Main Article Content
COVID-19, mental health, therapeutic setting, psychiatrist, psychologist, psychotherapist
Background: The new 2019 coronavirus disease (COVID-19) outbreak forced mental health providers to overcome their general reluctance about telematic assistance, shifting from a face-to-face approach to online therapy to promote continuity of care for psychiatric patients.
Methods: An ad-hoc web-based survey questionnaire assessing the impact of the COVID-19 pandemic on therapeutic setting in Mental Health Services was sent via email from March 15, 2021 to June 15, 2021 to mental health providers in Genova, Italy. The survey was anonymous and a free Google Forms® software was used.
Results: Two hundred nineteen mental health providers completed the survey, and the overall response rate (ORR) was 65%. During the COVID-19 pandemic period, the continuity of care was mainly guaranteed using electronic devices. Psychologists reported a higher availability of video call assistance service to guarantee continuity of care for psychiatric patients compared to psychiatrists and psychotherapists (p<0,001). Psychiatrists reported the lowest degree of satisfaction about this new telematic approach (p<0,01), while psychologists and to a lesser extent psychotherapists speculated to use it even in non-pandemic times (p=0,02).
Conclusions: COVID-19 pandemic creates an opportunity to overcome normative, technological and cultural barriers to the use of online psychotherapy, showing the importance of adapting the therapeutic setting to both collective and individual needs. Despite initial concerns about its effectiveness and efficacy, a general degree of satisfaction was expressed by the majority of the mental health providers. Further efforts will be needed to enhance this new way of working and to train therapists with particular regard to those employed in the public health system.
2. Amerio A, Odone A, Marzano L, Costanza A, Aguglia A, Serafini G, Signorelli C, Ghaemi SN, Amore M. Covid-19: The last call for telepsychiatry. Acta Biomed 2020; 91(3): e2020050.
3. Chherawala N, Gill S. Up-to-date review of psychotherapy via videoconference: implications and recommendations for the RANZCP Psychotherapy Written Case during the COVID-19 pandemic. Australas Psychiatry 2020; 28(5): 517-520.
4. Amerio A, Aguglia A, Odone A, Gianfredi V, Serafini G, Signorelli C, Amore M. Covid-19 pandemic impact on mental health of vulnerable populations. Acta Biomed 2020; 91(9-S): 95-96.
5. Connolly SL, Miller CJ, Lindsay JA & Bauer MS. A systematic review of providers’ attitudes toward telemental health via videoconferencing. Clinical Psychology: Science and Practice 2020; 27(2): e12311.
6. Békés V, Aafjes-van Doorn K, Prout TA, Hoffman L. Stretching the Analytic Frame: Analytic Therapists' Experiences with Remote Therapy During COVID-19. J Am Psychoanal Assoc 2020; 68(3): 437-446.
7. Békés V & Kafjes–Van Doorn K. Psychotherapists’ attitudes toward online therapy during the COVID-19 pandemic. J Psychother Integr 2020; 30: 238–247.
8. Liberman D. (1970-72). Citato in Etchegoyen H.R.I fondamenti della tecnica ,1986.
9. Odone A, Lugo A, Amerio A, Borroni E, Bosetti C, Carreras G, Cavalieri D’Oro L, Colombo P, Fanucchi T, Ghislandi S, Gorini G, Iacoviello L, Pacifici R, Serafini G, Signorelli C, Stival C, Stuckler D, Tersalvi CA, Gallus S. COVID-19 lockdown impact on lifestyle habits of Italian adults. Acta Biomed 2020; 91(9-S): 87-89.
10. Ehrlich LT. Teleanalysis: Slippery slope or rich opportunity? J Am Psychoanal Assoc 2019; 67: 249–279.
11. Svenson K. Teleanalytic Therapy in the Era of Covid-19: Dissociation in the Countertransference. J Am Psychoanal Assoc 2020; 68(3): 447-454.
13. Odone A, Salvati S, Bellini L, Bucci D, Capraro M, Gaetti G, Amerio A, Signorelli C. The runaway science: a bibliometric analysis of the COVID-19 scientific literature. Acta Biomed 2020; 91(9-S): 34-39.
14. Costanza A, Amerio A, Radomska M, Ambrosetti J, Di Marco S, Prelati M, Aguglia A, Serafini G, Amore M, Bondolfi G, Michaud L, Pompili M. Suicidality Assessment of the Elderly With Physical Illness in the Emergency Department. Front Psychiatry 2020; 11: 558974.
15. Ambrosetti J, Macheret L, Folliet A, Wullschleger A, Amerio A, Aguglia A, Serafini G, Prada P, Kaiser S, Bondolfi G, Sarasin F, Costanza A. Impact of the COVID-19 Pandemic on Psychiatric Admissions to a Large Swiss Emergency Department: An Observational Study. Int J Environ Res Public Health 2021; 18(3): 1174.
16. Shklarski L, Abrams A, Bakst E. Navigating changes in the physical and psychological spaces of psychotherapists during Covid-19: When home becomes the office. Practice Innovations. 2021
17. O'Brien M, McNicholas F. The use of telepsychiatry during COVID-19 and beyond. Ir J Psychol Med 2020; 37(4): 250-255.
18. Feijt M, de Kort Y, Bongers I, Bierbooms J, Westerink J, Ijsselsteijn W. Mental health care goes online: Practitioners’ experiences of providing mental health care during the COVID-19 pandemic. Cyberpsychol Behav Soc Netw 2020; 23(12): 860-864.
19. Fiorentini G, Frangini G, Molone P, Mori Ubaldini M, Robutti A. Dalle regole del setting all’assetto mentale dell’analista. Rivista di psicoanalisi 1995.
20. Zhou X, Snoswell CL, Harding LE, Bambling M, Edirippulige S, Bai X, Smith AC. The Role of Telehealth in Reducing the Mental Health Burden from COVID-19. Telemed J E Health 2020; 26(4): 377-379.
21. Mitchell E. “Much more than second best”: Therapists’ experiences of videoconferencing psychotherapy. EJQRP 2020; 10: 121–135.
22. Fonagy P. Thinking about thinking: some clinical and theoretical considerations in the treatment of a borderline patient. Int J Psychoanal 1991; 72(4): 639-56.
23. Costanza A, Ambrosetti J, Wyss K, Bondolfi G, Sarasin F, Khan R. Prevention of suicide at Emergency Room: from the « Interpersonal Theory of Suicide » to the connectedness [Prévenir le suicide aux urgences : de la « Théorie Interpersonnelle du Suicide » à la connectedness). Rev Med Suisse 2018; 14(593): 335-338.
24. Turner V. The Ritual Process: Structure and Anti-Structure. Chicago: Aldine Publishing Company, 1969.