“Bridge over troubled water”: A first look at adolescent psychiatric outpatients transited from regular care to teletherapy during the COVID-19 outbreak using quantitative and qualitative analyses.

Abstract

<jats:title>Abstract</jats:title> <jats:p><jats:bold>Background</jats:bold>Adolescents suffering from psychiatric disorders are at risk of disproportionally suffering from the current COVID-19-pandemic. We aimed to assess their specific needs and to evaluate factors influencing a successful transition into teletherapy.<jats:bold>Methods</jats:bold>Thirty adolescent psychiatric outpatients participated in a series of interviews. The primary outcome was the level of psychosocial functioning. Secondary outcome were potential changes in differential symptom domains. Additionally, answers to open questions were analysed qualitatively.<jats:bold>Results</jats:bold>Within-group effect size estimates revealed a significant decrease in the level of functioning within the first two months after transition from face-to-face therapy (M = 2·7, SD = 1·258) to teletherapy (M = 3·0, SD = 1·245) (<jats:italic>T</jats:italic><jats:sub>29 </jats:sub>= -2·536, <jats:italic>p</jats:italic> = 0·017, <jats:italic>d</jats:italic> = 0·46). Qualitative analysis revealed a marked difference in the level of perceived social support in the subgroup of patients who deteriorated in their level of functioning. Those patients also showed a lower degree of verbal differentiation concerning emotions and affect, as well as a higher degree of introspection and rumination. <jats:bold>Conclusions</jats:bold>Despite an overall deterioration, in absolute numbers most patients showed a stagnation in their level of functioning, even if difficulties were expressed. The most prominent difference in the subgroup who showed a decreased level of functioning, was the lack of perceived social support. Provision of strategies to enhance verbalisation and differentiation of emotions and affect might be beneficial.</jats:p>

Impact of COVID-19 Confinement on Adolescent Patients with Anorexia Nervosa: A Qualitative Interview Study Involving Adolescents and Parents

“…However, some basic requirements must be met, including stable Internet connection, use of video instead of audio only, and privacy. These aspects are important for adolescent psychiatry patients in general [ 21 ]. The treatment setting and any concerns regarding remote therapy should be evaluated with the patients on a regular basis.…”

“…Although online therapy seems to be well accepted among eating disorder patients [ 18 ], particularly in adolescents [ 11 ], mental health experts point to potential pitfalls of teletherapy. For example, less sense of privacy and confidentiality when being at home, problems with Internet speed/connection, difficulties regarding building therapeutic alliance, and the feeling that therapeutic online sessions are more “superficial” compared with face-to-face sessions were mentioned [ 11 , 19 , 20 , 21 ]. Patients with AN reported the greatest dissatisfaction with online therapy compared with patients with other eating disorder diagnoses; however, the reason for this is unclear [ 22 ].…”

Teletherapy for Adolescent Psychiatric Outpatients: The Soaring Flight of so far Idle Technologies during the COVID-19 Pandemic

“…Given the novelty of the situation and the velocity of change, there is not a large volume of prior research to build upon in investigating diverse aspects of the current crisis. This article was thus conceptualized as brief communication discussing a small number of results from an ongoing investigation (Huscsava et al, 2020), integrating further ideas in a spotlight format. We followed up 30 mostly female patients (86,7%), ranging from 12 to 18 years of age, who were in established weekly outpatient treatment before the onset of the COVID-19 pandemic, in the process of transition into teletherapy.…”

“…A description of the interview content, as well as sample characteristics and detailed results concerning the transition into teletherapy are available as preprint. (Huscsava et al, 2020) Thoughts expressed by psychiatrists and psychologists obtained in informal discussions are integrated where appropriate to provide a comprehensive overview.…”