Grignoli Nicola, Arnaboldi Paola, Antonini Mattia
Servizio di Psichiatria e Psicologia Medica, Organizzazione Sociopsichiatrica Cantonale, Savosa, Switzerland.
Lega Ticinese Contro il Cancro, Bellinzona, Switzerland.
Front Psychol. 2021 Mar 24;12:638274. doi: 10.3389/fpsyg.2021.638274. eCollection 2021.
The COVID-19 pandemic outbreak has led to a general reorganization of health services and an increase in outpatient telemedicine in mental healthcare for physically ill people. Current literature highlights facilitators and obstacles concerning the use of new technologies in psychotherapy, an underrated topic of research in the context of supportive expressive psychotherapy. More insight is needed to explore the characteristics of video in therapeutic alliance for treatment of specific mental disorders experienced in psychosomatics, particularly with people suffering from a disturbed body- and self-image. Using two clinical vignettes, it is the authors' intention to enrich the critical debate on current knowledge in psychosomatic remote psychotherapy, with special focus on mentalization deficits and their impact on therapeutic alliance in the consultation-liaison psychiatry setting. In particular, we will question the interpersonal processes at stake related to mirroring and the disruption caused by the use of videoconference applications. We will also reflect upon the relationship between the therapeutic alliance and the medical team, and that between patient and psychotherapist. The aim is to improve psychotherapeutic alliance maintained during the pandemic for specific mental disorders and to inform about possible clinical factors that could be the subject of future empirical studies or professional guidelines.
新冠疫情的爆发导致了医疗服务的全面重组，以及为身体疾病患者提供的精神卫生保健门诊远程医疗的增加。当前文献强调了心理治疗中使用新技术的促进因素和障碍，这在支持性表达心理治疗背景下是一个被低估的研究主题。需要更多的见解来探索视频在治疗联盟中治疗身心医学中特定精神障碍的特征，特别是对于那些身体形象和自我形象受到干扰的人。通过两个临床案例，作者旨在丰富关于身心远程心理治疗现有知识的批判性辩论，特别关注心理化缺陷及其在会诊联络精神病学环境中对治疗联盟的影响。特别是，我们将质疑与镜像相关的利害攸关的人际过程以及视频会议应用程序的使用所造成的干扰。我们还将思考治疗联盟与医疗团队之间的关系，以及患者与心理治疗师之间的关系。目的是改善疫情期间针对特定精神障碍维持的心理治疗联盟，并告知可能成为未来实证研究或专业指南主题的临床因素。
