Italy was one of the first countries to be significantly affected by the coronavirus disease 2019 (COVID-19) pandemic, determining a unique scenario for Italian psychotherapists to consider changing the modality in which they deliver treatment. The present study aimed at studying which factors related to psychotherapists and their clinical practice had a major role in predicting two main outcomes: (1) the rate of interrupted treatments during lockdown and (2) psychotherapists' satisfaction with the telepsychotherapy modality. Methods: An online survey was administered to licensed psychotherapists (n = 306), who worked mainly as private practitioners, between April 5 and May 10, 2020 (i.e., the peak of the pandemic in Italy). Results: Psychotherapists reported that 42.1% (SD = 28.9) of their treatments had been interrupted, suggesting that Italy faced an important undersupply of psychotherapy during the lockdown. Using the Akaike information criterion (AIC) model selection, we identified three predictors of the rate of interrupted treatments: (1) psychotherapists' lack of experience with telepsychotherapy prior to the lockdown, (2) their theoretical orientation (with cognitive behavioral psychotherapists reporting a higher rate of interrupted treatments), and (3) patients' lack of privacy at home, as reported to the psychotherapists. Furthermore, we found four predictors of psychotherapists' satisfaction with the telepsychotherapy modality: (1) the rate of interrupted treatments, (2) psychotherapists' previous experience with telepsychotherapy, (3) their beliefs about the compatibility of telepsychotherapy with their theoretical orientation, and (4) their use of a video-conferencing modality, rather than telephone. Conclusion: The following recommendations can help policy makers, professional associations, and practitioners in promoting the continuity of psychotherapy treatments during the COVID-19 outbreak and in future emergencies: (i) disseminating training programs for practitioners on telepsychotherapy, (ii) supporting patients to pragmatically access a private space at home, (iii) encouraging practitioners to use video-conferencing (instead of telephone) to deliver remote therapy, and (iv) increasing the acceptance of telepsychotherapy among both clinicians and the general public.

Simulation models of facial expressions propose that sensorimotor regions may increase the clarity of facial expressions representations in extrastriate areas. We monitored the event-related potential marker of visual working memory (VWM) representations, namely the sustained posterior contralateral negativity (SPCN), also termed contralateral delay activity, while participants performed a change detection task including to-be-memorized faces with different intensities of anger. In one condition participants could freely use their facial mimicry during the encoding/VWM maintenance of the faces while in a different condition participants had their facial mimicry blocked by a gel. Notably, SPCN amplitude was reduced for faces in the blocked mimicry condition when compared to the free mimicry condition. This modulation interacted with the empathy levels of participants such that only participants with medium-high empathy scores showed such reduction of the SPCN amplitude when their mimicry was blocked. The SPCN amplitude was larger for full expressions when compared to neutral and subtle expressions, while subtle expressions elicited lower SPCN amplitudes than neutral faces. These findings provide evidence of a functional link between mimicry and VWM for faces and further shed light on how this memory system may receive feedbacks from sensorimotor regions during the processing of facial expressions.

Social and affective relations may shape empathy to others’ affective states. Previous studies also revealed that people tend to form very different mental representations of stimuli on the basis of their physical distance. In this regard, embodied cognition and embodied simulation propose that different physical distances between individuals activate different interpersonal processing modes, such that close physical distance tends to activate the interpersonal processing mode typical of socially and affectively close relationships. In Experiment 1, two groups of participants were administered a pain decision task involving upright and inverted face stimuli painfully or neutrally stimulated, and we monitored their neural empathic reactions by means of event-related potentials (ERPs) technique. Crucially, participants were presented with face stimuli of one of two possible sizes in order to manipulate retinal size and perceived physical distance, roughly corresponding to the close and far portions of social distance. ERPs modulations compatible with an empathic reaction were observed only for the group exposed to face stimuli appearing to be at a close social distance from the participants. This reaction was absent in the group exposed to smaller stimuli corresponding to face stimuli observed from a far social distance. In Experiment 2, one different group of participants was engaged in a match-to-sample task involving the two-size upright face stimuli of Experiment 1 to test whether the modulation of neural empathic reaction observed in Experiment 1 could be ascribable to differences in the ability to identify faces of the two different sizes. Results suggested that face stimuli of the two sizes could be equally identifiable. In line with the Construal Level and Embodied Simulation theoretical frameworks, we conclude that perceived physical distance may shape empathy as well as social and affective distance.

Aims: The COVID-19 pandemic and consequent extreme restrictions imposed by governments across the world forced psychotherapists to abruptly change their working modality. The first aim of the current study was to assess psychotherapists’ self-perceptions (i.e., affective and cognitive perceptions about their self and their self in relation to clients) when providing telepsychotherapy during the first peak of the COVID-19 pandemic in Italy. The second aim was to explore the associations between psychotherapists’ self-perceptions, characteristics, and clinical practices.Method: An online survey was administered to 281 Italian licensed psychotherapists (Mage=45.15; SD=10.2; 83.6% female) between April 5 and May 10, 2020. The survey comprised ad-hoc questions that were designed to collect sociodemographic details and information related to working practices. Moreover, a semantic differential (SD) scale was developed to assess psychotherapists’ self-perceptions, and a factor analysis was performed from the SD items.Results: The SD scale showed an overall trend of positive psychotherapist self-perception during telepsychotherapy, despite reports of greater fatigue and directive and talkative behavior during sessions. Four SD factors accounted for 45% of the variance: “Affective Availability,” “Attitude Predisposition,” “Well-being,” and “Interventionism.” Scores on the first three factors were indicative of psychotherapists’ Positive vs. Negative self-perception. A comparison of the Positive and Negative attitudinal profiles using the chi-squared test with Yates’s correction and a Monte Carlo simulation found that psychotherapists with a Positive profile reported greater satisfaction with the telematic modality and were more likely to perceive that their clients were able to maintain privacy during sessions.Conclusion: The results suggest that Italian psychotherapists have been able to promptly adapt to the imposed telematic modality during the COVID-19 pandemic. However, they may have attempted to compensate for their physical distance from clients by intervening more during sessions. These findings may support psychotherapists who are currently practicing and inform future practitioners who are considering the use of telematic treatment as a routine component of psychotherapeutic care.