Alone, in the presence of a group

The article offers a reflection on the experience of the Marches Group of the Italian Society of Psychoanalytical Psychotherapy for Children, Adolescents and Couples during lockdown. Group members were able to share their thoughts from a distance during the emergency created by Covid-19 and this experience also continued subsequently. The group proved to be an important resource during this difficult period as it allowed members' minds to continue thinking while the world had come to a halt. The article dwells on a clinical case that was shared during the group's evening meetings. The protagonist was a girl in the latency period, whose symptoms arose during the Covid emergency. The group acted as a container and fostered thoughts and associations that supported the psychotherapist in this clinical experience. The group sharing was equally important for helping members to leave the protective shell of their homes when everything got going again. (PsycInfo Database Record (c) 2023 APA, all rights reserved) (Italian) La riflessione che proponiamo si articola sull'esperienza del gruppo Asne-Sipsia Marche nel corso del lockdown. Durante Femergenza da Covid 19 abbiamo potuto condividere pensieri da remoto, esperienza che e continuata anche successivamente. Il gruppo si e rivelato una risorsa importante in questo periodo difficile, permettendo alle nostre menti di continuare a pensare, mentre il mondo si era fermato. In questo lavoro ci soffermiamo su un caso clinico, condiviso nelle nostre serate, che ha come protagonista una bambina in eta di latenza la cui sintomatologia si inserisce nella cornice delFemergenza Covid. Il gruppo ha svolto la funzione di contenitore e ha favorito pensieri e associazioni che hanno sostenuto la psicoterapia in questa esperienza clinica. La condivisione e stata altrettanto importante per Fuscita dal guscio protettivo delle nostre case, al momento della ripartenza. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Keeping connected: Family therapists' experiences of working online during the COVID‐19 pandemic

For this qualitative study, eight family therapists were interviewed about their experiences of practising online during the pandemic. Findings are organised using a framework of problems, possibilities, resources and restraints (PPRR, Neden & Burnham, 2007). Despite variation in therapist confidence in online practice, all participants found new possibilities in this way of working, including connecting family members across distance, increased co‐construction within therapeutic relationships and engaging clients who would not usually attend appointments. Therapeutic alliance was generally possible to establish online, though felt more challenging with whole families than individuals. Problems and restraints included therapist fatigue, risk and safety management, and attuning to nuanced expression of emotion. Implications for practice and future research are proposed. It is suggested that systemic practice has unique qualities to offer the field of online psychotherapy.

Preliminary Efficacy of Remote, Brief Telepsychotherapy for Covid-19 Patients and Their First-Degree Relatives

Introduction: Over the last two years, the COVID-19 pandemic has negatively impacted the mental health of both COVID-19 patients and the general population. Adults with COVID-19 risked their lives, lost their loved ones, struggled with comorbid clinical conditions to manage, and have been unable to enjoy the physical presence of their families during the infection, quarantine, and lockdown periods. During hospitalization and discharge, family members often did not receive clinical updates from providers and patients, were unable to offer in-person assistance, and to receive psychological support. Incidence and prevalence of depression and anxiety among COVID- 19 older adults and their family members skyrocketed beyond the possibilities of any mental health system to address psychological aftermath of this pandemic and intervene with in-person services. In response to the urgent need for treatments that could be remotely delivered at a large scale, we designed DigiCOVID, a digital mental health approach that offered remote brief tele-psychotherapy to COVID-19 patients and/or their first-degree relatives. The main goal of this single arm, naturalistic study was to evaluate the feasibility, acceptability and usability of DigiCOVID. Additionally, we assessed the impact of DigiCOVID on psychopathology by means of self-report questionnaires. Method(s): Participants underwent an initial phonebased screening to of inclusion and exclusion criteria. Inclusion criteria were: 18-80 years old;positive nasopharyngeal swabs or serology to COVID-19 (for the patients' subgroup);absence of visual/ motor deficits that might interfere with study participation;good level of Italian;and adequate tech literacy. Participants were excluded if they had a previous or actual DSM-5 diagnosis of bipolar disorder, psychotic disorder, or substance use disorder;if they had a diagnosis of dementia;or if they presented suicidal ideation assessed through the Columbia Suicide Severity Rating Scale. Next, they completed a neuropsychological test over video to assess IQ (if lower than 70 participants were excluded), and filled out online gold-standard selfreports for depression (PHQ-9), anxiety (GAD-7), insomnia (ISI), post traumatic symptoms (IES-R) and general wellbeing (GHQ-12). Participants were then assigned to a psychotherapist who remotely conducted eight remote tele-psychotherapy sessions. After treatment, online questionnaires were filled out again to collect data on preliminary efficacy. Result(s): Since November 2021, 138 patients were recruited, 83 completed the intervention (57 patients, 26 fist-degree relatives), and 55 dropped out. At a group level, participants showed significant improvements on all clinical outcomes (PHQ-9: R2=0.12, p=.0019;ISI: R2=0.15, p=.0004;IES-R: R2=0.11, p=.0003;GHQ- 12: R2=0.23, p<.0001;GAD-7: R2=0.12, p=.0011). Given the high heterogeneity in illness severity and psychopathology, we conducted clustering on baseline data coming from the five online questionnaires: 55% of the whole sample had no psychopathology (Cluster 1), whereas 45% showed severe psychopathology (Cluster 2). When clustering was conducted on post-treatment data, three clusters emerged: no psychopathology, residual psychopathology and severe psychopathology. 71% of Cluster 1 participants remained asymptomatic;25% of Cluster 2 participants showed full symptom remission, while 48% and 28% of Cluster 2 participants showed partial symptom remission and no significant effect of treatment, respectively. Conclusion(s): Remote brief tele-psychotherapy for COVID-19 patients and their first-degree relatives is feasible and preliminary efficacious at reducing COVID-related psychopathology. Further research is needed to investigate distinct profiles of treatment response.

Lessons Learnt from Delivering a Brief Telepsychotherapy Intervention for Covid-19 Patients and Famili Members: Between Limits and Possibilities of Novel Care Delivery Models

Introduction: The implementation of a brief tele-psychotherapy intervention for COVID-19 patients and family members by a team of psychotherapists with different orientations (psychodynamic, phenomenological, cognitive behavioral) led to a shared reflection on the possibilities as well as on the therapeutic and technical limits of this treatment. Because the brief tele-psychotherapy intervention is designed to have a targeted focus on the COVID-19 experience and how this has affected the patient's life, it allows to read COVID-19 related suffering as a guide to diagnosis: medical comorbidities and unprocessed psychological suffering interplay with the experience of COVID-19 illness - with symptomatic severity ranging from absence to hospitalization in intensive care depending on the case. The interplay among these elements produces psychopathological scenarios that are at times evident and complex, at other times apparently less serious and difficult to connect to the suffering that the patient endorses and to their COVID-19-related medical symptoms. Method(s): This work summarizes qualitative data produced by a team of ten psychotherapists involved for 18 months in a brief tele-psychotherapy service for COVID-19 patients and family members, and engaged in a weekly group supervision/ intervision experience. Result(s): The remote nature of the brief tele-psychotherapy intervention made it possible to overcome the distance caused by the barriers imposed by social isolation, and to provide psychological assistance to patients who were ill, were sheltered in place because they tested positive, were elderly at risk, or young people who lost contact with their peers. Cases in which the consequences of COVID- 19 undermined self-esteem, sleep quality, induced anxiety and depression, and emotional dysregulation have been treated with impactful Results: The brief tele-psychotherapy experience allowed patients to mitigate the risks and negative consequences of the COVID-19 experience on physical and mental health, and to restore goal-setting abilities in light of the traumatic experience. Patients in need of psychiatric assistances were referred to the relevant services thanks to an interdisciplinary network. Based on the group supervision/ intervision experience, three areas of discussion were identified: the remote nature of the setting, the relationship between illness severity and treatment seeking, and patients' intrinsic motivation towards psychotherapy. (i) Therapists with different orientations agreed that the 'remote' setting had advantages and disadvantages. The meaning of the setting encompasses symbolic aspects such as 'pre-', 'during-', and 'post'-session moments, because a well-defined place implies the presence, attention, active participation of therapist/client as well as the typical rules such as timeliness. We observed that the 'remote' setting impoverishes the shape and meaning of the typical mental and physical state associated with in-person psychotherapy, as it induces the therapist to manage the session within a client's life space-time that is very often improvised, corrupted by intermittent connectivity issues, lacking privacy or populated with unpredictable environmental circumstances. As such, the conceptual value each theoretical orientation assigns to the psychotherapeutic setting is, on all accounts, contaminated. (ii) Patients with overt traumatic experiences (long hospitalization in COVID-19 wards, intensive care units, rehabilitation facilities) responded better to CBT-oriented psychotherapy. For example, CBT initiates the therapeutic process with case formulation - which aims to describe the problems presented by the patient and to make theoretical inferences about its causes and its maintenance factors. This formulation serves as the basis of a strategically oriented psychotherapeutic intervention, and accompanies all phases of therapy until its Conclusion(s): Conversely, psychodynamic therapists read COVID-related psychopathology as a window into intrapsychic mechanisms that can hardly be orked through in the context of eight sessions. Interestingly, patients lacking frank COVID-19 related medical or psychological symptoms were those for whom a psychodynamic process seemed more indicated, in that it oriented the clinical work towards awareness building, and exploration of intrapsychic and interpersonal goals that transcended current circumstances. (iii) A third, notable point concerns patients' motivational attitudes towards therapy. Because therapists were operating in the context of a research protocol, therapy was presented as a free service that was seeking patients, rather than vice versa. Here, therapists took on an unusual role as they attempted to psychologically transform patients' availability into a request for psychological assistance, even when this was - at least in some cases - consciously absent. In such cases, the transformational processes that are typical of therapy evolved without a clear initial direction, shedding doubts on actual patients' motivation, and leading therapists to offer a final restitution that was limited to the phase of therapy during which an actual psychological goal was voiced by the patient. Conclusion(s): We illustrated the possibilities and limits of brief tele-psychotherapy with regard to the factors that are common to the various theoretical orientations. We noticed that the remote delivery alters conceptual properties, roles, and symbolic connotations of the setting. Similarly, the seek for help, often not defined, can hardly find adequate space within eight sessions, while the severity of COVID-19 related psychopathology seems to be associated with greater efficacy. Future research should examine how brief remote psychotherapy adjusts to emerging clinical difficulties, and should incorporate a prospective design to better establish causality between expected efficacy and interfering occurrences. Further examination on the mechanisms of these interferences is also needed. Ultimately, this line of research can provide precious information about the dissemination of remote tele-psychotherapy above and beyond COVID-19-related psychopathology.

Brief tele-psychotherapy for COVID-19 patients and their family members

Since the COVID-19 pandemic onset, researchers and clinicians have attempted to characterize a heterogeneous cluster of psychopathological symptoms that typically emerge when patients are no longer positive to SARS-CoV-2 infection, and can persist for weeks if not months. These symptoms include depression, anxiety, acute/posttraumatic stress, and sleep disturbances, and are frequently observed in COVID-19 patients as well as in their first-degree relatives. COVIDrelated symptomatology seems to map onto well-established psychopathological macro-areas: 1) trauma and post-traumatic symptoms, mainly for those who have experienced hospitalization or loss;2) adaptation and functional reorientation due to physical complications or sequelae;3) identity reorientation following the experience of illness/isolation/lockdown;and 4) exacerbation of premorbid psychopathological traits solicited by the COVID-19 experience. Notably, the severity of COVID-19 related psychopathology ranges from mild to more disabling conditions and seems to affect youth, adults, and elders irrespectively of the severity of the acute COVID-19 illness. Nonetheless, it unequivocally affects wellbeing, quality of life, and real-world functioning. In response to the urgent need for treatments that could be offered safely, without burdening an already strained mental health system, an interdisciplinary group of psychotherapists and researchers based in Milan, Italy has undertaken the first national attempt to create a research-informed infrastructure to study the feasibility and efficacy of a remote tele-psychotherapy free service for COVID-19 patients and their first-degree relatives. The process initially leveraged clinical experiences with COVID-19 patients and family members remotely referred to the Ospedale Maggiore Policlinico in Milan for psychological assistance from various intensive care units and hospital wards. Next, the research group reviewed the scientific literature on psychotherapeutic approaches designed to remotely treat psychopathology. The harmonization of techniques and strategies deriving from several psychotherapeutic orientations (psychodynamic therapy, constructivist therapy and hermeneutic-phenomenological therapy) culminated in the development of the first brief psychotherapy service for COVID-19 related psychopathology. The service, designed to easily integrate with the workflow of the national health system, consists of 8 remote, 50-minute, individual psychological sessions that are offered weekly using secure video conferencing software. The feasibility and evidence base for this treatment have been investigated thanks to a research project funded by Fondazione Cariplo and Regione Lombardia that has recruited as of June 2022 more than 140 participants, between COVID-19 patients and firstdegree relatives. Results from this study will be presented during the symposium and indicate that remote brief tele-psychotherapy for COVID-19 patients and their first-degree relatives is feasible and efficacious at significantly reducing anxiety, depression, post-traumatic symptoms, and sleep disturbances. Interestingly, statistical analyses suggest distinct profiles of treatment response among participants with severe COVID-19 related psychopathology, in that 25% showed full symptom remission, 48% showed partial symptom remission, and 28% showed no significant effect of treatment. 30 months after the pandemic onset, the same interdisciplinary group of psychotherapists and researchers summarizes reflections from the weekly experiences of group supervision/intervision, and offers a retrospective on the possibilities and limits of this brief tele-psychotherapy service, with an emphasis on the conceptual properties, roles, and symbolic connotations of the remote setting, and on the relationship between patients' illness severity and intrinsic motivation. Above and beyond COVID-19-related psychopathology, the novel quantitative and qualitative data presented at this symposium will provide insightful information about the implementation potent al of remote brief tele-psychotherapy - a promising treatment model that can change clinical practice, enhance cost-effectiveness, and lead to better wellbeing and quality of life for patients.

Multiple voices and lockdown

Between January 2019 and December 2022, a student (named L.A.) doing a BTS (a senior technologist's certificate) in Management was treated using a trimodal system of care by the BAPU of the Claude Bernard Center. How was this original system organized, and how did changes related to the lockdown of March-May 2020 allow for progress in the proposed treatment? The consulting psychologist, Ms. Beaudre, received the initial request: L.A. had multiple difficulties (learning, language, social, psychic, somatic, etc.). Rapid guidance was recommended in an individual space dedicated to educational psychology, while continuing with consultations. In the educational psychology space, L.A. met with Mr. Sanchez and first explained to him her concerns about her difficulties with the French language, her rejection of her mother tongue and her accent. Her learning difficulties made her fear she would fail the BTS. L.A. had low self-esteem. At the start of the lockdown of March-May 2020, the educational psychological support was done at a distance (by telephone), and this did not help to reduce L.A.'s anxiety. Shortly before the start of the lockdown, L.A. had met with Ms. Dziwulski, psychologist-psychotherapist, as part of a therapeutic relaxation session. The question of the physical isolation was an overwhelming concern. The isolation imposed by COVID-19 posed a serious problem for the continued use of this trimodal system of care: how to continue working with L.A.? Within the parameters of this trimodal care, an attempt was made to adapt the follow-up for L.A. around the question of the verbal contact via telephone and the physical presence (distant or real), in a way which would allow this young woman to question/examine the orders given by her inner voice that she called her "policeman". The temporary suspension of in person contact, as well as work on her self-image and imagination, the exclusivity of her inner voice and then the application of the telephone voice/real physical presence at the BAPU leading to the questioning of the role of the body in her difficulties, allowed L.A to exist differently. The establishment of and the modifications made to this system of care ultimately functioned as a mediation, which provided L.A. the possibility of acquiring another voice, another space in which to think.Copyright © 2023

Clinicians' Reflections of the Therapeutic Relationship in Videoconferencing: A Qualitative Study

Introduction: In recent years the use of distance psychotherapy has been gaining in popularity (Hollis et al., 2015), especially due to the Covid-19 pandemic, which has forced many clinicians to use online interventions to comply with social distancing rules, enabling them to experience the resources and the limitations of online tools and consultations (Van Daele et al., 2020). Among the different ways of providing online psychotherapy, videoconferencing psychotherapy has many advantages (e.g., reaching people who have conditions that hinder the carrying out of a face-to-face treatment, the possibility of improving the integration network between the different territorial services, facilitating access to them) and its effectiveness was demonstrated in the literature (Thomas et a., 2021;Backhaus et al., 2012). Despite these advantages, for clinicians, one of the biggest concerns about videoconferencing psychotherapy is its potential negative influence on the therapeutic relationship with clients in terms of strategies, quality and emotion detection by the online communication modality, especially because of the lack or reduction of conventional, non-verbal signs and clues typical of a traditional clinical setting (Cipolletta & Mocellin, 2018). Many clinicians report feeling insecure about their ability to communicate their empathy and build a therapeutic alliance online as well as to feel more tired, less competent and confident, less authentic or genuine, and less connected with clients during online video sessions (Bekes & Aafjes-van Doorn, 2020). Moreover, recent studies seem to suggest that different relational aspects may intervene in the video-mediated relationship than in the presence, such as the necessity of an extensive use of ostensive cues (Fisher et al., 2020), a greater disinhibition and openness in videoconferencing or an increased flexibility;these elements could have a different role in online than face-to-face interventions (Simpson et al., 2020;Cipolletta et al., 2017). According to these considerations, the aim of this work is to further explore which are the peculiar aspects involved in the video-mediated clinical relationship and its differences from face-to-face interventions. Method(s): We involved in the study 32 psychotherapists (85.2% female;Mage=35.07) affiliated to an Italian agency that provides online psychotherapy, which were divided into three groups based on their levels of clinical experience. Each group attended an online 2-session focus group conducted by two psychotherapists who administered an ad hoc semi-structured interview to the participants based on the core issues of this study and the evidence presented in the literature about the characteristics of video-mediated relationship. In the focus groups the experiences of the therapists were investigated through 4 areas: (1) therapeutic relationship;(2) personal and professional background;(3) non-verbal communication and (4) management of therapeutic boundaries. All sessions were video-recorded and transcribed. Transcripts were coded using the inductive thematic analysis method (Braun & Clarke, 2012) by three coders supervised at regular intervals by two experts. Each of the coder independently coded the transcripts and each discrepancy was discussed in group until obtaining agreement among coders. Result(s): Preliminary results show that clinicians refer how the relationship in videoconferencing has distinctive characteristics that differed from face-to-face setting. These characteristics are related to four main areas, which emerged from the analysis: (1) emotional and relational aspects of psychotherapy;(2) motivation and beliefs;(3) corporeity and movement and (4) management of therapeutic boundaries. Regarding emotional and relational as- pects, clinicians reported the presence of some elements that differ from face-to-face therapy, such as the establishing of the therapeutic alliance, the level of intimacy and safety of the therapeutic relationship and the drop-out rates. About the second area, principal themes pointed out by clinicians regarding the presence of differences in levels of motivation and urgency in the request of psychological intervention expressed by patients who choose online psychotherapy;furthermore, both clinicians and patients (as referred by their therapist) initially have some prejudices about the effectiveness of videoconferencing psychotherapy. There is a general agreement among therapists about the lack of non-verbal signals and corporeity in videoconferencing that forced clinicians to focus on facial movements, eye contact and tone of voice;furthermore, also the use of silence is different in online psychotherapy. Lastly, concerning the management of therapeutic boundaries, therapists affirmed that technical problems (internet connection, device use.), the possibility of maintaining privacy, the increased responsibility of the patient in the setting construction and the consequent need to educate the patient on how to be in therapy are the principal characteristics of the videoconferencing therapy. Further and more detailed results will be presented. Conclusion(s): The preliminary results of this study suggest that in the therapist's perception the therapeutic relationship in videoconferencing has peculiar characteristics and is different from the face-to-face context, but there is no agreement on what. Perception is highly variable from therapist to therapist and the critical aspects identified vary from prejudice to technical problems, from the setting to the quality of the relationship.

COVID-19 Anxiety and Washing Obsessive-compulsive Symptoms: Stress Coping Styles as a Mediator

Background: The COVID-19 pandemic has significantly impacted people's psychological functioning, including how they cope with anxiety. This study aimed to assess the role of coping styles in the relationship between COVID-19 anxiety and Washing ObsessiveCompulsive Disorder (W-OCD) symptoms. Methods: A cross-sectional study was performed on 420 people living in Kashan city (Iran) from March to April, 2020. Participants were selected by the convenience sampling method due to the difficulties brought about by COVID-19 and completed the contamination subscale of the Padua Inventory, COVID-19 anxiety inventory, and coping strategies scale. Data were analyzed by structural equation modeling (SEM) using AMOS-22. Results: The results revealed that emotion-focused, somatization and social support coping strategies were significantly associated with W-OCD symptoms. Also, there was a significant correlation between COVID-19 anxiety and the W-OCD symptoms. SEM results revealed that emotion-focused and somatization coping strategies positively mediated the relationship between COVID-19 and W-OCD symptoms. Conclusion: Emotion-focused and somatization coping strategies increase W-OCD symptoms following COVID-19 anxiety. Psychoeducation interventions addressing COVID-19's physical and psychological impacts on health, discriminating the rational and adaptive behavior and obsessive and compulsive behaviors, and restricting the information gathering from numerous sources, which may lead to increased negative emotions, might be helpful. © 2023 Bentham Science Publishers.

Therapeutic encounters at the onset of the COVID-19 pandemic: psychodynamic therapists' experiences of transition to remote psychotherapy

The COVID-19 pandemic crippled many parts of society as it spread throughout the world beginning in early 2020. Overnight, whole societies were forced to change their way of life, because of social distancing and lockdowns. For therapists, the pandemic meant that in-person sessions were no longer possible and many switched to different forms of synchronous remote communication by telephone, online audio or video link. The aim of this study was to explore psychodynamic therapists' experiences over time of forced transitions to telepsychotherapy. Five therapists were interviewed at the beginning of the pandemic and at a one-year follow-up. The data were analysed by applying thematic analysis with a phenomenological approach. Initially, the therapists struggled with technical and safety issues. The loss of the therapy room and of access to non-verbal nuances contributed to impaired contact with the patients and more superficial conversations. The therapists experienced that the very nature of psychodynamic psychotherapy was affected, even if telepsychotherapy could give some new opportunities. One year later many of the difficulties remained, but the therapists developed better coping strategies and were back to the therapy focus. One implication of this study is that telepsychotherapy needs to be integrated into psychotherapy training and supervision.Copyright © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Loss and Survival: Experiences of Psychoanalytic Psychotherapists Working Remotely During the COVID-19 Pandemic

This paper presents the findings of a research project that explored the experiences of psychoanalytic psychotherapists based in the UK during the first period of lockdown in the COVID 19 pandemic. Groups of therapists met regularly to share and reflect on the impact of the sudden changes to their practice, and this paper pulls together the key themes which emerged from these discussions. The overarching preoccupations of the psychotherapists were those of loss and survival, with sub-themes of difficulty holding the frame;reduced security and safety;challenged analytic technique;and altered relationship dynamics. The groups were highly valued by participants as offering support during times of unprecedented stress, while also providing a forum to learn from and make creative use of the challenges presented by working remotely. Copyright © 2022 The Authors. British Journal of Psychotherapy published by BPF and John Wiley & Sons Ltd.

"Why become a shrink and why remain one? The identities of the psychotherapist": Reports of a group experience

There are a multitude of motivations that lead each psychotherapist to choose this profession and to practice it. The ARPAG (Association Romande pour l'Analyse de Groupe;Francophone Swiss Association for Group Analysis) has set up an experiential group seminar to give participants, at different stages of their professional career, the opportunity to delve into questions related to their professional identity as psychotherapists. The group analytic approach through discussion groups and psychodrama made it possible to explore certain aspects and to put them into play in a group. We discuss some of these themes. This type of group experience, with psychotherapists of different ages, offers each of us the opportunity to question our investments in our current practice. We also trace the ups and downs in the organization and rollout of this seminar, which took place in October 2020 in Archanes (Crete). It was held in the middle of the COVID-19 pandemic. Moreover, powerful earthquakes struck Crete during the holding of the seminar. This particular environment had a great influence on the process. Copyright © 2022 Editions Medecine et Hygiene. All rights reserved.

Trajectories of burnout and psychological well-being among psychotherapists during the Covid-19 pandemic: Results of a 1-year prospective study.

The main goal of this study was to investigate the trajectories of the changes in burnout and subjective well-being (SWB) among psychotherapists in relation to social support, self-efficacy, sociodemographic, and work-related factors, with additional control for the subjectively experienced Covid-19 related distress. This study was carried out over a 1-year period during the critical time of the Covid-19 pandemic. We reached 226 Polish psychotherapists, of which 207 psychotherapists (91.6%) participated in all three measurements. The participants completed the following measurements: the Maslach Burnout Inventory-Human Service Survey, the Satisfaction with Life Scale, the General Self-Efficacy Scale, the Multidimensional Scale of Perceived Social Support, and a questionnaire regarding sociodemographic, work-related factors and Covid-19 related distress. Several trajectories were observed for both burnout and SWB, which were differently associated with the level of social support, self-efficacy, and sociodemographic and work-related factors. We did not find a significant relationship between Covid-19 related distress and the inclusion of either burnout or SWB trajectories. This study calls for greater interest in the psychological health of psychotherapists. More specifically, our findings may entail some implications for the practice of psychotherapy by creating customized intervention programs to reduce burnout and enhance well-being in this specific occupation.

Psychotherapists' Acceptance of Telepsychotherapy: A Machine Learning Approach

Introduction: Therapists' forced transition to provide psychotherapy remotely during the COVID-19 pandemic offers a unique opportunity to examine therapists' views and challenges with teletherapy. Objective(s): We aimed to develop predictive models of three aspects of psychotherapists' acceptance of teletherapy during the COVID-19 pandemic;attitudes towards teletherapy, concerns about using teletherapy, and intention to use it in the future. Method(s): In an international survey, therapists (N = 795) completed a survey about their experiences during the pandemic, including quality of therapeutic relationship, professional self-doubt, vicarious trauma, and telepsychotherapy acceptance. Regression decision trees machine learning analyses were used to build prediction models for each aspects of telepsychotherapy acceptance. Result(s): Attitudes toward telepsychotherapy were most positive for therapists who reported neutral or strong online working alliance, especially if they experienced little professional self-doubt and were younger than 40 years old. Therapists who were most concerned about telepsychotherapy, were those who reported higher levels of professional self-doubt, particularly if they also reported vicarious trauma experiences. Therapists who reported low working alliance were the least likely to use telepsychotherapy in the future. Conclusion(s): Therapists' professional self-doubt and the quality of their working alliance with their telepsychotherapy patients appear to be the most pertinent factors associated with therapists' acceptance of telepsychotherapy during COVID-19, and should be addressed in future training and research.

Con

The Covid-19 Pandemia is not a turning point for e-health It might seem meaningful that this e-health approach will also continue in mental health care after the Covid-19, given the obvious pragmatic advantages. But several issues could at least delimitate a future use of e-health technology in psychiatry/psychotherapy: Patient with severe depression and suicidality seem not to be the right target group Same with other serious mental disorders First contact patients (depending among others on their personality characteristics), often have problems to open themselves at phone or video contacts In Germany (and probably other European countries?) a relative high percentage of psychiatrists/psychotherapists are reluctant or at least ambivalent against video based interventions A quite high percentage of psychiatrists/psychotherapists in Germany believe that a relevant proportion of their patients might not accept this very technical approach of doctor-patient-interaction. Currently in Germany, probably also in some other European countries, complain that some legal and billing issues are not fully solved. Some of these problems could decrease in the future and insofar it is difficult to make a valid prediction of the place of e-health technology in psychiatry/psychotherapy. Beside this one point seems of great importance to me: the current e-health success, driven by the Covid-19 Pandemia, should not be the direction of more cost saving psychiatry/psychotherapy, generally neglecting the need for personal interaction between patients and therapists.

Online psychotherapy during COVID-19 pandemic - experiences of psychotherapists Research review

In 2019, mass infections caused by the SARS-CoV-2 coronavirus and the disease caused by it became the reason for global social, economic and health crises. This situation required changes, also in the field of psychotherapeutic practice and the implementation of new solutions. One of the possibilities of continuing services provision was to start the Internet usage Aim: The purpose of this paper is to review the latest research related to the experiences of psychotherapists working online during the pandemic. An additional goal is to present the broadest possible analysis of the literature based on research conducted in various countries around the world. Materials: Google Scholar, PubMed, Scopus and PsycNet were searched for a review. From among the search results that met the general criteria, those related to psychotherapeutic practice in the given countries were selected. Conclusion(s): Online psychotherapy has become a significant component of psychotherapeutic practice during a pandemic. Earlier expectations and concerns could be verified. The presented results of selected studies create a picture of the functioning of psychotherapists in many countries and constitute the basis for future research and forecasts for the development of psychotherapy after the pandemic. Copyright © 2022 Polish Psychiatric Association. All rights reserved.

Subjective well-being among psychotherapists during the coronavirus disease pandemic: A cross-cultural survey from 12 european countries.

OBJECTIVE: The aim of this study is to examine the amount of the total variance of the subjective well-being (SWB) of psychotherapists from 12 European countries explained by between-country vs. between-person differences regarding its cognitive (life satisfaction) and affective components (positive affect [PA] and negative affect [NA]). Second, we explored a link between the SWB and their personal (self-efficacy) and social resources (social support) after controlling for sociodemographics, work characteristics, and COVID-19-related distress. METHODS: In total, 2915 psychotherapists from 12 countries (Austria, Bulgaria, Cyprus, Finland, Great Britain, Serbia, Spain, Norway, Poland, Romania, Sweden, and Switzerland) participated in this study. The participants completed the Satisfaction with Life Scale (SWLS), the International Positive and Negative Affect Schedule Short Form (I-PANAS-SF), the General Self-Efficacy Scale, and the Multidimensional Scale of Perceived Social Support. RESULTS: Cognitive well-being (CWB; satisfaction with life) was a more country-dependent component of SWB than affective well-being (AWB). Consequently, at the individual level, significant correlates were found only for AWB but not for CWB. Higher AWB was linked to being female, older age, higher weekly workload, and lower COVID-19-related distress. Self-efficacy and social support explained AWB only, including their main effects and the moderating effect of self-efficacy. CONCLUSIONS: The results highlight more individual characteristics of AWB compared to CWB, with a more critical role of low self-efficacy for the link between social support and PA rather than NA. This finding suggests the need for greater self-care among psychotherapists regarding their AWB and the more complex conditions underlying their CWB.

Dynamic Interactive Social Cognition Training in Virtual Reality (DiSCoVR) for adults with Autism Spectrum Disorder: A feasibility study

Background: Social cognitive difficulties in Autism Spectrum Disorder (ASD) can affect the daily lives of people with ASD profoundly, impacting the development and maintenance of meaningful social relations. Social cognition training (SCT) is commonly used for improving social functioning, but lacks ecological validity and the ability to effectively mimic social situations. Development of virtual reality (VR) interventions, focusing on enhancing social cognition, could add to the effectiveness of SCT within ASD care, by offering a safe, interactive and practical training setting, where generalization of knowledge and skills to the real-world are promoted. In this paper, our primary aim is to evaluate the feasibility and acceptance by participants and therapists of the Dynamic Interactive Social Cognition Method: Training in Virtual Reality (DiSCoVR) protocol as developed for adults with schizophrenic spectrum disorder (SSD), adapted for ASD (DiSCoVR-A). 26 participants, aged 18–63, took part in a pilot study. 22 participants completed baseline and post-assessment, including primary outcome evaluation assessment through a semi-structured interview. Secondary measures focused on social cognition, emotion recognition, mental flexibility, social anxiety, empathy and social responsiveness and were assessed at baseline (T0), post-treatment (T1), and at follow-up (T2) sixteen weeks after completion of the intervention. Results: Our results show that the majority of participant and therapists found the VR intervention acceptable and feasible, as reported in evaluation questionnaires and interviews. Conclusion: These preliminary findings are promising;however, controlled research is needed to further investigate the effectiveness of VR within social cognition training for adults with ASD.

Peculiarities of psychological assistance in overcoming the consequences of COVID-19: a resilience approach

Introduction: The urgency of the study is due to the appearance of an emergency caused by an extremely dangerous outbreak of the COVID-19 pandemic. Every emergency, especially one which threatens health, is characterized by increased anxiety and depression among the population, causes chronic emotional disorders and requires provision of psychological and psychosocial assistance to the individual. In this regard, this article aims to describe and summarize theoretical and empirical research that will help identify the factors that shape the appropriate resource strategies for the development of resilience in overcoming the consequences of COVID-19. At the same time, this study revealed the role of resilience as a potential protective factor for mental health during an outbreak of the COVID-19 pandemic. Material and methods: The leading method of research is theoretical and methodological analysis, comprehension, comparison, classification and generalization of the main content of bibliographic sources that are relevant to the problem and purpose of the study. Results: The article presents the factors influencing resilience in the individual overcoming the consequences of COVID-19 taking into account the world experience. The main approaches to providing psychological assistance to a person in difficult life circumstances caused by the pandemic are identified. Conclusions: The factors influencing the resilience of a person during the COVID-19 pandemic are substantiated and singled out. The materials of the article are of practical value and extremely important for psychologists, psychotherapists, and physicians working to eliminate the consequences of the pandemic.

Long COVID Shared Medical Appointments: Lifestyle and Mind-Body Medicine with Peer Support

Methods: We describe our novel shared medical appointment (SMA) program developed to provide lifestyle education, mindfulness training, and group peer support for patients with long COVID symptoms. Patients virtually attended two-hour weekly visits for six weeks. The SMAs are co-led by a medical provider and a holistic psychotherapist. Every session includes mindfulness practice and peer support with daily homework consisting of lifestyle goals and mindfulness practices. Our objective was to provide patients education and support to recuperate from Long COVID symptoms. For quantitative outcomes, we assessed pre-and post-intervention change in symptoms using Medical Questionnaire Symptom Score (MSQ) and Patient-Reported Outcomes Measurement Information System (PROMIS) Global -10 measures. We used a two-tailed paired t-test. Thematic analysis of patients' feedback of the program is reported. Results: Since May 2021, nine SMA cohorts have been conducted, and 64 patients have completed the program. We have analyzed 40 MSQ's to date, which shows significant improvement in symptoms (mean difference -16.4, P = 0.001). PROMIS-10 scores for 38 patients have been analyzed. Most patients show improvements in PROMIS-10 scores, but the findings were not statistically significant (p = 0.12). Patients felt educated, connected, and supported (“I amnot alone, I amnot crazy.” “This class gives me tools to help myself”). Background: Long COVID is a new rising health concern where patients have multiple distressing symptoms with no clear treatment guidelines. Early evidence indicates the role of cytokines and chronic inflammatory processes in developing long COVID. Healthy lifestyle behaviors and modifying stress responses reduce chronic systemic inflammation. Conclusion: Shared medical appointments with lifestyle education, mindfulness practices, and peer support can effectively support patients with Long COVID symptoms. We anticipate additional data from the current ongoing cohorts will demonstrate continued improvement in patient symptoms and possible significant improvement in PROMIS 10 scores.