Psychotherapy During COVID-19: How the Clinical Practice of Italian Psychotherapists Changed During the Pandemic

Abstract

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.

How Does It Feel to Be Online? Psychotherapists’ Self-Perceptions in Telepsychotherapy Sessions During the COVID-19 Pandemic in Italy

“…Data collection began approximately 4 weeks after the start of the lockdown (April 4, 2020) and continued until May 10, 2020. Participants completed an online survey that was developed ad-hoc as part of a broader research project (see Boldrini et al, 2020). Recruitment was performed using the snowballing method.…”

“…However, it is most likely that the transition to telepsychotherapy has been particularly challenging for clinicians with no previous experience of telepsychotherapy (Boldrini et al, 2020) and/or a strong preference for in-person treatment (Reay et al, 2020). Indeed, clinicians delivering telepsychotherapy have reported concerns about their ability to be authentically and emotionally connected to their clients, as well as their ability to be as effective as they would otherwise be in a traditional therapy setting (Aafjes-van Doorn et al, 2020;Békés and van Doorn, 2020;Messina and Löffler-Stastka, 2021).…”

Desafios na transição dos atendimentos psicoterápicos presenciais para online na pandemia de CO VID-19: revisão sistemática

“…Nos estudos analisados sobre psicoterapia online, a videoconferência foi a Tecnologia de Informação e Comunicação mais utilizada 4,5,6,7,8 . Pode-se pensar que a preferência por chamadas de vídeos se deve ao fato de que possibilita, de certo modo, a reprodução de um setting terapêutico o mais parecido possível com o presencial.…”

Online Supportive Group as social intervention to face COVID lockdown. A qualitative study on psychotherapists, psychology trainees and students, and community people

“…Indeed, studies on psychotherapists and COVID-19 investigated their relation with the online setting (e.g., Boldrini, Lomoriello, Del Corno, Lingiardi, & Salcuni, 2020;Farber, Ort, & Mayopoulos, 2020;Humer, Stippl, et al, 2020;Mac-Mullin, Jerry, & Cook, 2020;McBeath, du Plock, & Bager Charleson, 2020;Poletti et al, 2020), their fear of becoming infected with COVID-19 during psychotherapy in personal contact with relapses on their clinical activity Probst, Tagini et al, 2020), their role as informants on their patients' wellbeing (Probst, Humer, et al, 2020b).…”