Development of a Brief Group CBT Intervention to Reduce COVID-19 Related Distress Among School-Age Youth

School-aged youth have been significantly impacted by the COVID-19 pandemic. The effects of the pandemic will likely have long-standing effects on the well-being of youth, and access to mental health care is even more critical during this time. For the past 5 years, TRAILS (Transforming Research into Action to Improve the Lives of Students) has been working throughout the state to increase utilization of evidence-based mental health practices among K-12 school mental health professionals (SMHPs). By leveraging SMHPs who are widely accessible to students, TRAILS seeks to improve youth access to effective mental health care and reduce current mental health inequities. In March 2020, TRAILS responded to the COVID-19 pandemic by developing a group manual designed to be delivered virtually by SMHPs to help students develop effective coping skills to mitigate the impact of COVID-19. TRAILS focuses on promoting use of CBT and mindfulness, as these skills are ideally suited for school-based delivery, and thus the new manual, Coping with COVID-19 (CC-19), was grounded in these modalities. This article will describe the design, development, and deployment of the CC-19 program to address the mental health needs of students in the context of the pandemic. Early acceptability and penetration data will also be discussed.     

COVID-19 pandemic impact on family life and exacerbated emotional and behavioral health among preschool children: A longitudinal study

Background/ObjectiveThis study aimed to examine associations of the impact of COVID-19 pandemic on family life with emotional and behavioral health among preschool children.MethodsA longitudinal study including 1595 preschool children aged 3–6 years and their families was conducted in Anhui Province. The linear regression was applied to examine associations between the impact of COVID-19 pandemic on family life and emotional and behavioral health.ResultsResults of the multivariable linear regression indicated that the severe impact of COVID-19 pandemic on family life was significantly associated with more sleep problems, poor dietary behavior habits, more anxiety symptoms, and more problematic behaviors; and these effects exhibited gender and age differences.ConclusionsThe severe impact of COVID-19 pandemic on family life significantly increased the risk for exacerbated emotional and behavioral health among preschool children. It is considered vital to identify risk factors for vulnerable families and then to implement precise interventions when necessary for emotional and behavioral health of children in these families.     

Social determinants of health,prenatal maternal stress,and earlier birth during the COVID-19 pandemic

During the COVID-19 pandemic, pregnant women, especially those from socioeconomically disadvantaged and marginalized groups, experienced unprecedented stress. Prenatal stress and social determinants of health (SDoH) such as lower education and lack of a relationship partner are known to contribute to earlier birth. However, whether SDoH and stress independently contribute or whether the harmful impact of SDoH is mediated by stress is unknown. Moreover, the contributions of these factors has not been investigated in the context of a communal health crisis such as the COVID-19 pandemic. To examine these processes, we used a longitudinal cohort of 2473 women pregnant during the COVID-19 pandemic who reported a live birth. We compared structural equation models predicting gestational age at birth from SDoH (race/ethnicity, education, financial security, health insurance, relationship status, and lifetime abuse) and from prenatal maternal stress related and unrelated to the COVID-19 pandemic. Results indicate that the association of SDoH with earlier birth was partially mediated by prenatal stress. These findings help uncover mechanisms explaining health disparities in the U.S. and highlight the need to address both SDoH and the stress that these factors produce in under-resourced and marginalized communities.     

Life Interrupted: Family Routines Buffer Stress during the COVID-19 Pandemic

Adoption of certain behavioral and social routines that organize and structure the home environment may help families navigate the challenges presented by the COVID-19 pandemic. The current cross-sectional study aimed to assess family routines prior to and during the COVID-19 pandemic and examine associations with individual and family well-being. Using a national sample, 300 caregivers of children ages 6-18 were surveyed using Amazon Mechanical Turk platform during the first three months of COVID-19 pandemic in the United States. Caregivers reported on family demographics, COVID-19-related stress, engagement in family routines (prior to and during the COVID-19 pandemic), stress mindset, self-efficacy, and family resiliency. Overall, families reported engaging in fewer routines during the COVID-19 pandemic compared to prior to the pandemic. COVID-19-related stress was highest in low-income families, families of healthcare workers, and among caregivers who had experienced the COVID-19 virus. Moreover, COVID-19-related stress was negatively related to self-efficacy, positively related to an enhancing stress mindset, and negatively related to family resilience. Engagement in family routines buffered relations between COVID-19-related stress and family resilience, such that COVID-19-related stress was not associated with lower family resilience among families that engaged in high levels of family routines. Results suggest that family routines were challenging to maintain in the context of the COVID-19 pandemic, but were associated with better individual and family well-being during this period of acute health, economic, and social stress.

     

Mental Health Inequalities During COVID-19 Outbreak: The Role of Financial Insecurity and Attentional Control

The COVID-19 pandemic and subsequent lockdowns negatively impacted the mental health of populations. This impact is not equally distributed and increases existing mental health inequalities. Indeed, government restrictions and the economic consequences of the pandemic affect more the less educated and less wealthy people. However, psychological processes implicated in this increase of mental health inequalities during the COVID-19 pandemic remain unexplored. The present study (N=591) tested the role of financial insecurity and attentional control in the relation between socioeconomic status and mental health, along with the influence of trait anxiety. Based on Structural Equation Modelling, findings showed a mediation effect of financial insecurity, but not of attentional control, in the relationship between socioeconomic status and mental health. In addition, exploratory analyses suggested that financial insecurity also mediated the effect of attentional control on mental health. Results of the present research point at the importance of understanding psychological processes implicated in the effect of economic crises on mental health inequalities.     

COVID-19 and pre-tenure counseling faculty: A collaborative autoethnographic investigation

Higher education faculty worldwide experienced heightened stressors due to the COVID-19 pandemic, from completing their professional roles and responsibilities virtually to balancing personal and professional stressors. Consequently, the pandemic created many adjustments for pre-tenure counseling faculty across research, teaching, and service. In response to this pandemic, we explored the impact of the COVID-19 pandemic on the personal and professional lives of four pre-tenure counseling faculty members. Accordingly, we used collaborative autoethnography to investigate our experiences and narratives as pre-tenure counseling faculty, which resulted in seven overarching themes. We discussed the implications for practice, advocacy, education, and faculty training.     

Perceived COVID-induced racism and contextual predictors of fear and psychological distress among Black men

The present study examined if Black men's perceptions of COVID-induced racism (i.e., the extent to which racism increased during the beginning months of the COVID-19 pandemic) were associated with their reported fear of COVID-19 and psychological distress. Self-report COVID-related variables and psychological distress data from 231 Black men in the U.S. were analyzed alongside archival percentages of confirmed cases and deaths by participants' county at the time of participation. Hierarchical regressions identified perceptions of COVID-induced racism as a significant predictor of Black men's psychological distress over and above contextual (e.g., county-level COVID-19 case %) and individual-level predictors (i.e., perceived race-related infection risk and self-reported COVID-related stressful life events). This work contributes to the growing literature on health inequities during the COVID-19 pandemic with a snapshot of Black men's experiences during the COVID-19 and racism pandemics of 2020 in the U.S.     

Experiences of psychotherapists transitioning to private practice during COVID-19

The purpose of this qualitative phenomenological study was to gain insight into the lived experiences of psychotherapists transitioning to private practice during the COVID-19 pandemic. With an ever-expanding need for targeted and accessible mental health care, it is vital to understand this phenomenon and how it impacted patient access and care, and the providers themselves. Eighteen licensed psychotherapists were interviewed and their responses highlighted meaningful professional and clinical implications. As a result of the participant interviews, three major themes were identified: (1) the unknown related to COVID-19, (2) ease of transition and (3) work–life balance. Eleven additional subthemes emerged. Results suggested that psychotherapists had various personal and professional stressors exacerbated by the pandemic, along with a desire to balance work and life, manage the changes brought on by the pandemic, and gain or retain autonomy in their professional careers. Ultimately, the results of the study point to some shared experiences among psychotherapists, potential issues of access to psychotherapy, issues related to career satisfaction among psychotherapists, as well as some important areas for future research.     

Parent–Child Relationships and the COVID-19 Pandemic: An Exploratory Qualitative Study with Parents in Early,Middle, and Late Adulthood

The impact of the COVID-19 pandemic on families is currently unknown. Parents and children have experienced a variety of changes as public health interventions have been implemented to slow the spread of the virus. The current exploratory qualitative study recruited parents (n?=?365) in early (ages 20–34), middle (ages 35–64), and late (ages 65 and older) adulthood to understand how the early weeks of the pandemic influenced their parent–child relationships. Participants completed an online survey between March 21 and 31, 2020. Three themes emerged through qualitative content analysis: (1) relational steadiness, (2) navigating COVID-19 challenges in relationships, and (3) relational enhancement.

     

Therapist Experiences and Attitudes About Implementing Internet-Delivered Parent-Child Interaction Therapy During COVID-19

It has been widely recognized that access to mental health treatment is imperative to address current and long-term stressors for children and parents during COVID-19. Internet-delivered Parent-Child Interaction Therapy (iPCIT, previously referred to as I-PCIT) is a strong model for remote service delivery during social distancing restrictions due to its empirical base. However, this treatment modality was not widely implemented before COVID-19, likely due to barriers to providing telehealth services. This mixed methods study conducted a follow-up survey to gather therapist experiences (N = 223) in delivering iPCIT during COVID-19, including qualitative data on the benefits and challenges to delivering iPCIT. The vast majority of therapists (82%) indicated that they transitioned to deliver PCIT via telehealth in response to COVID-19. PCIT caseloads decreased slightly from the first survey to the COVID-19 follow-up survey, but the racial and ethnic composition of caseloads were not significantly different between the two surveys. Of the 183 therapists who transitioned to deliver PCIT via telehealth, 82% expressed interest in continuing to provide iPCIT following the COVID-19 pandemic. Reported benefits of iPCIT included decreased barriers to access and the ability to practice skills within the naturalistic home environment. Challenges to iPCIT were primarily issues with technology as well as other logistical barriers, which could limit engagement for some families. Findings from this study may be beneficial in improving future implementation of iPCIT during and post-COVID-19.     

Ministering at the Margins in a Time of Pandemic

COVID-19 is having a devastating effect globally, especially among those who live at the margins of societies. Health and economic crises are impacting communities and countries, with particularly adverse effects on vulnerable populations. COVID-19’s impact is increased when we factor in racism, land displacement, and gender injustice. The marginalization and oppression experienced from racial injustice, displacement, and gender injustice increase vulnerability and intensify trauma from COVID-19 globally. Churches can respond effectively to the COVID-19 pandemic with particular focus on communities at the margins. Churches that respond to COVID-19 through ministries of evangelism, compassion, empowerment, and advocacy can demonstrate Christ’s love in the midst of the pandemic and contribute to reconciliation and solidarity with vulnerable communities forced to the margins. This article offers insights related to four themes identified by the reference group for the Pilgrimage of Justice and Peace that was initiated at the 10th Assembly of the World Council of Churches in Busan in 2013.     

Rising to the Occasion of This COVID-19-Impacted Nation: Development,Implementation, and Feasibility of the Brief Assessment-Informed Skills Intervention for COVID-19 (BASIC)

The COVID-19 pandemic has had a profound impact on the global economy, physical health, and mental health. This pandemic, like previous viral outbreaks, has resulted in spikes in anxiety, depression, and stress. Even though millions of individuals face the physical health consequences of infection by COVID-19, even more individuals are confronted with the mental health consequences of this pandemic. This significantly increased demand for mental health services cannot be easily met by existing mental health systems, which often rely on courses of therapy to be delivered over months. Single session interventions (SSIs) may be one important approach to meeting this increased demand, as they are treatments designed to be delivered over the course of a single meeting. SSIs have been found to be effective for a range of mental health challenges, with durable effects lasting months to years later. Here, we describe an SSI designed for the COVID-19 pandemic. This Brief Assessment-informed Skills Intervention for COVID-19 (BASIC) program draws upon therapeutic skills from existing empirically supported treatments to target common presenting complaints due to this pandemic. We discuss the process of developing and implementing this intervention, as well as explore feasibility and initial clinical insights. In short, BASIC is an easy-to-adopt intervention that is designed to be effective in a single session, making it well-suited for handling the increased demand for mental health services due to COVID-19.     

Mediation of Mothers’ Anxiety and Parenting in Children’s Behavior Problems during COVID-19

The outbreak of COVID-19 is affecting the lives of millions of families around the world. The current study was carried out in Israel, following the pandemic’s initial outbreak and during the resulting enforced quarantine, confining parents and children to their homes. A sample of 141 Israeli mothers with at least one child between the ages of 3 and 12 (M?=?6.92, SD?=?2.55) participated as volunteers. About half the sample (50.7%) consisted of girls. Most mothers were cohabiting with a spouse (93%). Mothers completed online questionnaires about their perceptions about the health and economic threats of COVID-19, availability of social support, their anxiety symptoms, hostile/coercive and supportive/engaged parenting behavior, and their children’s behavior problems. Results showed expected significant associations between the mothers’ reports about having little social support, their anxiety symptoms, hostile/coercive and supportive/engaged parenting behavior, and children’s externalizing problems. Likewise, expected significant associations were found between mothers’ perceptions about the health and economic threats of COVID-19, their anxiety symptoms, hostile/coercive parenting behavior, and children’s internalizing and externalizing problems. Importantly, maternal anxiety and hostile/coercive parenting behavior mediated the associations between lack of support, negative perceptions about the health and economic threats of COVID-19, and children’s behavior problems. These findings stress the importance of mothers’ mental health and parenting behaviors for children’s socioemotional adaptation in the context of COVID-19. Implications of the findings for family interventions intended to help parents and children at this time are suggested.

     

Supporting Romantic Relationships During COVID-19 Using Virtual Couple Therapy

The novel coronavirus disease pandemic (COVID-19) has profoundly impacted people’s lives, resulting in economic turmoil, death and suffering, and drastic changes to everyday life. The adjustment and strain of such challenges can spill over into couples’ relationship processes, including how partners spend time together, talk to one another, and manage conflict. Drawing from our experiences conducting virtual couple therapy (VCT) in a university-based training clinic and community-based clinic, as well as themes from an informal survey of 29 couple therapy clinicians, the current paper discusses the unique challenges that couples face in therapy during COVID-19. Such challenges include renegotiating quality time together, navigating less personal space and time alone, experiencing individual anxiety and stress prompted by the pandemic, and increases in conflict. We discuss our clinical recommendations for addressing these challenges for couples and utilize clinical case examples to illustrate our points. Despite these challenges, we also comment on several positive aspects of COVID-19 on couple relationships. Guided by these considerations and recommendations, our observations suggest that clinicians can effectively support couples’ growth and progress using VCT during COVID-19.     

Family Science in the Context of the COVID-19 Pandemic: Solutions and New Directions

The coronavirus disease 2019 (COVID-19) pandemic has precipitated substantial global disruption and will continue to pose major challenges. In recognition of the challenges currently faced by family scientists, we share our perspectives about conducting family research in the context of the COVID-19 pandemic. There are two primary issues we address in this article. First, we present a range of potential solutions to challenges in research, resulting from the pandemic, and discuss strategies for preserving ongoing research efforts. We discuss approaches to scaling back existing protocols, share ideas for adapting laboratory-based measures for online administration (e.g., using video chat platforms), and suggest strategies for addressing missing data and reduced sample size due to lower participation rates and funding restrictions. We also discuss the importance of measuring COVID-19 relevant factors to use as controls or explore as moderators of primary hypotheses. Second, we discuss how the COVID-19 pandemic represents a scientifically important context for understanding how families adjust and adapt to change and adversity. Increased stress precipitated by the pandemic, varying from acute stress associated with job loss to more chronic and enduring stress, will undoubtedly take a toll. We discuss ways that family scientists can contribute to pandemic-related research to promote optimal family functioning and protect the health of family members.     

Parental Buffering of Stress in the Time of COVID-19: Family-Level Factors May Moderate the Association Between Pandemic-Related Stress and Youth Symptomatology

Nearly all families in the United States were exposed to varying degrees of stress related to the COVID-19 pandemic during the spring of 2020. Building on previous research documenting the pernicious effects of stress on youth mental health, we aimed to test the effects of exposure to COVID-19-related stress on youth symptomatology. Further, in light of evidence suggesting that parents play an important role in buffering children from environmental stress, we assessed how specific parental behaviors (i.e., parental emotion socialization, maintenance of home routines, and availability to discuss the pandemic with child) contributed to effective parental buffering of the impact of pandemic-related stress on children’s symptomatology. Conversely, we tested whether parental anxiety-related symptomatology and parenting stress exacerbated the effect of children’s exposure to pandemic-related stress on children’s symptomatology. Results suggest that parents who engaged in relatively higher levels of emotion coaching of children’s negative emotions and who maintained more stable home routines during the pandemic were more effectively able to buffer the effects of pandemic-related stress on children’s symptomatology. Parents who reported higher levels of parenting stress and anxiety-related symptomatology were less likely to effectively buffer stress. Though interpretation of the findings is limited due to sole reliance on parental report and the cross-sectional study design due to the constraints of collecting data during a global pandemic, findings underscore the importance of assessing family-level factors when considering the impact of stressors on children’s symptomatology and highlight the need to support parents during global events that place families under significant stress.

     

Excessive Worrying as a Central Feature of Anxiety during the First COVID-19 Lockdown-Phase in Belgium: Insights from a Network Approach

Since the WHO declared the COVID-19 pandemic on March 11, 2020, the novel coronavirus, SARS-CoV-2, has profoundly impacted public health and the economy worldwide. But there are not the only ones to be hit. The COVID-19 pandemic has also substantially altered mental health, with anxiety symptoms being one of the most frequently reported problems. Especially, the number of people reporting anxiety symptoms increased significantly during the first lockdown-phase compared to similar data collected before the pandemic. Yet, most of these studies relied on a unitary approach to anxiety, wherein its different constitutive features (i.e., symptoms) were tallied into one sum-score, thus ignoring any possibility of interactions between them. Therefore, in this study, we seek to map the associations between the core features of anxiety during the first weeks of the first Belgian COVID-19 lockdown-phase (n = 2,829). To do so, we implemented, in a preregistered fashion, two distinct computational network approaches: a Gaussian graphical model and a Bayesian network modelling approach to estimate a directed acyclic graph. Despite their varying assumptions, constraints, and computational methods to determine nodes (i.e., the variables) and edges (i.e., the relations between them), both approaches pointed to excessive worrying as a node playing an especially influential role in the network system of the anxiety features. Altogether, our findings offer novel data-driven clues for the ongoing field’s larger quest to examine, and eventually alleviate, the mental health consequences of the COVID-19 pandemic.     

Burden and Growth during COVID-19: Comparing Parents of Children with and without Disabilities

Journal of Child and Family Studies - The COVID-19 pandemic and the measures taken to contain it have had a disproportionate impact on families with young children, especially with disabilities....     

Together – apart: in touch in a time of separation

This paper explores the experience of working as a Jungian analyst through the various phases of the global COVID-19 pandemic, examining the importance of the physical containing space alongside the analyst’s internal mind and how technology can both help and hinder understanding. A number of clinical vignettes illustrate the challenge of communicating over a distance, paying particular attention to the way countertransference phenomena can become re-attuned. Reference is made to mythology and symbols of hope, and consideration given to the meaning and purpose of the pandemic.     

Conducting Prolonged Exposure for PTSD During the COVID-19 Pandemic: Considerations for Treatment

The unprecedented effects and duration of the COVID-19 crisis are likely to elevate the population’s level of anxiety due to psychological stress, economic hardship, and social isolation. This effect may be especially potent for individuals with preexisting mental health conditions, such as posttraumatic stress disorder (PTSD). Prolonged Exposure (PE) therapy is a highly effective treatment for PTSD across trauma-exposed populations, and has been implemented effectively via telehealth. Nevertheless, PE implementation via telehealth may require specific adaptations during the COVID-19 crisis due to public health mandates calling for sheltering in place and physical distancing. This paper discusses strategies for implementing PE for PTSD during the COVID-19 pandemic, which may also be applied to other situations in which physical distancing must be considered.