make creative arts therapies more accessible to the aging population, as many have limited access to these services. This need has been catalyzed by the advent of the COVID-19 pandemic. Tele-CAT offers a possible solution. This study explored the experiences of older adults who participated in an online creative process of digital photocollage based on CAT. Twenty-four Italian and Israeli community-dwelling older adults aged 78 to 92 participated in this research through Zoom teleconferencing software. Transcriptions of the sessions and the art produced through the photocollage were qualitatively analyzed through Thematic Analysis. The findings show that the projective stimuli of digital photographs supported older adults' narratives and engaged them in a more embodied emotional experience. Participant experiences involved artistic enjoyment within a positive and safe interaction with therapists. The creation of digital photocollages allowed the participants to process their life experiences and create an integrative view of their life, a vital developmental task in late life. These results point to the advantages and challenges of tele-CAT for older adults.

Online Dignity Therapy and Photo Collages: The Narratives of Israeli and Italian Older Adults in the COVID-19 Era

The social isolation imposed by the Covid-19 pandemic has significantly affected older adults, and has impacted both their physical and mental health. The pandemic has led to an increase in ageism associated with poorer mental health and a lower sense of dignity, self-esteem and contribution to society. This cross-cultural study involved 24 participants from Italy and Israel aged 79 to 92. The aim was to develop a brief art-based online intervention to enhance the participants’ sense of dignity and sense of meaning in life during this time of crisis. The process focused on the creation of digital photo-collages that captured the participants’ values through three perspectives: their past experiences, legacy, and future perspectives. It employed an arts-based research methodology to explore the participants’ experiences by analysing their relationship with the artistic expression, the photo collage, and its creative process.

Tele-psychodrama therapy during the COVID-19 pandemic: Participants' experiences.

Italy was severely hit by the COVID-19 pandemic. In early March 2020, a series of legislative decrees have been issued, establishing the restrictions that all Italian citizens are required to respect, according to which it is strictly forbidden to leave the house if not for reasons of necessity, health, or work. This qualitative study investigated which aspects clients find helpful or hindering in shifting to group tele-psychodrama due to the COVID-19 pandemic, after participation in an in-person psychodrama group. Participants were 15 adults who were members of a pre-existing in-person psychodrama group that shifted to a tele-psychodrama group format facilitated by two psychodrama therapists. The Client Change Interview was used at the end of the tele-psychodrama as a post-treatment assessment. All the interviews were transcribed and then underwent a thematic analysis. The analysis yielded six shared themes: the role of tele-psychodrama sessions during COVID-19 pandemic; perceived effectiveness of tele-psychodrama; main advantages of tele-psychodrama; limitations encountered during the online intervention; the termination of tele-psychodrama; and the relationship with the therapist. The findings provide preliminary evidence for the clinical practice of tele-psychodrama and lays the groundwork for further studies that can contribute to the use of electronic platforms in psychodrama interventions.

Conflicts Between Women's Religiosity and Sense of Free Will in the Context of Elective Abortion: A Qualitative Study in the Worst Period of Italy's COVID-19 Crisis.

This qualitative study considers the relationship between abortion, bereavement, and the effects of the COVID-19 lockdown nine women who had undergone an elective abortion, which is voluntarily termination of a pregnancy at the woman's request. These women were interviewed in three time points (1 month, 6 months, and 1 year after the event) to consider the possible evolution of their experience. The third phase was concurrent with the COVID-19 pandemic and particularly with Pope Francis's Easter declaration against abortion. All the interviews were conducted and analysed through qualitative research in psychology. Results showed that the abortion experience led to physical, relational, and psychological suffering, similar to perinatal grief. Participants were non-practising Catholics and religiosity did not help them to overcome their sorrow. Though religiosity is a possible resilience factor in other stressful conditions, in this case it is a factor that aggravated suffering. Finally, we discuss the difficulties experienced by Catholic women who choose to have an abortion and assert the necessity of psychological and spiritual interventions to support these women.

The Moderating Effect of Older Adults' Receptive Arts Engagement on the Association Between Resilience and Anxiety Symptoms During Coronavirus Breakout.

ABSTRACT: In this study, we evaluated whether levels of receptive arts engagement (visiting museums/concerts/the theater/the cinema) during the year preceding the COVID-19 outbreak may have served as a psychological resource for older adults that mitigated the association between resilience levels and COVID-19 anxiety when the pandemic broke out. Data were collected after the enactment of the first emergency regulations (between March 15 and April 1, 2020) via the Qualtrics Survey Software link that was sent out through social media platforms. In total, 205 participants aged 65 to 92 (mean age, 72.32; SD, 5.63) reported general anxiety symptom levels (GAD-7) (Spitzer et al., 2006), resilience (Connor-Davidson Resilience Scale), frequency of receptive arts engagement in the previous year, health status, exposure to risk situations, and behavioral changes due to the pandemic. Our hypothesis that receptive arts would moderate the resilience-COVID-19 anxiety link was examined by a multiple hierarchical regression analysis and with the PROCESS computational tool. Findings show that resilience was associated with COVID-19 anxiety and that this association was moderated by levels of receptive arts engagement. The findings show that high levels of prior art engagement constituted a potent buffer against subsequent COVID-19 anxiety. Policy makers may benefit older adults by encouraging their engagement in arts activities, even during social distancing.