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新冠疫情期间的心理治疗:意大利心理治疗师的临床实践在大流行期间如何变化。

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

作者信息

Boldrini Tommaso, Schiano Lomoriello Arianna, Del Corno Franco, Lingiardi Vittorio, Salcuni Silvia

机构信息

Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy.

Department of Cognitive System, Denmark Technical University (DTU), Copenhagen, Denmark.

出版信息

Front Psychol. 2020 Oct 21;11:591170. doi: 10.3389/fpsyg.2020.591170. eCollection 2020.

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. An online survey was administered to licensed psychotherapists ( = 306), who worked mainly as private practitioners, between April 5 and May 10, 2020 (i.e., the peak of the pandemic in Italy). 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. 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.

摘要

意大利是最早受到2019冠状病毒病(COVID-19)大流行严重影响的国家之一,这为意大利心理治疗师带来了一种独特的情况,促使他们考虑改变提供治疗的方式。本研究旨在探讨与心理治疗师及其临床实践相关的哪些因素在预测两个主要结果方面起主要作用:(1)封锁期间治疗中断的比例;(2)心理治疗师对远程心理治疗方式的满意度。2020年4月5日至5月10日(即意大利疫情高峰期),对主要从事私人执业的持牌心理治疗师(n = 306)进行了一项在线调查。心理治疗师报告称,他们42.1%(标准差 = 28.9)的治疗被中断,这表明意大利在封锁期间面临心理治疗供应严重不足的问题。使用赤池信息准则(AIC)模型选择,我们确定了治疗中断比例的三个预测因素:(1)封锁前心理治疗师缺乏远程心理治疗经验;(2)他们的理论取向(认知行为心理治疗师报告的治疗中断比例更高);(3)据心理治疗师报告,患者在家中缺乏隐私。此外,我们发现了心理治疗师对远程心理治疗方式满意度的四个预测因素:(1)治疗中断比例;(2)心理治疗师以前的远程心理治疗经验;(3)他们对远程心理治疗与自己理论取向兼容性的看法;(4)他们使用视频会议方式而非电话。以下建议可帮助政策制定者、专业协会和从业者在COVID-19疫情爆发期间及未来紧急情况下促进心理治疗的连续性:(i)为从业者传播远程心理治疗培训项目;(ii)支持患者切实在家中获得私人空间;(iii)鼓励从业者使用视频会议(而非电话)提供远程治疗;(iv)提高临床医生和公众对远程心理治疗的接受度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a6f/7641613/bb427dad770e/fpsyg-11-591170-g001.jpg

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