Pandemic related mental health

OnTrackNY is a nationally recognized Coordinated Specialty Care model disseminated across New York state for young people experiencing early non-affective psychosis. OnTrackNY is a network of 22 teams located in licensed outpatient clinics, serving over 2500 individuals. OnTrackNY offers medication management, case management, individual and group cognitive behaviourally oriented therapy, family support and psychoeducation, supported employment and education, and peer support services. Teams receive training for implementation through an intermediary organization called OnTrack Central. OnTrackNY was selected as a regional hub of the National Institute of Mental Health Early Psychosis Intervention Network (EPINET), a national learning healthcare system (LHS) for young adults with early psychosis. This symposium will present the different ways in which EPINET OnTrackNY implemented systematic communitybased participatory processes to ensure robust stakeholder involvement to improve the quality of OnTrackNY care. Florence will present results of an assessment of stakeholder feedback experiences used to develop strategies for assertive outreach and engagement of program participants, families and providers. Bello will present on mechanisms for integrating of co-creation principles to design, develop and execute quality improvement projects in EPINET OnTrackNY. Stefancic will present on quality improvement projects that used rapid cycle qualitative methods, tools, and strategies to build team capacity and flexibility to respond to an LHS. Montague will present adaptations to OnTrackNY services during the COVID-19 pandemic using an implementation science framework. Finally, Patel will lead a discussion on the implications of involving individuals with lived experiences in all phases of the process to maximize learning in an LHS.

RED-EMAR - A Chilean pilot initiative of early detection and intervention in clinical high-risk subjects

The COVID-19 crisis has had a significant impact on the mental health of adolescents and young adults in South America. As a result, the appearance of a higher incidence of anxiety and depressive disorders in these countries have been documented and could lead to the appearance of severe mental health disorders. In this context, the prevention and early intervention in mental health is a current challenge in Central and South America. Since the last decade, the existence of initiatives in this field has been mapped in Mexico, Brazil, Chile and Argentina, mostly in first episode psychosis programs. However, Chile is the only country in South America with a multicentre prospective initiative for early detection and intervention in clinical high-risk subjects (called RED-EMAR). The aim of RED-EMAR is disseminate the value of the at-risk mental state concept (abbreviated to EMAR in Spanish), establish agreed therapeutic strategies in this field, and establish potential new evidence-based local interventions. The successful experiences of this network include the monitoring and discussion of clinical cases in telemedicine and the development of mental health psychoeducation guidelines. However, Insufficient resources, stigma, and the lack of mental health public policies are some of the weaknesses of this initiatives in South America. The development and access to early detection and intervention services in South America could be a window of opportunity to reduce the impact of severe mental health disorders such as psychosis and related disorders and move towards an approach aimed at prevention or delaying its onset.

Psychoeducation and emotional regulation in times of confinement: Feasibility and interest of YouTube videos of dialectical behavioral therapy

Introduction: Dialectical Behavior Therapy (DBT) aims to decrease emotional dysregulation, particularly through psychoeducation groups targeting skills learning. In March 2020, the confinement due to COVID-19 abruptly interrupted these groups. We continued skills training through YouTube videos. Our objective is to evaluate the feasibility of this format during the confinement. Method(s): All the participants in the DBT skills group carried out in Strasbourg were included (n = 37). The psychoeducational videos were published biweekly during the confinement on the YouTube channel "GREMO HUS". Participants were encouraged to view these videos by calls/messages. One month after the end of the confinement, an online questionnaire assessed satisfaction. Result(s): In total, 92% of patients responded. Of the 34 respondents, 28 (82%) had watched at least one video, and 32% had watched more than 6 videos. A very large majority of users were satisfied with the videos. Seventy-nine percent said they were very helpful in understanding the skills, and 77% thought they had used the DBT skills more frequently. All but one said that the skills helped them to overcome difficulties in times of confinement. Discussion(s): Our study is the first to interview patients directly regarding DBT YouTube videos. These videos were considered relevant by participants during the confinement period. Their use could compliment DBT skills training groups, and serve as a training support for therapists.Copyright © 2021 Elsevier Masson SAS

Factors associated with quality of life during COVID-19 pandemic

Introduction: The worldwide lockdown in response to the COVID-19 pandemic has been reported to have an impact on many people's quality of life. This study aims to measure the quality of life for Malaysians during this time and its associated factors. Method(s): This national online survey from August to December 2021 via placement of QR codes in public places such as shopping malls, vaccination centres, and hospital outpatient clinics. The QR code is linked to a google form in Malay, which consists of four sections, including: socio-demographic;validated Fear of COVID-19 Scale;validated Brief COPE scale to assess coping strategies as well as regulating cognition in response to stressors coping mechanisms, and quality of life, measured using a validated WHOQOL-BREF questionnaire. The data collected were analysed via linear regression to obtain the final model. Result(s): There were 4904 Malaysian adults who participated in this survey with a mean of age 32(SD=9.2), and the majority being female (83.7%). Based on the finding, 59.1% claim to have had a low overall quality of life during the pandemic. Age, education status, and income as well as psychological related predictors (fear of COVID-19, coping strategies, and psychological distress) are the predictors that explain 69% of the total variance in quality of life among Malaysians. Conclusion(s): Targeting modifiable factors such as psychoeducation on fear of COVID-19, and coping strategies can potentially improve the quality of life during the COVID-19 pandemic among Malaysians.

Care, compassion, & controversy: Supporting children in a COVID-19 vaccine pod through music therapy & child life

The Covid-19 pandemic has had a trajectory punctuated by controversy, from understanding the virus itself to the development of therapeutics and a vaccine. The offering of vaccination to children through a destination Covid-19 vaccine pod fore grounded the need for procedural support within a psychosocial reality of children and families navigating the pandemic. Children receiving the Covid-19 vaccine benefitted from a synthesis of music therapy and child life services into a comprehensive approach that proved essential for not only the child, but for personal caregivers, and very often the nursing staff administering the vaccine itself. This article presents the praxis of psychoeducational interventions, psychotherapeutic support, and procedural support including both pre- and post-procedural interventions to support children receiving the Covid-19 vaccine. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Meeting the Behavioral Health Needs of Health Care Workers During COVID-19 by Leveraging Chatbot Technology: Development and Usability Study.

BACKGROUND: During the COVID-19 pandemic, health care systems were faced with the urgent need to implement strategies to address the behavioral health needs of health care workers. A primary concern of any large health care system is developing an easy-to-access, streamlined system of triage and support despite limited behavioral health resources. OBJECTIVE: This study provides a detailed description of the design and implementation of a chatbot program designed to triage and facilitate access to behavioral health assessment and treatment for the workforce of a large academic medical center. The University of California, San Francisco (UCSF) Faculty, Staff, and Trainee Coping and Resiliency Program (UCSF Cope) aimed to provide timely access to a live telehealth navigator for triage and live telehealth assessment and treatment, curated web-based self-management tools, and nontreatment support groups for those experiencing stress related to their unique roles. METHODS: In a public-private partnership, the UCSF Cope team built a chatbot to triage employees based on behavioral health needs. The chatbot is an algorithm-based, automated, and interactive artificial intelligence conversational tool that uses natural language understanding to engage users by presenting a series of questions with simple multiple-choice answers. The goal of each chatbot session was to guide users to services that were appropriate for their needs. Designers developed a chatbot data dashboard to identify and follow trends directly through the chatbot. Regarding other program elements, website user data were collected monthly and participant satisfaction was gathered for each nontreatment support group. RESULTS: The UCSF Cope chatbot was rapidly developed and launched on April 20, 2020. As of May 31, 2022, a total of 10.88% (3785/34,790) of employees accessed the technology. Among those reporting any form of psychological distress, 39.7% (708/1783) of employees requested in-person services, including those who had an existing provider. UCSF employees responded positively to all program elements. As of May 31, 2022, the UCSF Cope website had 615,334 unique users, with 66,585 unique views of webinars and 601,471 unique views of video shorts. All units across UCSF were reached by UCSF Cope staff for special interventions, with >40 units requesting these services. Town halls were particularly well received, with >80% of attendees reporting the experience as helpful. CONCLUSIONS: UCSF Cope used chatbot technology to incorporate individualized behavioral health triage, assessment, treatment, and general emotional support for an entire employee base (N=34,790). This level of triage for a population of this size would not have been possible without the use of chatbot technology. The UCSF Cope model has the potential to be scaled, adapted, and implemented across both academically and nonacademically affiliated medical settings.

Identification of psychoeducation needs and an intervention response for pre-symptomatic Huntington's disease.

People who are aware that they are gene-positive for Huntington's disease (HD) may face an array of personal, relationship, social, financial and employment challenges prior to the onset of the disease. These challenges have been associated with increased psychological problems such as anxiety and depression. Information and support for people with pre-symptomatic HD is indicated, but there is a scarcity of research and service models to inform psychological interventions. We trialled an intervention strategy involving psychoeducation forums designed specifically for pre-symptomatic HD. In phase I of the study, we asked people with pre-symptomatic HD to identify their uppermost needs for information. Phase II involved the delivery of this information via a series of forums. The forums also provided an opportunity for interaction among the participants. Three forums were attended by 88 people with pre-symptomatic HD and significant others. Analysis of post-forum feedback questionnaires indicated high levels of satisfaction with the forums' structure, content and relevance, and notably, the pre-symptomatic specificity of focus. Additional qualitative data from recordings of forum discussion groups revealed that participants greatly valued the opportunity to meet similar others, and share their concerns and strategies for addressing these concerns. There was an abundance of requests for more forums on a wide range of relevant topics. It is recommended that this model of intervention may be of value for implementation in other HD services or community groups.

REACH-ASD: a UK randomised controlled trial of a new post-diagnostic psycho-education and acceptance and commitment therapy programme against treatment-as-usual for improving the mental health and adjustment of caregivers of children recently diagnosed with autism spectrum disorder.

BACKGROUND: Autism is a neurodevelopmental disability affecting over 1% of UK children. The period following a child's autism diagnosis can present real challenges in adaptation for families. Twenty to 50% of caregivers show clinically significant levels of mental health need within the post-diagnostic period and on an ongoing basis. Best practice guidelines recommend timely post-diagnostic family support. Current provision is patchy, largely unevidenced, and a source of dissatisfaction for both families and professionals. There is a pressing need for an evidenced programme of post-diagnostic support focusing on caregiver mental health and adjustment, alongside autism psycho-education. This trial tests the clinical and cost-effectiveness of a new brief manualised psychosocial intervention designed to address this gap. METHODS: This is a multi-centre two-parallel-group single (researcher)-blinded randomised controlled trial of the Empower-Autism programme plus treatment-as-usual versus usual local post-diagnostic offer plus treatment-as-usual. Caregivers of children aged 2-15 years with a recent autism diagnosis will be recruited from North West England NHS or local authority centres. Randomisation is individually by child, with one "index" caregiver per child, stratified by centre, using 2:1 randomisation ratio to assist recruitment and timely intervention. Empower-Autism is a group-based, manualised, post-diagnostic programme that combines autism psycho-education and psychotherapeutic components based on Acceptance and Commitment Therapy to support caregiver mental health, stress management and adjustment to their child's diagnosis. The comparator is any usual local group-based post-diagnostic psycho-education offer. Receipt of services will be specified through health economic data. PRIMARY OUTCOME: caregiver mental health (General Health Questionnaire-30) at 52-week follow-up. SECONDARY OUTCOMES: key caregiver measures (wellbeing, self-efficacy, adjustment, autism knowledge) at 12-, 26- and 52-week follow-up and family and child outcomes (wellbeing and functioning) at 52-week endpoint. SAMPLE: N=380 (approximately 253 intervention/127 treatment-as-usual). Primary analysis will follow intention-to-treat principles using linear mixed models with random intercepts for group membership and repeated measures. Cost-effectiveness acceptability analyses will be over 52 weeks, with decision modelling to extrapolate to longer time periods. DISCUSSION: If effective, this new approach will fill a key gap in the provision of evidence-based care pathways for autistic children and their families. TRIAL REGISTRATION: ISRCTN 45412843 . Prospectively registered on 11 September 2019.

Online psychological support during the first Italian lockdown from pandemic COVID-19

Objective: The spread of the Covid-19 pandemic led to a lockdown that caused a widespread discomfort among the Italian-and worlwide-population, as evidenced by several national and international studies. GliPsicologiOnline (GPO) was conceived as a reaction to this scenario of great difficulty. GPO is a free online service that aims at addressing the citizens' needs of listening and support, as well as dealing with psychoeducational issues. The aim of this study was to describe the population that has requested psychological support using the GPO platform, with particular focus on the distribution throughout Italy and the type of problems that emerged in relation to age. Furthermore, the time of onset of the specific problem reported and the type of intervention implemented by therapists of the Institute for the Study and Research of Psychic Disorders (ISeRDiP) was also taken in consideration. Method: A cross-sectional descriptive study was conducted with data collected by a group of ISeRDiP researchers, who were also involved as clinicians in the active phase of the project. The database allowed analysis using descriptive statistics and qualitative comparison of infra-cluster results. Results: 157 individuals joined the project (138 women, 19 men), with an average age of 29 years. 74% went through only one session (15% two, 11% three sessions). The GPO service was contacted by 15 different Italian regions with a greater participation by the Lombard population (32%). The majority of the sample (93%) did not request help for symptoms directly related to Covid-19, but rather for psychological problems that developed in the context of isolation due to lockdown. Notably, in 44% of cases, the perceived discomfort was experienced for the first (mainly of the anxious type, 19%). Strong variability in the reasons for seeking help has also emerged. Conclusions: The service offered by the GPO project gave the Italian population an opportunity to receive free support, prevent negative psychological outcome, improve psychoeducation and learn about the potential of online support services. It is not surprising that the majority of the help seeking individuals came from the Lombardy region, which was more affected than others by the pandemic. Moreover, the variability of the reasons for seeking help seems to be in line with difficulties throughout development phases and life cycle typically reported in the age group taken into consideration. (PsycInfo Database Record (c) 2023 APA, all rights reserved) Abstract (Italian) Oggetto: La diffusione della pandemia da Covid-19 ha portato a un lockdown che ha visto l'emergere, nella popolazione italiana, ma non solo, di un disagio diffuso, come evidenziato da diversi studi nazionali e internazionali. In questa situazione di forte difficolta nasce "GliPsicologiOnline" (GPO), un progetto creato per rispondere gratuitamente ai bisogni di ascolto, psicoeducazione e supporto, attraverso l'utilizzo di una piattaforma online. Obiettivo del presente studio e quello di descrivere la popolazione che ha richiesto supporto psicologico attraverso l'utilizzo della piattaforma GPO, con particolare riferimento alla distribuzione sul territorio italiano e al tipo di problematiche emerse in relazione all'eta. Particolare attenzione e stata inoltre posta all'individuazione dell'epoca di insorgenza della problematica rappresentata e ai tipi di interventi di aiuto prevalenti messi in atto dai terapeuti dell'Istituto per lo Studio e la Ricerca sui Disturbi Psichici (ISeRDiP). Metodo: Sulla base dei dati e stato condotto uno studio descrittivo trasversale con raccolta dati crosssezionale da parte di un gruppo di ricercatori ISeRDiP, coinvolti anche come clinici nella fase attiva del progetto. La creazione di un database, ove sono state indicate le variabili di interesse, ha permesso di procedere a un'analisi tramite statistiche descrittive e comparazione qualitativa dei risultati infracluster. Risultati: Al progetto hanno aderito 157 soggetti, (138 donne, 19 uomini), con un'eta media di 29 anni. Il servizio GPO e stato contattato da 15 diverse regioni italiane con una maggior partecipazione da parte della popolazione lombarda (32%). La maggioranza del campione (93%) non ha richiesto aiuto per una sintomatologia direttamente connessa al Covid ma per problematiche psicologiche sviluppatesi nell'ambito dell'isolamento dovuto al lockdown;nel 44% dei casi, infatti, il disagio emerso era di nuova insorgenza (prevalentemente di tipo ansioso, 19%). E' emersa altresi una forte variabilita nei motivi della richiesta di aiuto. Conclusioni: Il servizio offerto dal progetto GPO ha rappresentato un'opportunita per la popolazione italiana di ricevere un sostegno gratuito, fare prevenzione sul danno psicologico, migliorare la cultura psicologica e conoscere le potenzialita dei servizi di supporto online. Non stupisce che la maggior richiesta di aiuto sia pervenuta dalla regione Lombardia, piu colpita di altre dalla pandemia, e la variabilita dei motivi della richiesta di aiuto che, in base alla fascia d'eta presa in considerazione, sembra essere in linea con le problematiche tipiche delle fasi di sviluppo e del ciclo di vita. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Cognitive-behavioral therapy for panic disorders.

This article discusses the treatment of panic disorder in terms of cognitive behavioral psychotherapy. Panic disorder is one of the most common anxiety disorders. The etiology of panic disorder assumes the coexistence of genetic and environmental factors. Panic attacks often accompany other mental and somatic diseases. The constant feeling of intense anxiety with a number of somatic symptoms affects the deterioration of everyday functioning, significantly reducing one's quality of life. The global situation caused by SARS-CoV-2 may correlate with the increase in the incidence of panic disorder. The introduction of appropriate therapeutic interventions at the earliest possible stage of the disease gives patients a chance for long-term remission. So far, it has been proven that the best results of pharmacological treatment are achieved thanks to the antidepressant and benzodiazepine drug groups. One of the non-pharmacological interventions with the highest clinical effectiveness is cognitive-behavioral psychotherapy. Compared to other trends, cognitive- behavioral therapy is characterized by the most reliable research proving its high effectiveness. Psychotherapy of panic disorders in the cognitive-behavioral approach includes a complete conceptualization of the patient's problem, taking into account individual theoretical models. Treatment of panic attacks is based on a protocol which takes into account both cognitive and behavioral interventions, e.g. psychoeducation, cognitive restructuring, breathing training, relaxation exercises and both interoceptive and in vivo exposures. Research results indicate that this therapy is an alternative form of treatment for panic disorders. Sources indicate that the effectiveness of interventions based on cognitive-behavioral therapy is comparable to that of pharmacotherapy.Copyright © 2022 Termedia Publishing House Ltd.. All rights reserved.

Choking Phobia in an Older Adult: A Telephone-Based CBT Case Study Informed by Gerontology

Fear of choking is a relatively understudied phenomenon in older adults, despite the higher incidence of choking to death in this population and the associated mental health burden. This case report presents the use of a cognitive-behavioral (CBT) approach to treating choking phobia in an older adult in her 80s, with sessions conducted over the telephone during the COVID-19 pandemic. A reliable change in self-reported avoidance of solid food was observed, although indices of general distress appeared to have remained stable. By placing a seemingly focal problem (choking phobia) within a comprehensive conceptualization framework using gerontology, we were able to consider additional complexity related to aging-related beliefs and experiences of distress to address therapeutic opportunities and challenges, including the COVID-19 context.Copyright © 2022 Hogrefe.

Simultaneous Individual Complicated Grief Treatment With a Couple

Persistent complex bereavement/complicated grief occurs when, after a period of 12 months following a death, there remains an ongoing intense yearning and sorrow for the deceased, preoccupation with the death and its circumstances, difficulty accepting its reality, and disruption in personal identity. This case study illustrates the successful application of Complicated Grief Treatment (CGT), a manualized research-supported intervention, with a husband and wife each receiving individual therapy simultaneously with separate clinicians. The core of CGT involves graded completion of imaginal and situational revisiting (i.e., exposure) exercises. To target maladaptive rumination and counterfactual thinking more explicitly, strategies from a research-based treatment for trauma, Cognitive Processing Therapy, were also incorporated for one member of the couple. To our knowledge, CGT has not been examined with couples receiving individual therapy delivered simultaneously. As such, practitioners have little information about how to proceed with cases where multiple members of the same family are experiencing complicated grief. We will detail the treatment provided, outlining the course of care for each member of the couple, highlighting unique adjustments made to tailor implementation to each individual and to deliver the intervention simultaneously. Quantitative and qualitative data show the effects of treatment on symptoms of complicated grief, depression, and relationship satisfaction.Copyright © The Author(s) 2022.

Prescribing medicines by a teacher: A case report of unusual presentation of OCD

Background: Obsessive Compulsive Disorder (OCD) can present with unusual symptomatology. Aim(s): To discuss a case of OCD with an atypical manifestation in an adult male teacher who has an obsession and compulsion of prescribing medications to the villagers and its management. Case Summary: A 35 years old male teacher presented with complaint of recurrent obsessional thoughts about prescribing medications to patients and compulsion for the same. He started having these thoughts after conducting duty at a community health center as a COVID-19 booth controller. He perceived these thoughts as intrusive, irrational, absurd, anxiety provoking and distressing;would trying to resist them, but won't be able to do so. He used to sit beside hospitals, squares in villages, and medical shops to find patients and prescribe medications to them to relieve his anxiety. After prescribing medications although his anxiety symptoms would decrease, but he would feel guilty about prescribing medication as he knew that is not an expert. He also faced financial issues as he used to buy medications for villagers, so that they allow him to prescribe medications. He was diagnosed as a case of OCD with good insight and was started on Tab. Escitalopram which was gradually built up to 20 mg over the 3 months along with psychoeducation and supportive sessions. Currently he is in remission and maintaining well since last 2 months. Conclusion(s): This case report illustrates that clinician should remain vigilant about the unusual presentations of OCD to avoid the misdiagnosis and timely management.

Who benefits most from suicide prevention workshops in schools?

To improve suicide prevention in schools, we implemented workshops for students in grades 8-10. The students (N=200) were randomly assigned to either a training or a control group and were surveyed regarding their help-seeking and help-giving behavior and their depressive symptoms both before and after the training as well as 3 months later. The results indicate that especially those students assessed to be at a higher risk for suicide benefitted most from the training. Their number of depressive symptoms decreased significantly and remained stable. Participants undergoing the training tended to be more likely to ask a teacher for help and to initiate more crisis counseling interactions with peers in need than did untrained controls;these differences, however, were not statistically significant. Though hampered by high dropout rates because of the Covid-19 pandemic and a restrictive prescreening process, these results indicate the positive effects of an extracurricular suicide prevention program on students' well-being and behavior. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (German) Um die Suizidpravention an Schulen zu verbessern, wurden psychoedukative Workshops fur Schuler_innen implementiert und angeboten. N=200 Schuler_innen der 8.-10. Jahrgangsstufe wurden zufallig einer Experimental- oder Kontrollgruppe zugewiesen. Vor und nach dem Training sowie nach drei Monaten wurden sie zu ihrem hilfesuchenden und hilfegebendem Verhalten sowie ihrer depressiven Symptomatik befragt. Die Ergebnisse weisen darauf hin, dass besonders die als starker suizidgefahrdet eingestuften Jugendlichen von dem Training durch eine Abnahme ihrer depressiven Symptomatik profitierten. Schuler_innen der Kontrollgruppe verbesserten sich demgegenuber nicht signifikant in ihrer depressiven Symptomatik. Fur das hilfesuchende ebenso wie das hilfegebende Verhalten zeigten sich positive Trends, die jedoch nicht statistisch signifikant wurden. Diese Ergebnisse zeigen - wenn auch mit Limitationen aufgrund von Ausfallen durch die Coronapandemie 2020 und durch ein restriktives Vor-Screening - die Wirksamkeit einer aufwandigen auserschulischen Suizidpravention auf Befinden und Verhalten. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Resilience in Heath Care workers during Disaster situation-Experience from tertiary care hospital during Covid 19 and future lessons

Aims and objective: To present a series of 5 cases of Stress Related Disorders in HCWs during the covid second wave where they bounced back and recovered fully, returned to work Methodology: Reporting 5 different cases of psychological trauma in healthcare workers working in the peak of covid pandemic as frontline workers -02 doctors, 02 Nurses, and 01 health assistant who reported symptoms of vague nature arising out of stress during handling of Covid 19 pts. All of them had clear cut psychological symptoms arising in close temporal relation to experiencing the trauma of handling covid patients and the agony and disaster that befell us during the covid second wave from April to Aug 2021. None of them had any past history of psychiatric illness or genetic loading of significance. None of them had any other significant live stressor in personal life or h/o drug abuse. Thus underlying the life threatening nature of Covid exposure as a healthcare worker and it's psychological implications. All of them were referred for vague symptoms like irritable mood, not able to function as before, physical symptoms of headache, marital discord etc. The exposure ranged from personal handling of serious covid patients to handling dead bodies in the mortuary to managing relatives of dying patients. No preventive distressing mechanism was available to them, the need of which is the learning from this study. Also, the remarkable recovery and resumption of functioning and return to duty shown by these frontline healthcare covid warriors with minimal support from the environment is a lesson in bouncing back from psychological trauma, a concept recognized as resilience. The Resilient HCWs ascribed their bouncing back to peer and organizational support during crisis, a sense of duty to care and psychoeducation as their driving force to early recovery, among other things Results: High index of suspicion, early intervention, empathetic handling, psycho education, behavioral modifications and cognitive counseling with a short course of anxiolytics and antitidepressants in few, helped all of them improve completely with return to almost normal functioning. Conclusion(s): The Covid experience has been a life threatening experience for HCWs involved in treatment of serious covid patients during covid pandemic esp the second wave. It has been a never before experienced reality, completely overwhelming and traumatogenic enough to cause psychological decompensation in some of them. For the few diagnosed, there would be many undiagnosed HCWs. The focus should be on high index of suspicion for stress related psychological trauma in HCWs and it's mitigation through early detection and support for complete recovery. The importance of systemic, family and peer support is emphasized.

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.

Telehealth psychoeducational groups with latinx college students: Findings from focus groups

ABSTRACT The literatures examining psychoeducational groups and telehealth services have demonstrated positive results but less is known about the efficacy of psychoeducational telehealth groups. This study examines the perspectives of 105 Latinx college students who participated in an 8-session psychoeducational group via a telehealth platform during the COVID-19 pandemic. The research questions included (a) What was the experience of these Latinx college students participating in telehealth psychoeducational groups? and (b) What were the potential perceived advantages and disadvantages of implementing telehealth psychoeducational groups? Postintervention, a total of 16 focus groups were convened with a total of 105 Latinx college students (average number of participants per group = 6). Interviews were coded using conventional qualitative analysis and yielded four main themes: (1) group cohesion, which involved group members feeling that they were connected and that the group was a safe space;(2) group leaders, which involved leaders' preparation and knowledge and their ability to foster a safe environment);(3) cultural issues, which involved cultural values and acculturative and first-generation stress.;and (4) telehealth implementation, wherein participants described advantages and disadvantages of the telehealth approach. We discuss study limitations and directions for future research. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Developing a Brief Tele-Psychotherapy Model for Covid-19 Patients and Their Family Members

Introduction: While many studies are available on the psychological impact that the pandemic has had on the general population, few studies have considered survivors of COVID-19 and their first-degree relatives. The incidence and prevalence of psychological distress in COVID-19 patients greatly vary by country and by study methodology, and go beyond the current possibilities of any mental health system to offer in-person services, with the result that most users fail to receive the necessary support. There exists an urgent need to intervene on the psychological suffering of COVID-19 patients and their family members with treatments that can be offered safely and on a large scale, without burdening an already strained health system. We leveraged the ongoing clinical experiences with COVID-19 survivors and family members to design a clinical intervention model that could be remotely administered and could easily integrate with the workflow of the regional health system. The result of this process was the development of a brief remote psychotherapy program to be delivered via telemedicine. Method(s): We first reviewed the scientific literature on psychotherapeutic interventions that were designed to treat psychopathology among COVID-19 patients and family-members. Based on this evidence, we harmonized techniques and strategies deriving from several psychotherapeutic orientations into a brief psychotherapy program that was developed along three main theoretical trajectories: psychodynamic therapy, constructivist therapy and hermeneutic-phenomenological therapy. Result(s): The program consists of 8 remote, 50-minute, individual psychological sessions offered weekly using secure video conferencing software. The severity of the clinical conditions of COVID-19 patients has largely influenced the sequencing of the intervention both for patients themselves and for their family members dealing with the COVID-19 hospitalization/discharge/loss of a loved one. We considered it appropriate to circumscribe the exploration of the different psychological targets within each session, given the unpredictable nature of the course of illness, and the possible onset of events that could radically change the psychological state of patients and family members. During the initial phase of treatment, the therapist highlights the patient's ways of suffering and coping, in hopes to identify together with the patient which ones are already familiar and which ones are novel. In the context of the patient's textual refiguration, the therapist makes room for interpretative cooperation by sharing clinical objectives: a commonality of intents that brings therapist and patient to accept the challenge of the clinical work. During all phases of the clinical work, suffering is contextualized both in the light of the recent traumatic experience (bereavement, hospitalization in intensive care, fear for one's life or that of a relative), and in the light of historical ways of suffering, so that the patient is able to recognize the meaning of the currently experienced symptom. Session 1 includes introductions and exploration of the patient's current experience space as well as identification of the areas of suffering and brief recapitulation of the patient's psychological functioning pre- COVID. Session 2 attempts to define shared goals for the therapeutic process and creates an initial diagnostic framework to identify unprocessed or unregulated emotions. Session 3 aims to validate the intrapsychic and interpersonal resources associated with a greater degree of adaptation to the stressful situation, including: a flexible personality;positive beliefs about the self;identity roles and acceptance and commitment skills;work functioning;s solid network of friends;family/loved ones. In Sessions 4 through 6, areas of clinical concern are addressed and defense mechanisms are examined. Session 7 aims to integrate the lived experience in the cohesive narrative of the self. In Session 8, internal working models or relational patterns that have emerged during ther py closure are discussed and psychoeducation on relapse prevention is offered. Conclusion(s): We described a newly designed remote psychotherapeutic approach to tackle the COVID-19 pandemic psychological aftermath. We believe that the intervention model described here has great innovation potential in that: (1) it offers immediate psychotherapeutic support to all those who experience psychological suffering associated with COVID-19;(2) helps therapists to operate in acute and subacute settings, overcoming the barriers imposed by public health and prevention measures;and (3) contributes to study and determine the procedures by which tele-psychotherapy can be best implemented. In doing so, this treatment model could provide a blueprint for future tele-psychology wide-scale interventions.

Career Decision Making Self Efficacy and Its Implications on Guidance and Counseling Programs: A Study of High School Students During the Covid-19 Pandemic

Aims The aimed of thus study is to examine and ascertain students' level of self-efficacy in choosing profession decisions during the Covid-19 epidemic. Instrument & Methods 469 students (245 junior high school students and 224 senior high school students) were selected for this quantitative descriptive study using the cluster proportionate stratified random sampling technique. Findings The findings indicated that the self-efficacy of high school students in making career decisions during the COVID-19 pandemic was rated as moderate. There was no discernible difference in the level of self-efficacy in career decision-making between the sexes (t(467) =-0.007). Yet, there is a substantial difference in the pupils' academic standing (t(467) =-2.228). In addition, there was a significant difference solely in the indicator of problem-solving. Conclusion The results of problem-solving indicators can therefore be used to create guidance and counseling programs in schools and have consequences for future career planning. © 2023, Tarbiat Modares University. All rights reserved.