Remote and digitally delivered mental health support for care-experienced young people: Some practice-based reflections in response to cummings (2023)

In a recent contribution to this journal, Cummings (2023) reports findings from a preliminary qualitative study of practitioner viewpoints regarding digitally delivered mental health support to care-experienced young people. Cummings' study highlights the need to engage with professional experiences of using digital methods with this group, both during and outside of the COVID-19 pandemic. A response to - and commentary on - Cummings' contribution is provided, to advance discussion of issues identified by the research. We reflect on our experience as practitioners and researchers working in and alongside specialist child and adolescent mental health service teams serving care-experienced children and young people. We focus on workspaces in remote working, therapeutic technique in online and telephone-based care, and virtues and challenges of remote care delivery. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Internet-based interventions for family carers of people with dementia

There is an urgent global need for accessible, usable, effective and scalable skills training and support programs for carers of people with dementia, particularly in LMICs. WHO's iSupport is filling this gap by providing such a program, accessible for translation and cultural adaptation worldwide. First steps have been undertaken to support the systematic and culturally fair translation and adaptation of the program in several countries. However, while web-based or online programs for dementia carers such as iSupport seem to be promising, the scaling of these programs remains challenging and is a common issue for digital health solutions. In fact, the findings of a first efficacy study from India highlight the need to understand carers' individual situation better and tailor support programs even more to their specific needs. Going forward, iSupport could be improved by adding a mobile phone application to offer more flexibility to users, including an interactive or moderated chat function or more audio-visual materials to the online program to increase its appeal. To assist carers who wish to use more traditional ways of learning, WHO has released the iSupport hardcopy manual, which presents the entire iSupport content in book format. Further robust cultural adaptations and high-quality research investigating the effectiveness of iSupport across different settings and for different groups of carers are required. Finally, in the context of the ongoing COVID-19 pandemic, digital support services such as iSupport are more important than ever and present a real opportunity to build back better, which will help to reach the global target set by WHO that 75% of countries will provide support and training programs for carers and families of people with dementia by 2025. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

The impact of technology systems and level of support in digital mental health interventions: a secondary meta-analysis.

BACKGROUND: The majority of people with a chronic disease (e.g., diabetes, hypertension, COPD) have more than one concurrent condition and are also at higher risk for developing comorbidities in mental health, including anxiety and depression. There is an urgent need for more relevant and accurate data on digital interventions in this area to prepare for an increase demand for mental health services. The aim of this study was to conduct a meta-analysis of the digital mental health interventions for people with comorbid physical and mental chronic diseases to compare the effect of technology systems and level of support. METHODS: This secondary meta-analysis follows a rapid review of systematic reviews, a virtual workshop with knowledge users to identify research questions and a modified Delphi study to guide research methods: What types of digital health interventions (according to a recognized categorization) are the most effective for the management of concomitant mental health and chronic disease conditions in adults? We conducted a secondary analysis of the primary studies identified in the rapid review. Two reviewers independently screened the titles and abstracts and applied inclusion criteria: RCT design using a digital mental health intervention in a population of adults with another chronic condition, published after 2010 in French or English, and including an outcome measurement of anxiety or depression. RESULTS: Seven hundred eight primary studies were extracted from the systematic reviews and 84 primary studies met the inclusion criteria Digital mental health interventions were significantly more effective than in-person care for both anxiety and depression outcomes. Online messaging was the most effective technology to improve anxiety and depression scores; however, all technology types were effective. Interventions partially supported by healthcare professionals were more effective than self-administered. CONCLUSIONS: While our meta-analysis identifies digital intervention's characteristics are associated with better effectiveness, all technologies and levels of support could be used considering implementation context and population. TRIAL REGISTRATION: The protocol for this review is registered in the National Collaborating Centre for Methods and Tools (NCCMT) COVID-19 Rapid Evidence Service (ID 75).

Designing an Artifact to Empower Chronic Patients for Monitoring Health During a Pandemic: A COVID-19 Screening App

Chronic diseases have been declared as an invisible epidemic by the World Health Organization (WHO, 2005). Over the past fifty years, the prevalence of chronic conditions has increased, leading to the disease burden caused by cancer, cardiovascular diseases, diabetes, musculoskeletal conditions, and mental and substance use disorders (DOH, 2021). Chronic patients need to reimagine how they will empower themselves to effectively manage and monitor their health and wellbeing in a COVID-19 era, when frequent in-person health care visits will no longer be feasible. In this study, we propose the features for the design of a mobile based application that will aid chronic patients and end-users to self-manage and monitor their health during the pandemic era. Based on an empirical investigation involving pharmacists and researchers, we designed and developed a prototype capable of empowering chronic patients. This study particularly focuses on how technological interventions can help chronic patients to self-manage and monitor their health and wellbeing related to COVID-19 where the user expectations are met with less attrition rates. © 2023 IEEE Computer Society. All rights reserved.

Standing up for Myself (STORM): Adapting and piloting a web-delivered psychosocial group intervention for people with intellectual disabilities.

BACKGROUND: Our STORM intervention was developed for people (16 +) with intellectual disabilities to enhance their capacity to manage and resist stigma. The current study describes the adaptation of STORM for (synchronous) on-line delivery in the context of the Covid-19 pandemic. AIMS: To adapt the manualised face-to-face STORM group intervention for delivery via web-based meeting platforms and to conduct an initial pilot study to consider its acceptability and feasibility. METHODS AND PROCEDURES: The 5-session STORM intervention was carefully adapted for online delivery. In a pilot study with four community groups (N = 22), outcome, health economics and attendance data were collected, and fidelity of delivery assessed. Focus groups with participants, and interviews with facilitators provided data on acceptability and feasibility. OUTCOMES AND RESULTS: The intervention was adapted with minimal changes to the content required. In the pilot study, 95% of participants were retained at follow-up, 91% attended at least three of the five sessions. Outcome measure completion and fidelity were excellent, and facilitators reported implementation to be feasible. The intervention was reported to be acceptable by participants. CONCLUSIONS AND IMPLICATIONS: When provided with the necessary resources and support, people with intellectual disabilities participate actively in web-delivered group interventions.

The integration of technology: Benefits and challenges

Every effort to ensure that palliative care is effective and meaningful has been touched by technology. Digital health interventions may be used, for example, to facilitate targeted communications to individuals through reminders and health promotion messaging in order to stimulate demand for services and broaden access to health information. Palliative social workers have an opportunity to utilize the various forms of technology to enhance overall care. The rise of telehealth services, including telemedicine and teletherapy, began prior to the COVID-19 pandemic when use escalated rapidly as critical services needed to continue while practicing social distancing for safety and well- being. Additionally, palliative social workers have an opportunity to improve quality of care by using technology to create social connectedness, help minimize loneliness and isolation, and enhance the patient and family's knowledge base. Technology enables a world of information to be readily available at one's fingertips, and this can have significant implications for patients and families. Palliative social workers have the task of incorporating technology into the process of seeing and supporting the strengths and being present to the vulnerabilities of patients and families while identifying when the technology causes harm. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Creating solace and hope during COVID-19: An innovative Internet-based social work intervention

During megacity lockdown, a team of social work practitioners and researchers in Beijing developed a rapid, innovative, Internet-based intervention that provided social-emotional support for participating families through indoor micro-gardening. As COVID-19 continues to restrict in-person interactions and traditional social activities, this type of online social-emotional support and community building should become a major social work method for crisis intervention and service provision. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Leveraging Digital Technology to Support Pregnant and Early Parenting Women in Recovery from Addictive Substances: A Scoping Review.

Little is known about digital health interventions used to support treatment for pregnant and early parenting women (PEPW) with substance use disorders (SUD). METHODS: Guided by the Arksey and O'Malley's Scoping Review Framework, empirical studies were identified within the CINAHL, PsycInfo, PubMed, and ProQuest databases using subject headings and free-text keywords. Studies were selected based on a priori inclusion/exclusion criteria, and data extraction and descriptive analysis were performed. RESULTS: A total of 27 original studies and 30 articles were included. Varying study designs were used, including several feasibility and acceptability studies. However, efficacious findings on abstinence and other clinically important outcomes were reported in several studies. Most studies focused on digital interventions for pregnant women (89.7%), suggesting a dearth of research on how digital technologies may support early parenting women with SUD. No studies included PEPW family members or involved PEPW women in the intervention design. CONCLUSIONS: The science of digital interventions to support treatment for PEPW is in an early stage, but feasibility and efficacy results are promising. Future research should explore community-based participatory partnerships with PEPW to develop or tailor digital interventions and include family or external support systems to engage in the intervention alongside PEPW.

Digital interventions for substance use disorders in young people: rapid review.

BACKGROUND: Young people are disproportionately more likely than other age groups to use substances. The rise in substance use and related harms, including overdose, during the Covid-19 pandemic has created a critical need for more innovative and accessible substance use interventions. Digital interventions have shown effectiveness and can provide more engaging, less stigmatizing, and accessible interventions that meet the needs of young people. This review provides an overview of recent literature on the nature of recently published digital interventions for young people in terms of technologies used, substances targeted, intended outcomes and theoretical or therapeutic models employed. METHODS: Rapid review methodology was used to identify and assess the literature on digital interventions for young people. An initial keyword search was conducted using MEDLINE the Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment Database (HTA) and PROSPERO for the years 2015-2020, and later updated to December 2021. Following a title/abstract and full-text screening of articles, and consensus decision on study inclusion, the data extraction process proceeded using an extraction grid developed for the study. Data synthesis relied on an adapted conceptual framework by Stockings, et al. that involved a three-level treatment spectrum for youth substance use (prevention, early intervention, and treatment) for any type of substance. RESULTS: In total, the review identified 43 articles describing 39 different digital interventions. Most were early interventions (n = 28), followed by prevention interventions (n = 6) and treatment interventions (n = 5). The identified digital technologies included web-based (n = 14), game-based (n = 10), mobile-based (n = 7), and computer-based (n = 5) technologies, and virtual reality (n = 3). Most interventions targeted alcohol use (n = 20) followed by tobacco/nicotine (n = 5), cannabis (n = 2), opioids (n = 2), ketamine (1) and multiple, or any substances (n = 9). Most interventions used a personalized or normative feedback approach and aimed to effect behaviour change as the intended outcome. Interestingly, a harm reduction approach guided only one of the 39 interventions. CONCLUSIONS: While web-based interventions represented the most common type of technology, more recently developed immersive and interactive technologies such as virtual reality and game-based interventions call for further exploration. Digital interventions focused mainly on alcohol use, reflecting less concern for tobacco, cannabis, co-occurring substance use, and illicit drug use. Specifically, the recent exacerbation in the opioid crisis throughout North American underlines the urgent need for more prevention-oriented digital interventions for opioid use. The uptake of digital interventions among youth also depends on the incorporation of harm reduction approaches.

Economic and health impacts of the Change4Life Food Scanner app: Findings from a randomized pilot and feasibility study.

Introduction: The UK Government developed the Change4Life Food Scanner app to provide families with engaging feedback on the nutritional content of packaged foods. There is a lack of research exploring the cost-effectiveness of dietary health promotion apps. Methods: Through stakeholder engagement, a conceptual model was developed, outlining the pathway by which the Food Scanner app leads to proximal and distal outcomes. The conceptual model informed the development of a pilot randomized controlled trial which investigated the feasibility and acceptability of evaluating clinical outcomes in children and economic effectiveness of the Food Scanner app through a cost-consequence analysis. Parents of 4-11 years-olds (n = 126) were randomized into an app exposure condition (n = 62), or no intervention control (n = 64). Parent-reported Child Health Utility 9 Dimension (CHU9D) outcomes were collected alongside child healthcare resource use and associated costs, school absenteeism and parent productivity losses at baseline and 3 months follow up. Results for the CHU9D were converted into utility scores based on UK adult preference weights. Sensitivity analysis accounted for outliers and multiple imputation methods were adopted for the handling of missing data. Results: 64 participants (51%) completed the study (intervention: n = 29; control: n = 35). There was a mean reduction in quality adjusted life years between groups over the trial period of -0.004 (SD = 0.024, 95% CI: -0.005; 0.012). There was a mean reduction in healthcare costs of -£30.77 (SD = 230.97; 95% CI: -£113.80; £52.26) and a mean reduction in workplace productivity losses of -£64.24 (SD = 241.66, 95% CI: -£147.54; £19.07) within the intervention arm, compared to the control arm, over the data collection period. Similar findings were apparent after multiple imputation. Discussion: Modest mean differences between study arms may have been due to the exploration of distal outcomes over a short follow-up period. The study was also disrupted due to the coronavirus pandemic, which may have confounded healthcare resource data. Although measures adopted were deemed feasible, the study highlighted difficulties in obtaining data on app development and maintenance costs, as well as the importance of economic modeling to predict long-term outcomes that may not be reliably captured over the short-term. Clinical trial registration: https://osf.io/, identifier 62hzt.

Decreasing the public health burden of eating disorders: Commentary Schleider et al. (2023).

Eating disorders (EDs) are common, disabling, and costly; yet, less than 20% of those with EDs receive treatment. EDs have also skyrocketed in the COVID-19 pandemic, with access to care worse than ever, further solidifying the need to not only make EDs a priority but also embrace new approaches to address this major public health problem. Schleider et al. argue for the single-session intervention (SSI) as one such option and outline an agenda that would aid in building the evidence base and realizing the promise of SSIs for EDs. This commentary details three additional key issues that need to be addressed in order to realize the full potential of SSIs and related approaches and ultimately decrease the public health burden of EDs. These include conducting work to optimize interventions for greatest effectiveness, recognizing the value and working to massively increase reach of interventions like SSIs that can scale and meet diverse needs, and engaging in the work needed to address structural barriers to widespread dissemination of these approaches. Through this agenda, we will do more than embrace a single-session "mindset" and will catalyze the work needed to disseminate SSIs and related approaches at massive scale and maximize their impact.

Spatio-Temporal Clustering of Adolescent Bereavement in the United States During the Extended Response to COVID-19: A Follow-Up Study.

PURPOSE: This follow-up study investigated the spatio-temporal clustering of adolescent bereavement during the extended response to COVID-19 from October 2020-January 2022 in the continental United States. METHODS: Deidentified and anonymized bereavement data from Crisis Text Line (CTL), a text-based crisis intervention service, and SaTScan cluster analysis were used to identify space-time clustering of bereavement among adolescents, aged 24 years and less, during the COVID-19 pandemic. RESULTS: Clustering of bereavement conversations occurred during waves of high COVID-19 case and death counts, with the highest risk occurring in the Southeastern United States during the fall of 2020 (relative risk: 5.86, confidence interval: 3.48-8.24). Of the CTL texters who shared their demographic information, Indigenous American, Black, male, and female adolescents were more likely to seek help for bereavement when compared to the other CTL users. DISCUSSION: Findings show an increased need for bereavement counseling resources during periods of high COVID-19 cases and deaths.

Unlocking infodemics and mysteries in COVID-19 vaccine hesitancy: Nexus of conspiracy beliefs, digital informational support, psychological Well-being, and religious fatalism.

Guarding against an anti-science camouflage within infodemics is paramount for sustaining the global vaccination drive. Vaccine hesitancy remains a growing concern and a significant threat to public health, especially in developing countries. Infodemics, conspiracy beliefs and religious fatalism primarily fuel vaccine hesitancy. In addition, anti-vaccine disinformation, lack of understanding, and erroneous religious beliefs also trigger vaccine hesitancy. Global behavioral strategies such as wearing face masks and long-term preventive measures (i.e., COVID-19 vaccination) have effectively limited the virus's spread. Despite the alarming rate of global deaths (i.e., over 99% being unvaccinated), a large proportion of the global population remains reluctant to vaccinate. New evidence validates the usefulness of technology-driven communication strategies (i.e., digital interventions) to address the complex socio-psychological influence of the pandemic. Hence, the present research explored the digital information processing model to assess the interface between informational support (through digital interventions) and antecedents of vaccine hesitancy. This research involved two separate studies: a focus group to operationalize the construct of infodemics, which remained ambiguous in previous literature (Study 1), followed by a cross-sectional survey (Study 2) to examine the conceptual model. Data were collected from 1906 respondents through a standard questionnaire administered online. The focus group's findings revealed a multi-dimensional nature of infodemics that was also validated in Study 2. The cross-sectional survey results substantiated infodemics, religious fatalism and conspiracy beliefs as significant predictors of vaccine hesitancy. Similarly, conspiracy beliefs negatively influence an individual's psychological well-being. Furthermore, information support (through digital intervention) affected infodemics and religious fatalism, whereas it inversely influenced the strength of their relationships with vaccine hesitancy. Information support (through digital intervention) also moderated the relationship between conspiracy beliefs and psychological well-being.

Implementation, uptake and use of a digital COVID-19 symptom tracker in English care homes in the coronavirus pandemic: a mixed-methods, multi-locality case study.

BACKGROUND: COVID-19 spread rapidly in UK care homes for older people in the early pandemic. National infection control recommendations included remote resident assessment. A region in North-West England introduced a digital COVID-19 symptom tracker for homes to identify early signs of resident deterioration to facilitate care responses. We examined the implementation, uptake and use of the tracker in care homes across four geographical case study localities in the first year of the pandemic. METHODS: This was a rapid, mixed-methods, multi-locality case study. Tracker uptake was calculated using the number of care homes taking up the tracker as a proportion of the total number of care homes in a locality. Mean tracker use was summarised at locality level and compared. Semi-structured interviews were conducted with professionals involved in tracker implementation and used to explore implementation factors across localities. Template Analysis with the Consolidated Framework for Implementation Research (CFIR) guided the interpretation of qualitative data. RESULTS: Uptake varied across the four case study localities ranging between 13.8 and 77.8%. Tracker use decreased in all localities over time at different rates, with average use ranging between 18 and 58%. The implementation context differed between localities and the process of implementation deviated over time from the initially planned strategy, for stakeholder engagement and care homes' training. Four interpretative themes reflected the most influential factors appearing to affect tracker uptake and use: (1) the process of implementation, (2) implementation readiness, (3) clarity of purpose/perceived value and (4) relative priority in the context of wider system pressures. CONCLUSIONS: Our study findings resonate with the digital solutions evidence base prior to the COVID-19 pandemic, suggesting three key factors that can inform future development and implementation of rapid digital responses in care home settings even in times of crisis: an incremental approach to implementation with testing of organisational readiness and attention to implementation climate, particularly the innovation's fit with local contexts (i.e. systems, infrastructure, work processes and practices); involvement of end-users in innovation design and development; and enabling users' easy access to sustained, high-quality, appropriate training and support to enable staff to adapt to digital solutions.

Understanding Engagement in Digital Mental Health and Well-being Programs for Women in the Perinatal Period: Systematic Review Without Meta-analysis.

BACKGROUND: Pregnancy and the postnatal period can be a time of increased psychological distress, which can be detrimental to both the mother and the developing child. Digital interventions are cost-effective and accessible tools to support positive mental health in women during the perinatal period. Although studies report efficacy, a key concern regarding web-based interventions is the lack of engagement leading to drop out, lack of participation, or reduced potential intervention benefits. OBJECTIVE: This systematic review aimed to understand the reporting and levels of engagement in studies of digital psychological mental health or well-being interventions administered during the perinatal period. Specific objectives were to understand how studies report engagement across 4 domains specified in the Connect, Attend, Participate, and Enact (CAPE) model, make recommendations on best practices to report engagement in digital mental health interventions (DMHIs), and understand levels of engagement in intervention studies in this area. To maximize the utility of this systematic review, we intended to develop practical tools for public health use: to develop a logic model to reference the theory of change, evaluate the studies using the CAPE framework, and develop a guide for future data collection to enable consistent reporting in digital interventions. METHODS: This systematic review used the Cochrane Synthesis Without Meta-analysis reporting guidelines. This study aimed to identify studies reporting DMHIs delivered during the perinatal period in women with subclinical mood symptoms. A systematic database search was used to identify relevant papers using the Ovid Platform for MEDLINE, PsycINFO, EMBASE, Scopus, Web of Science, and Medical Subject Headings on Demand for all English-language articles published in the past 10 years. RESULTS: Searches generated a database of 3473 potentially eligible studies, with a final selection of 16 (0.46%) studies grouped by study design. Participant engagement was evaluated using the CAPE framework and comparable variables were described. All studies reported at least one engagement metric. However, the measures used were inconsistent, which may have contributed to the wide-ranging results. There was insufficient reporting for enactment (ie, participants' real-world use of intervention skills), with only 38% (6/16) of studies clearly recording longer-term practice through postintervention interviews. The logic model proposes ways of conceptualizing and reporting engagement details in DMHIs more consistently in the future. CONCLUSIONS: The perinatal period is the optimal time to intervene with strength-based digital tools to build positive mental health. Despite the growing number of studies on digital interventions, few robustly explore engagement, and there is limited evidence of long-term skill use beyond the intervention period. Our results indicate variability in the reporting of both short- and long-term participant engagement behaviors, and we recommend the adoption of standardized reporting metrics in future digital interventions. TRIAL REGISTRATION: PROSPERO CRD42020162283; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=162283.

Use of digital technologies in mental health during COVID-19

Most countries did not have a consolidated digital health structure before the pandemic. Both social distancing and mental health problems resulting from the situation justify the urgency of discussions on web-mediated interventions. The objective of this work is to present the panorama of technological mediation in mental health services and their specificities in the context of the pandemic. This paper is grounded on a critical look at the migration from face-to-face care to the Internet environment, highlighting: the international experiences using digital technologies in the pandemic context;the challenges in online consultations, emphasizing the importance of the ethical, technical/technological, and clinical domains, which are recurring issues in the international literature;the challenges and perspectives in the use of technologies. It is essential to develop strategies aligned with government incentives, aiming at the quality of the offered services and the guarantee of an adequate hybrid qualification. (PsycInfo Database Record (c) 2022 APA, all rights reserved) Impact Statement (Portuguese) A maioria dos paises nao possuia uma estrutura de saude digital consolidada antes da pandemia. Tanto o distanciamento social quanto os agravos psicologicos decorrentes da propria situacao justificam a urgencia de discussoes cientificas sobre intervencoes mediadas pela web. O objetivo deste trabalho e apresentar o panorama da mediacao tecnologica nos servicos de saude mental e suas especificidades no contexto da pandemia. Parte-se de um olhar critico diante da migracao do cuidado face a face ao ambiente da Internet, ressaltando: experiencias internacionais no uso das tecnologias digitais no contexto da pandemia;desafios nas consultas online, com destaque a importancia dos dominios etico, tecnico/tecnologico e da clinica recorrentes na literatura internacional;desafios e perspectivas do uso das tecnologias. E imprescindivel desenvolver estrategias com incentivo governamental, visando a qualidade dos servicos oferecidos e a garantia de formacao hibrida adequada. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Behind screens-An end to dreaming? How the switch to video consulting in the wake of COVID-19 contributed to a patient's breakdown

In Germany in March 2020, a sudden change from the classical analytical setting to a video setting (for only four sessions) in response to the threat of the Covid-19 virus led to a breakdown of the patient. Based on her dream after the first video encounter, ensuing associations, the dreamlike elements in the reverie that accompanied the narration of the dream, and the countertransference of the analyst, an attempt is made to work out in what way the conditions of the video setting contributed to the breakdown. Both clinically and based on the model of the alpha-function, the author shows deficiencies of somatic countertransference and unconscious rapport in the virtual setting. Since the video encounter allows only a restricted qualification of beta-elements via the alpha-function, pre-conceptions remain insufficiently articulated and therefore cannot be intuited and realised by the analyst, which means that their psychic transformation fails. For the patient, who was very dependent on being held and contained by the analyst especially in terms of the transformation of proto-emotional states into psychic experience, the analyst's inability to work in this setting like before felt like a rupture, like being dropped<<. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (German) Ein im Marz 2020 wegen der Infektionsgefahr durch das Covid-19-Virus abrupt erfolgter zwischenzeitlicher Wechsel vom klassisch-analytischen Setting in insgesamt vier Stunden einer Videosprechstunde fuhrte zu einem psychischen Absturz der Patientin. Anhand ihres Nachttraums nach der ersten Videobegegnung, den Assoziationen dazu, der die Traumerzahlung begleitenden traumerischen Elemente in der Reverie und der Gegenubertragung der Analytikerin wird der Versuch unternommen, herauszuarbeiten, in welchem Zusammenhang die Umstande des Videosettings mit dem Absturz der Patientin stehen. Klinisch und am Modell der Alpha-Funktion stellt die Autorin Einschrankungen der korperlichen Gegenubertragung und der Kommunikation von Unbewusst zu Unbewusst in dem virtuellen Setting dar. Die in der Videobegegnung nur eingeschrankte Qualifizierung von beta-Elementen durch die Alpha-Funktion geht mit einer ungenugenden Ausbildung von Pra-Konzeptionen einher, die dadurch von der Analytikerin nicht intuierbar sind und keine Realisierung erfahren, sodass ihre psychische Transformation ausbleibt. Die Patientin, die sehr darauf angewiesen war, dass die Analytikerin sie hielt, insbesondere indem sie die protoemotionalen Verfassungen der Patientin in sich aufnahm und darum bemuht war, sie in psychisches Erleben zu ubersetzen, erlebte die Unfahigkeit der Analytikerin, in diesem Setting wie zuvor zu arbeiten, als ein Fallen-gelassen-Werden. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Virtual social work care with older Black adults: A culturally relevant technology-based intervention to reduce social isolation and loneliness in a time of pandemic

This reprinted chapter originally appeared in Journal of Gerontological Social Work, 2020, 63[6-7], 679-681. (The following of the original article appeared in record 2021-00510-027.) Older Black adults are at an increased risk for COVID-19 for a number of reasons: poor socioeconomic status;living in rural/remote, high-density, or substandard physical environments;and difficulty accessing health care services (Bowden & Cain, 2020). Experience with anti-Black racism is also known to put members of Black and racialized communities at risk for COVID-19. These factors influence the health and social care of older Black adults, particularly those who are immunocompromised or present with underlying medical conditions, including diabetes, heart disease, hypertension, high blood pressure, and cancer. Current measures for reducing the transmission of COVID-19-including social distancing-do not take a racially and culturally informed approach to health and well-being. In the proposed intervention strategy, as in the traditional African practice of Ubuntu, individuals would see themselves as part of a collective whole. Older Black adults would have a central role in identifying their own and the group's needs, and determine with social workers the best possible solution for meeting those needs. Even at a distance, the interdependent relationship between older Black adults and social workers would depart from the traditional Eurocentric social work practice where the practitioner holds power, determines what the service user needs, and prescribes individualistic solutions. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Canadian perspectives of digital mental health supports: Findings from a national survey conducted during the COVID-19 pandemic.

Objectives: The impact of the COVID-19 pandemic on population mental health has highlighted the potential for digital mental health to support the needs of those requiring care. This study sought to understand the digital mental health experiences and priorities of Canadians affected by mental health conditions (i.e. seekers, patients, and care partners). Methods: A national cross-sectional electronic survey of Canadians was administered through a market research firm's survey panel. Seekers, patients, and care partners were asked about their digital mental health experiences (e.g. uptake, barriers to access) and priorities. Survey responses were summarized using descriptive statistics. Results: Overall, 1003 participants completed the survey. 70.2% of participants routinely use digital mental health supports to support themselves or those they care for; however, only 28.6% of participants are satisfied with the available digital mental health supports. Most participants (73.3%) have encountered some barriers when accessing digital mental health supports. Awareness of digital mental health supports was a top barrier identified by participants. The top digital mental health priorities consisted of digital mental health curation, navigation, and a digital mental health passport. Conclusions: Most participants use digital mental health supports for themselves or others, however, many are unaware of digital mental health supports available. Efforts to improve navigating access to digital and in-person mental health services are seen as a top priority, highlighting the need to enable seekers, patients, and care partners to find the appropriate support and make decisions on how to best improve their mental health.

Review of Mobile Apps for Women With Anxiety in Pregnancy: Maternity Care Professionals' Guide to Locating and Assessing Anxiety Apps.

BACKGROUND: Mental health and pregnancy apps are widely available and have the potential to improve health outcomes and enhance women's experience of pregnancy. Women frequently access digital information throughout their pregnancy. However, health care providers and women have little information to guide them toward potentially helpful or effective apps. OBJECTIVE: This review aimed to evaluate a methodology for systematically searching and reviewing commercially available apps that support pregnant women with symptoms of anxiety in order to assist maternity care professionals in identifying resources that they could recommend for these women. METHODS: A stepwise systematic approach was used to identify, select, describe, and assess the most popular and highly user-rated apps available in the United Kingdom from January to March 2021. This included developing a script-based search strategy and search process, writing evaluation criteria, and conducting a narrative description and evaluation of the selected apps. RESULTS: Useful search terms were identified, which included nonclinical, aspirational, and problem-based phrases. There were 39 apps selected for inclusion in the review. No apps specifically targeted women with anxiety in pregnancy. Of the 39 apps included in the review, 33 (85%) focused solely on mind-body techniques to promote relaxation, stress reduction, and psychological well-being. Only 8 of the 39 (21%) apps included in the review reported that health care professionals had contributed to app development and only 1/39 (3%) provided empirical evidence on the effectiveness and acceptability of the app. The top 12/39 (31%) apps were evaluated by 2 independent reviewers using the developed criteria and scores. There was a small negative correlation between the reviewers' scores and app user rating scores, with higher user rating scores associated with lower reviewer scores. CONCLUSIONS: App developers, publishers, and maternity care professionals should seek advice from women with lived experience of anxiety symptoms in pregnancy to locate, promote, and optimize the visibility of apps for pregnant women. There is a lack of resources that provide coping strategies based on current evidence for the treatment of anxiety in pregnancy. Maternity care providers are limited in their ability to locate and recommend acceptable and trustworthy apps because of the lack of information on the evidence base, development, and testing of apps. Maternity care professionals and women need access to libraries of trusted apps that have been evaluated against relevant and established criteria.