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Eur J Psychotraumatol ; 12(1): 1984049, 2021.
Article in English | MEDLINE | ID: covidwho-1506934


Background: Frontline healthcare workers, recovered COVID+ patients who had severe illness, and close others of COVID+ patients who have recovered or died are at risk for clinical levels of mental health symptoms in the context of the COVID-19 pandemic. RESTORE (Recovering from Extreme Stressors Through Online Resources and E-health) was specifically designed for this context. RESTORE is a transdiagnostic guided online intervention adapted from evidence-based cognitive-behavioural therapies. Objectives: RESTORE was designed to address depression, anxiety, and posttraumatic stress disorder symptoms associated with exposure to COVID-19-related traumatic and extreme stressors, and to overcome multiple barriers to accessing psychotherapies. Method: This paper describes the intervention components and platform, as well as the principles used to develop RESTORE. Current research and future directions in developing and testing RESTORE are outlined. Results: Preliminary data from an initial uncontrolled trial evaluating RESTORE in frontline healthcare workers is highly promising. Conclusion: We believe RESTORE has great potential to provide accessible, evidence-based psychological intervention to those in great need.

Antecedentes: Los trabajadores de salud de primera línea, los pacientes de COVID positivo recuperados que tenían una enfermedad grave y las personas cercanas a los pacientes de COVID positivo que se han recuperado o fallecido están en riesgo de presentar niveles clínicos de síntomas de salud mental en el contexto de la pandemia de COVID-19. RESTORE (por sus siglas en inglés: Recovering from Extreme Stressors Through Online Resources and E-health: Recuperación de estresores extremos a través de recursos en línea y salud electrónica) fue diseñada específicamente para este contexto. RESTORE es una intervención en línea guiada transdiagnóstica adaptada de terapias cognitivo-conductuales basadas en la evidencia.Objetivos: RESTORE fue diseñado para abordar la depresión, la ansiedad y los síntomas del trastorno de estrés postraumático asociados con la exposición a factores estresantes traumáticos y extremos relacionados con COVID-19, y para superar múltiples barreras para acceder a psicoterapias.Método: Este artículo describe los componentes y la plataforma de la intervención, así como los principios utilizados para desarrollar RESTORE. Se describen las investigaciones actuales y las direcciones futuras para desarrollar y testear RESTORE.Resultados: Los datos preliminares de un ensayo inicial no controlado que evalúa RESTORE en trabajadores de salud de primera línea son muy prometedores.Conclusión: Creemos que RESTORE tiene un gran potencial para brindar una intervención psicológica accesible y basada en la evidencia a quienes más lo necesitan.背景: 在 COVID-19 疫情背景下, 一线医护人员, 重症 COVID+ 康复患者以及已康复或死亡的 COVID+ 患者的其他亲友都有出现临床心理健康症状的风险。 RESTORE (通过在线资源和电子健康从极端应激源中恢复) 专为这种情况而设计。 RESTORE 是一种改编自循证认知行为疗法的跨诊断指导的在线干预。目的: RESTORE 旨在致力于 COVID-19 相关创伤性和极端应激源暴露相关的抑郁, 焦虑和创伤后应激障碍症状, 并克服心理治疗可得性的多种障碍。方法: 本文介绍了干预组成和平台, 以及用于开发RESTORE的原则。概述了开发和测试 RESTORE 的当前研究和未来方向。结果: 来自评估一线医护人员 RESTORE 的初始非对照试验的初步数据大有前景。结论: 我们相信 RESTORE 有很大的潜力为急需帮助者提供易得, 询证的心理干预。.

Anxiety/therapy , COVID-19/psychology , Cognitive Behavioral Therapy , Depression/therapy , Health Personnel/psychology , Internet-Based Intervention , Stress Disorders, Post-Traumatic/therapy , Anxiety/psychology , COVID-19/epidemiology , Depression/psychology , Humans , Mental Health , Pandemics , SARS-CoV-2 , Stress Disorders, Post-Traumatic/psychology
Drug Alcohol Depend ; 227: 109015, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1397293


BACKGROUND: Problematic substance use (SU) has increased substantially during the COVID-19 pandemic. While studies have identified risk factors for problematic SU during the pandemic (e.g., anxiety, depression, using substances to cope), these studies have been predominately cross-sectional, rarely examined changes in SU contexts during the pandemic as potential risk factors, and neglected sexual and gender minorities (SGM) - a health disparity population disproportionately impacted by substance use disorders and the pandemic. METHOD: We utilized two waves of data collected one month apart from a sample of 212 SGM assigned female at birth who used alcohol and/or cannabis (18-25 years old) collected between August 2020-February 2021. We examined associations between potential risk factors (i.e., retrospectively reported changes in anxiety/depression and in using substances in different contexts since before the pandemic): and 1) retrospectively reported changes in alcohol and cannabis consumption; 2) coping motives for use and SU consequences; and 3) subsequent changes in coping motives and consequences. RESULTS: An increase in solitary SU was a robust risk factor for concurrent and prospective increases in SU, coping motives, and consequences. Increases in SU with romantic partners were associated with concurrent increases in alcohol/cannabis consumption and consequences. Increases in anxiety and depression were associated with concurrent increases in SU and higher coping motives and consequences. CONCLUSIONS: Results indicate that solitary SU and increases in SU with romantic partners are robust risk factors for increases in SU and consequences in the context of the pandemic. Further, findings provide support for the self-medication theory of substance use.

COVID-19 , Sexual and Gender Minorities , Substance-Related Disorders , Adaptation, Psychological , Adolescent , Adult , Cross-Sectional Studies , Female , Humans , Infant, Newborn , Pandemics , Prospective Studies , Retrospective Studies , Risk Factors , SARS-CoV-2 , Substance-Related Disorders/epidemiology , Young Adult
J Trauma Stress ; 33(5): 623-633, 2020 10.
Article in English | MEDLINE | ID: covidwho-734793


The COVID-19 pandemic presents major challenges for mental health care providers. In particular, providers who treat posttraumatic stress disorder (PTSD) are now tasked with determining whether to initiate trauma-focused therapy during the pandemic and, if so, whether and how to adapt treatment. The purpose of this communication is to identify and organize key considerations for whether and how to deliver commonly used evidence-supported therapy protocols for trauma treatment-specifically, cognitive processing therapy (CPT) and prolonged exposure (PE) therapy-during the ongoing COVID-19 pandemic for adults who currently meet the criteria for PTSD. Based on relevant public health and clinical literature, we present a structured guide that can be used by treatment teams and individual providers to evaluate whether initiating CPT or PE is indicated given a particular patient-provider pair and system context amidst pandemic conditions. In addition, we suggest appropriate action steps, including problem-solving strategies, evidence-informed modifications to CPT and PE, and alternative intervention approaches.

Cognitive Behavioral Therapy/methods , Coronavirus Infections/psychology , Delivery of Health Care/organization & administration , Implosive Therapy/methods , Pneumonia, Viral/psychology , Stress Disorders, Post-Traumatic/therapy , Attitude of Health Personnel , Betacoronavirus , COVID-19 , Continuity of Patient Care , Humans , Pandemics , Patient Compliance , SARS-CoV-2 , Stress Disorders, Post-Traumatic/psychology
Psychol Trauma ; 12(S1): S115-S117, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-596133


During the COVID-19 pandemic, trauma-exposed individuals may have heightened risk for substance use. Using substances to cope may contribute to the development of problematic substance use over time. It is imperative to initiate conversations about substance use with clients during this time and motivational interviewing offers an ideal framework for doing so. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Coronavirus Infections , Motivational Interviewing , Pandemics , Pneumonia, Viral , Psychological Trauma/therapy , Stress, Psychological/therapy , Substance-Related Disorders/therapy , Adult , COVID-19 , Humans
J Trauma Stress ; 33(4): 371-379, 2020 08.
Article in English | MEDLINE | ID: covidwho-245465


The global outbreak of COVID-19 has required mental health providers to rapidly rethink and adapt how they provide care. Cognitive processing therapy (CPT) is a trauma-focused, evidence-based treatment for posttraumatic stress disorder that is effective when delivered in-person or via telehealth. Given current limitations on the provision of in-person mental health treatment during the COVID-19 pandemic, this article presents guidelines and treatment considerations when implementing CPT via telehealth. Based on lessons learned from prior studies and clinical delivery of CPT via telehealth, recommendations are made with regard to overall strategies for adapting CPT to a telehealth format, including how to conduct routine assessments and ensure treatment fidelity.

COVID-19/psychology , Cognitive Behavioral Therapy/methods , Stress Disorders, Post-Traumatic/therapy , Telemedicine/methods , Humans , Pandemics , SARS-CoV-2 , Stress Disorders, Post-Traumatic/psychology