Navigating changes in the physical and psychological spaces of psychotherapists during Covid-19: When home becomes the office.

Abstract

The emergence of the Covid-19 pandemic at the beginning of 2020 changed psychotherapists' personal and professional realities. The necessity of delivering health care safely within the lockdown and shelter-in-place mandates compelled psychotherapists to shift their practices away from providing in-person services to offering synchronous remote psychotherapy instead. This abrupt transition presented a unique and multifaceted challenge in terms of the service location; as therapists' houses effectively became their offices, their homes no longer served as purely personal spaces. Instead, psychotherapists needed their living environments to fulfill a dual function as a clinical office space that would be shared with their clients, albeit at a distance. This mixed-method study focused on assessing psychotherapists' most significant challenges and specific adaptations to this experience of providing remote therapy from home during the Covid-19 pandemic. Findings from the study revealed that the shared trauma experienced as a result of the pandemic, the unexpected and sudden transition to the new therapeutic setting, and "Zoom fatigue" were among the most significant challenges faced by therapists. The participants also demonstrated great resilience as they found creative ways to adapt and continue their meaningful work with their clients. This was especially true for those working with children. Ultimately, the participants had mixed feelings about the possibility of returning to the office setting. Clinical Impact StatementThe Covid-19 pandemic will have a lasting impact on the delivery of psychotherapy treatment. This mixed-method study assessed psychotherapists' most significant challenges when conducting remote psychotherapy sessions from their homes. The study's findings cover both the challenges and the strategies used to navigate them.

‘If I am not well, I can’t do sessions well’: An analysis of the narratives of Filipino Therapists during the COVID‐19 Pandemic

“…Having this shared experience deepened the rapport with the client and allowed for more self‐disclosure from the therapist to normalise the situation, similar to the findings of Shklarski et al. ( 2021 ) and Tosone ( 2011 ). This allowed the participants to process their own thoughts and feelings towards the pandemic, affirming the findings of Folkes‐Skinner ( 2016 ).…”

Burnout in Professional Psychotherapists: Relationships with Self-Compassion, Work–Life Balance, and Telepressure

“…In April 2020, 46.6% of people in the UK worked from home. A total of 86% of those people worked from home as a result of COVID-19 [26]. One of the occupational groups impacted substantially by new working arrangements are psychotherapists.…”

Peer Consultation: An Enriching Necessity Rather Than a Luxury for Psychologists During and Beyond the Pandemic

“…Additionally, psychologists had to navigate and adjust to teletherapy versus in-person sessions. Learning new platforms and addressing technological challenges presents an additional burden (Shklarski et al, 2021). Teletherapy adoption introduced new ethical and clinical concerns, as described in the clinical vignette.…”

“…Second, psychologists need adequate training in teletherapy to ensure treatment fidelity, given that in-person therapeutic skills are not automatically translatable to telehealth therapeutic skills (Stoll et al, 2020). For many psychologists, the initial process of conducting teletherapy requires more energy to be fully present and connect with clients (Shklarski et al, 2021). Lastly, there are risk management issues when a patient is a danger to self or others but the provider is in a different physical location, which presents additional crisis management difficulties in a virtual format (Stoll et al, 2020).…”

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The pandemic increased professional and personal demands on psychologists, resulting in higher levels of burnout and clinician isolation (Aafjes-van Doorn et al, 2020;Shklarski et al, 2021). Meanwhile, professional consultation is less available due to remote work and social distancing (Sasangohar et al, 2020).

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