Objective First, to investigate how psychotherapists and patients experience the change from in‐person to remote psychotherapy or vice versa during COVID‐19 regarding the therapeutic interventions used. Second, to explore the influence of therapeutic orientations on therapeutic interventions in in‐person versus remote psychotherapy. Method Psychotherapists ( N = 217) from Austria were recruited, who in turn recruited their patients ( N = 133). The therapeutic orientation of the therapists was psychodynamic (22.6%), humanistic (46.1%), systemic (20.7%) or behavioural (10.6%). All the data were collected remotely via online surveys. Therapists and patients completed two versions of the ‘Multitheoretical List of Therapeutic Interventions’ (MULTI‐30) (version 1: in‐person; version 2: remote) to investigate differences between in‐person and remote psychotherapy in the following therapeutic interventions: psychodynamic, common factors, person‐centred, process‐experiential, interpersonal, cognitive, behavioural and dialectical‐behavioural. Results Therapists rated all examined therapeutic interventions as more typical for in‐person than for remote psychotherapy. For patients, three therapeutic interventions (psychodynamic, process‐experiential, cognitive interventions) were more typical for in‐person than for remote psychotherapy after correcting for multiple testing. For two therapeutic interventions (behavioural, dialectical‐behavioural), differences between the four therapeutic orientations were more consistent for in‐person than for remote psychotherapy. Conclusions Therapeutic interventions differed between in‐person and remote psychotherapy and differences between therapeutic orientations in behavioural‐oriented interventions become indistinct in remote psychotherapy.

IntroductionThe impact of the Coronavirus disease (COVID-19) pandemic and the associated governmental restrictions on mental health have been reported in different countries. This cross-sectional study evaluated mental health during the COVID-19 pandemic in Austria and the association with sociodemographic factors (i.e., age, sex, education, income, employment status, partnership status, and migration background).MethodsA representative sample (N = 1,031) of the Austrian general population was surveyed online end of April 2022. Indicators of mental health were depression (PHQ-9), anxiety (GAD-7), insomnia (ISI), alcohol abuse (CAGE), eating disorders (SCOFF), and stress (PSS-10).Results1,031 participants completed the online survey (50.3% women; mean age: 45.6 ± 17.23 years). Cut-offs for clinically relevant depression were exceeded by 28%. 16% scored above the cut-off for clinically relevant anxiety symptoms, 15% for clinical insomnia, 18% for alcohol abuse, 26% for eating disorders, and 65% for moderate to high stress. Comparisons with another cross-sectional representative Austrian sample recruited during the first weeks of the COVID-19 pandemic in Austria (April 2020) revealed increases in depression (from 21 to 28%) but no significant changes in anxiety, insomnia, and moderate to high stress. Multivariable logistic regression showed the strongest associations of mental health indicators with age, income, and sex. Increasing age and income were associated with lower odds of mental health symptoms. Being female compared to male increased the odds of depressive symptoms while decreasing the odds of alcohol abuse.DiscussionThe COVID-19 crisis seems particularly stressful for younger adults (<35 years) and people with low income (<€2,000 net household income per month). Policymakers need to consider the high social and economic costs of lockdowns and think of optimal intervention methods for mental disorders among young and low-income individuals.

Vaccination is essential to control the COVID-19 pandemic. High vaccination willingness is a key for successful vaccination programs. This study assessed attitudes toward vaccination in Austrian adolescents and determined whether there are differences in vaccination readiness regarding education status, gender and migration background. Two cross-sectional online surveys were conducted from March to July 2021 in apprentices and high school students. Willingness to receive COVID-19 vaccination was rated on a 5-point scale. In total, n = 2006 ( n = 1442 apprentices and n = 564 high school students) completed the survey. Willingness to receive COVID-19 vaccination was higher in students compared to apprentices ( p < 0.001). Furthermore, migration background ( p = 0.023) and female gender ( p = 0.001) were associated with lower vaccination willingness. In conclusion, more efforts are required to improve confidence and willingness to vaccinate adolescents with lower educational levels, those with migrant backgrounds and females.

Adolescents suffer severely from the psychological consequences of the COVID-19 pandemic. Using qualitative content analysis, this study examined open-ended responses to a survey on the mental health of school students in Austria in February 2021. A representative sample (n = 214) was drawn from a total survey sample of 3052 adolescents aged 14–20. The analysis revealed several areas of concern, including school-related concerns, concerns about restrictions, self-related concerns, and interpersonal problems. School-related concerns associated with distance learning were mentioned most frequently. Compared with research conducted at the beginning of the pandemic, it appeared that concerns about educational and professional futures increased. The analysis also indicated young people’s most important sources of support, such as social contacts, recreational activities, attitudes and abilities, distraction, and escape. Of concern is the proportion of young people citing maladaptive coping strategies and the reluctance to seek professional support. Ideas for practice-oriented measures were developed from the study results, such as embedding youth-led peer interventions in traditional mental health services.

The COVID-19 pandemic and containment efforts seem to be particularly challenging for adolescents. This study assessed mental health in high school students 1.5 years after the pandemic began in Austria. A cross-sectional survey was carried out from September to November 2021. Well-being (WHO-5), depressive symptoms, anxiety symptoms and sleep quality were assessed. A total of 1505 adolescents participated (78% girls). The cut-offs for clinically relevant symptoms were exceeded by 62% girls and 38.1% boys for depression (PHQ-9 score ≥ 11), 49% girls and 29% boys for anxiety (GAD-7 score ≥ 11) and 28% girls and 17% boys for insomnia (ISI score ≥ 15). The prevalence of suicidal ideation (item 9 of the PHQ-9) within the last 2 weeks was 47% in girls and 32% in boys. These data collected in autumn 2021 (the start of the second semester of reopened schools; t2) were compared to data collected in February 2021 (one semester after remote schooling; t1). A matched pairs analysis according to age, gender, region, school type and migration background resulted in a total sample size of N = 2514 adolescents. Results showed small deteriorations in mental health (i.e., well-being, depression, insomnia, suicidal ideation) in girls at t2 compared to t1, and an increase in suicidal thoughts in boys (all p-values < 0.05). Qualitative data show that young people have a need for more psychological support, both professional and informal, as well as increased mental health literacy. Results suggest that mental health burden in adolescents remains high 1.5 years into the pandemic and highlight the need to implement timely psychological support.

The COVID-19 pandemic and subsequent governmental restrictions have had a major impact on the daily lives of Austrians and negatively affected their mental health. A representative sample of N = 1505 individuals was recruited via Qualtrics® to participate in an online survey between 23 December 2020 and 4 January 2021. A qualitative study design was used to determine the problem areas that emerged since the beginning of the pandemic (question 1), the factors that were the source of the greatest current concern (question 2), the biggest worries when thinking about the future (question 3), and what the most important source of support (question 4) during the pandemic was. The written responses were analyzed using conventional content analysis following a framework for qualitative research and reported in the form of descriptive statistics. Restrictions imposed by the government, sociopolitical developments, work- and health-related issues, and economic disruptions were identified as being the greatest concerns. Conversely, social contacts within and outside the family were the most important source of support, followed by recreational activities and distraction. Greater consideration should be given to psychosocial factors in future decisions to contain the pandemic. More detailed qualitative research, in particular, to collect the personal experience of more vulnerable groups such as young people, women, and the unemployed, is needed.

This study assessed the mental health of apprentices during the COVID-19 pandemic in Austria and the effect of gender, migration background, work situation, and work sector. An online survey via REDCap was performed with a sample of 1442 apprentices (female: 53.5%, male: 45.4%, diverse: 1.1%, migration background: 28.4%) from 29 March to 18 May 2021. Indicators of mental health were depression (PHQ-9), anxiety (GAD-7), well-being (WHO-5), disordered eating (EAT-8), and insomnia (ISI-7). There was a high prevalence of clinically relevant depression (cut-offs ≥11 for adolescents, ≥10 for adults: 48.3%), anxiety (cut-offs ≥11 for adolescents, ≥10 for adults: 35.4%), insomnia (cut-off ≥15: 27%), and disordered eating (cut-offs ≥2 for men, ≥3 for women: 50.6%). Linear models revealed that apprentices with female and diverse gender, migration background, and unemployed status showed the poorest scores on all mental health measures (all p-values < 0.05) except disordered eating. These findings emphasize the need for intersectional strategies to reduce and prevent adverse mental health consequences of the COVID-19 pandemic for apprentices.

The COVID-19-pandemic brought massive changes in the provision of psychotherapy. To contain the pandemic, many therapists switched from face-to-face sessions in personal contact to remote settings. This study focused on psychodynamic therapists practicing Guided Affective Imagery, Hypnosis and Autogenous Relaxation and their subjective experiences with psychotherapy via telephone and videoconferencing during the first COVID-19 related lockdown period in March 2020 in Austria. An online survey completed by 161 therapists produced both quantitative and qualitative data with the latter being subject to a qualitative content analysis. Our research suggests that telephone and videoconferencing are considered valuable treatment formats to deliver psychodynamic psychotherapy. However, therapists’ experiences with remote psychotherapy are multifaceted and ambiguous. In particular, the findings raise questions concerning the maintenance of the therapeutic alliance, the development of the analytic process, the sensitivity to unconscious communication, and the indication for certain types of patients that still need further investigation. Our research indicates that the long-standing reticence toward remote treatments offers among psychodynamic therapists is becoming more differentiated and partially dissolves as therapists gain experiences in their use. Attitudes are becoming more open. At the same time, the way is being prepared to take a closer look at the specific processes and dynamics of remote psychotherapy and to examine them critically in future studies.