Telepsychotherapy During the COVID-19 Pandemic: The Experience of Lebanese Mental Health Professionals

Abstract

The COVID-19 pandemic has taken the mental health system by surprise, with the state of lockdown forcing businesses to close their doors, including many mental health services. This has driven many psychotherapists and other mental health professionals towards telepsychotherapy, relying on online consultations to provide continuity of care. However, the adoption of telepsychotherapy required major adaptations from both mental health professionals and patients. This study set out to explore the predictors of the use of online consultations and the perceived level of comfort using telepsychotherapy in a sample of 73 Lebanese mental health professionals. Data was collected via online dissemination of a survey. Results show that 82% of participants made use of online consultations in the past few days, reflecting the adaptation of Lebanese mental health professionals to the atypical newly imposed situation triggered by the COVID-19 pandemic and its consequent lockdown. Having previous experience in the use of online consultations and perceived level of telepresence were significant predictors of the level of comfort of mental health professionals in the execution online consultations. We suggest that more awareness and trainings are required around the practice of telepsychotherapy outside the context of the COVID-19 pandemic.

Protocol for developing telephone-based brief psychosocial intervention for COVID-19 patients in India

“…Despite preferring face-to-face sessions, research shows that the more experience one has with online consultations, the more confident they feel about conquering the obstacles of telepsychotherapy. [ 43 ] Studies have demonstrated that cognitive-behavioural phone-based treatments are useful for patients suffering from anxiety, sadness, or obsessive-compulsive disorder. [ 44 45 ]…”

Mental health during COVID-19: an evaluation of an academic university’s contribution to existing research

“…They focused on the validation of different stress and anxiety scales in order to measure the level of psychological distress among the general population and correlate them with different socio-demographic factors aggravating their mental distress [41][42][43][44][45][46][47][48][49]. More research has examined the role of media coverage of diseases in in uencing people's health behavior, particularly their compliance with prevention measures through online consultations [50,51]. It was proven that increased media exposure to COVID-19 news positively relates to people's abidance by prevention measures and that perceived knowledge and fear mediate this relationship [52].…”

A change in frame and countertransference experiences: Transitioning from face‐to‐face to telepsychotherapy

“…Unprecedented changes to traditional psychotherapeutic practice arose from the lockdown restrictions associated with the COVID‐19 pandemic. These changes to practice included the imposed change to the therapeutic frame: transitioning clients from face‐to‐face meetings to delivery of psychotherapy sessions via videoconferencing, defined here as telepsychotherapy (Poletti et al, 2021; Tohme et al, 2021). Online therapy was an already growing industry prior to the COVID‐19 pandemic and is likely to continue to expand in utilisation postlockdown restrictions (Lin et al, 2022).…”

“…Given the recent nature of events that occurred from the pandemic lockdowns, impacting practice by imposing a change from face‐to‐face meetings to online sessions, research and insight into the potential impact on the clinician, the client and the therapeutic process is still yet to be thoroughly understood. There are a number of studies that have documented some important and emerging findings (e.g., Aafjes‐van Doorn et al, 2020; Békés et al, 2020; Humer et al, 2020; Shklarski et al, 2021; Tohme et al, 2021). These studies have been primarily survey‐based in design and have investigated various aspects of telepsychotherapy with findings relating to the following: technology disruptions and challenges inherent in the use of telepsychotherapy; the therapeutic relationship after the transition (Békés et al, 2020); aspects relating to the therapeutic relationship (professional self‐doubt and anxiety; Aafjes‐van Doorn et al, 2020); predictors related to the uptake of telepsychotherapy by mental health professionals (e.g., previous experience with online therapy; Tohme et al, 2021); decisions affecting the return to in‐person therapy (Shklarski et al, 2021); and the impact of therapeutic orientation on attitudes towards telepsychotherapy (Humer et al, 2020).…”

“…arrangements of therapy, as well as the parameters of the therapeutic relationship (e.g., the roles and boundaries). The therapist (as opposed to the client) is responsible for upholding and maintaining the frame, a duty that is relevant to all models of psychotherapeutic practice (Cherry & Gold, 1989) as it sets up foundations of safety, predictability and consistency, which are necessary conditions to facilitate therapy successfully (Knox & Cooper, 2015;Milton, 1993;Sutton, 2018). Specific aspects of the therapeutic frame can include the therapeutic relationship boundaries and contractual arrangements between the clinician and the client, such as the specific day and time the therapy sessions will occur, the environment in which the therapy sessions will take place, and the arrangements for when the therapist takes leave (Knox & Cooper, 2015).…”