Telepsychotherapy in the age of COVID-19: A commentary.

Abstract

This is a commentary on 15 articles addressing some of the major emergent challenges in provision of mental health services during the COVID-19 pandemic crisis, offering telepsychology as a viable and elegant solution to maintaining psychotherapy within and after the pandemic. The papers in the special issue both build on existing telepsychotherapy initiatives and offer rapid responses to the early phase of COVID-19. Two papers explore the relative effectiveness of in-person supervision and telesupervision, proposing telesupervision as a feasible alternative; and extending practical considerations to maintain effective clinical care in training settings while implementing telepsychology. Ten papers address technological challenges, with recommendations to create, enhance, and optimally configure telepsychotherapy services for clients across the mental health spectrum from common mental health problems, clinical high risk for psychosis, high risk for suicide, posttraumatic stress disorder, and family intervention. Turning to process, two papers explore psychotherapists’ attitudes toward online psychotherapy and their use of technology in practice. Finally, one paper addressed system considerations, describing the development of a virtual partial hospital program for acute psychiatric patients stepping down from inpatient hospitalization. We discuss the key themes emerging from this corpus of work, linking these themes to the current state of evidence regarding the mental health response to the COVID-19 pandemic. Crucially, the value of this special issue goes beyond the current crisis, enabling psychotherapists to be better prepared for physical distancing situations that they may face in the future.

Will We Ever Again Conduct in-Person Psychotherapy Sessions? Factors Associated with the Decision to Provide in-Person Therapy in the Age of COVID-19

“…Research on the provision of psychotherapy treatment during COVID-19 is emerging (Inchausti et al, 2020 ; Mitchell, 2020 ; Wright & Caudill, 2020 ), but the majority has focused on the experiences of therapists with telehealth, the quality of remote therapy, and the working alliance during the pandemic. For example, Békés and Aafjes-van Doorn ( 2020 ) conducted a cross-sectional survey with 145 psychotherapists to assess their attitudes toward online psychotherapy at the beginning of the COVID-19 pandemic.…”

Terapia On-line com Casais e Famílias: Prática e Formação na Pandemia de Covid-19

“…A doença causada pelo novo coronavírus (Covid-19) tem afetado o mundo de diferentes formas desde sua primeira notificação, em dezembro de 2019, na China (Inchausti, MacBeth, Hasson-Ohayon, & Dimaggio, 2020). Na terceira semana de agosto de 2020 (quando a redação do presente artigo foi concluída), havia o registro global de aproximadamente 22 milhões de casos de infecção e 775 mil óbitos por Covid-19 (World Health Organization, 2020).…”

“…ex., conflitos familiares, traição conjugal, disfunções sexuais), que consiste em uma barreira à busca por atendimento presencial, pode ser mais facilmente superado na terapia on-line (Roddy, Rothman, Cicila, & Doss, 2019). Ainda, para pessoas que moram em regiões com escassez de oferta de terapia presencial, a terapia on-line se mostra especialmente importante (Inchausti et al, 2020;Pickens et al, 2020;Wade et al, 2020). Sessões remotas podem ser intercaladas com sessões face a face, caso isso seja avaliado como uma opção viável no plano terapêutico do casal ou da família (Wrape & McGinn, 2019).…”

“…Embora a comunicação não-verbal dos clientes possa ser observada nos atendimentos remotos, o profissional tende a apresentar maiores dificuldades para compreendê-la e utilizá-la como recurso terapêutico (Inchausti et al, 2020;Wrape & McGinn, 2019). Similarmente, técnicas não-verbais, como as propostas pelo modelo estrutural sistêmico para sinalizar alianças temporárias (p.…”

“…Em linhas gerais, o ambiente digital requer que o terapeuta adote alternativas criativas às técnicas frequentemente utilizadas nos atendimentos presenciais, sem desconsiderar aspectos éticos (Inchausti et al, 2020). No entanto, essa tarefa é desafiadora, especialmente porque a terapia on-line com casais e famílias vinha sendo pouco explorada em termos de formação profissional (Hertlein et al 2015;Matheson et al, 2020), o que será abordado na seção a seguir.…”