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.     

“Hello,can you hear me?”: Narratives of online mental health counselling among Filipino adults during the pandemic

Filipinos are often reluctant to seek professional mental health (MH) help. However, literature reveals that online counselling is preferable to face-to-face (F2F) MH services, with the pandemic possibly magnifying technology's anonymity and disinhibiting benefits. To further explore facilitators of online MH help-seeking, this study tapped into the lived stories of Filipino adults who experienced at least one counselling session from March 2020 to March 2022. Among 83 screened respondents, 11 semistructured interviews were transcribed and analysed following Crossley's (2000) method. Findings reveal an overarching online MH counselling narrative composed of three phases and their respective events: (a) Precounselling (Resiliency Narrative versus MH Awareness, Turning Point, and Linking versus Searching); (b) Counselling (Two-way Introduction, Unloading and Untangling, and Decision to Maintain or Terminate); and (c) Postcounselling (Relapse and Journey towards Growth and Advocacy). Three all-encompassing facilitators were embedded throughout the process: Autonomy, Financial Capability, and MH Institutions. Notably, participants attributed their MH help-seeking to autonomy, despite culture and stigma, because of enabling environments that entail heightened MH literacy, positive past experiences with professional MH help, social support and encouragement, and a sense of shared reality. Benefits unique to online counselling were also apparent among participants' narratives, including alleviating geographical boundaries and added financial and personal pressures. Overall, findings posit that Filipino adults consider online counselling as a preferable alternative to F2F counselling, thus necessitating further development and institutional support.     

Client attendance measures in counselling psychology trainees

Counselling supervisors and educators have yet to reach a consensus about standard measures for evaluating the performance of graduate student therapists. Compared to self‐reports and rater judgements, client attendance records provide low‐inference behavioural data partially reflective of clients’ engagement with therapists. This naturalistic study evaluates client attendance data using archival records of 92 doctoral students in beginning and advanced counselling practica who produced data for 771 clients, 3,949 scheduled sessions and 3,186 attended sessions. Providing evidence of the sample representativeness for clinicians, results indicated that the mean number of sessions attended per client for student therapists (5.65) was very similar to that reported in the literature for outpatient therapists (<6). As expected because of structural differences in client assignment, beginning and advanced students evidenced statistically significant differences on attendance variables such as number of clients and scheduled sessions. In contrast, attendance ratios were equivalent across counsellor experience, suggesting that these individual difference variables could be useful for evaluation of therapist competencies related to client engagement.     

Research in counselling and psychotherapy Post‐COVID‐19

The COVID‐19 pandemic brings to light many areas the field of counselling and psychotherapy may need to address in future research. We outline several issues stemming from or exacerbated by the pandemic and offer suggestions for future research to address the mental health needs of those impacted. Our suggestions focus on five domains: (a) the health and well‐being of helping professionals, (b) the infodemic, (c) discrimination and minority stress, (d) spiritual and existential dynamics in mental health and (e) couple and family stress and resilience. We aim to provide a multi‐systemic perspective of mental health and well‐being in the time of COVID‐19, as well as encourage current and future studies to incorporate these suggestions to advance the health and well‐being of our communities through evidence‐based treatment approaches.     

Safety behaviors were associated with greater anxious symptoms during the first year of the COVID-19 pandemic

Research shows that people who use safety behaviors are at greater risk factor for anxiety than people who do not use safety behaviors. However, the perception of some safety behaviors changed during the COVID-19 pandemic; behaviors that were once considered unnecessary or excessive were now commonplace (e.g., monitoring bodily symptoms, avoiding crowds). The purpose of this study was to determine the degree to which the pandemic changed the status of health-related safety behaviors as a risk factor for symptoms of anxiety. To this end, we tested the effect of safety behavior use on anxious symptoms during the first year of the pandemic using a longitudinal design with 8 time points and participants (n = 233) from over 20 countries. Despite possible changes in their perception, those engaging in high levels of safety behaviors reported the greatest levels of anxious symptoms throughout the pandemic year. However, the outcomes for safety behavior users were not all negative. Safety behavior use at baseline was the only predictor of participants' willingness to receive the COVID-19 vaccine (measured one year later).     

Online counselling: The experience of counsellors providing synchronous single‐session counselling to young people

Kids Help Line (KHL) is a national Australian youth counselling service that provides free online and telephone counselling. This qualitative study examines the experience of 26 online KHL counsellors. Using a focus group methodology, counsellor responses were organised into categories: privacy and an emotionally safe environment; communication through text; and time. Counsellors reported the main benefit of the online environment to be emotional safety, due to reduced client emotional proximity to the counsellor, and the main disadvantage to be that reduced emotional proximity and the absence of non‐verbal cues could result in communication problems and difficulty in accurately assessing young people's concerns. Time proved a significant issue for counsellors, as the slow speed of text exchange could limit their ability to complete interventions. Methods that enhance both the process and effectiveness of online counselling are needed. Potential solutions to the challenges faced by online counsellors are discussed.     

Romantic relationship quality during the COVID-19 pandemic: The longitudinal associations with relationship loneliness and depression

The COVID-19 pandemic created significant strain on both mental health and romantic relationships. Therefore, we examined longitudinal associations between romantic relationship quality, relationship loneliness, and depressive symptoms over 6 months of the COVID-19 pandemic. We surveyed 122 couples (n = 244 individuals) in approximately May, September, and November 2020. Using a dyadic mediation model, findings indicated that relationship quality at Time 1 was positively associated with depression at Time 3 for men, but not for women. A significant indirect effect of relationship quality on depression via relationship loneliness at Time 2 was found for both men and women. Self-mastery, or feeling in control of one's life circumstances, was an important covariate of women's depressive symptoms. Overall, these findings highlight relationship loneliness as particularly salient for mental health and demonstrate the importance of high-quality relationships for promoting well-being during stressful events, such as global pandemics.     

Evaluation of a telehealth parent training program in teaching self-care skills to children with autism

The present study used synchronous video conferencing to remotely deliver a behavioral skills training-based (BST) parent training program to 3 parents of children with autism in the family home. Parents were taught to implement graduated guidance to teach their children several important self-care skills. Parents did not correctly implement graduated guidance after receiving detailed written instructions only. After parents received the BST parent training package, however, all parents implemented graduated guidance with near-perfect levels of fidelity, and all children completed the targeted self-care skills with substantially higher levels of accuracy and independence. Furthermore, parents reported high levels of satisfaction with graduated guidance, the telehealth BST training package, and their children's ability to complete self-care skills.     

Using telehealth to provide outpatient follow‐up to children with avoidant/restrictive food intake disorder

The COVID‐19 global health crisis compelled behavior analysts to consider alternatives to face‐to‐face services to treat children with feeding disorders. Research suggests telehealth is one method behavior analysts could use to initiate or continue assessment of and treatment for feeding disorders. In the current paper, we conducted pilot studies in which we analyzed chart records of patients with Avoidant/Restrictive Food Intake Disorder; who graduated from an intensive, day‐treatment program; and transitioned to an outpatient follow‐up program. In Experiment 1, we analyzed the data of participants who received follow‐up both in‐clinic and via telehealth. In Experiment 2, we analyzed goal attainment for participants who received outpatient follow‐up either in‐clinic exclusively or via telehealth exclusively. Results of both studies showed that outcomes were equivalent along most dimensions for in‐clinic and telehealth services. We provide recommendations for telehealth feeding services and discuss other considerations relevant to telehealth service delivery.     

Rice-farming areas report more anxiety across two years of the COVID-19 pandemic in China

Cultures responded to the COVID-19 pandemic differently. We investigated cultural differences in mental health during the pandemic. We found regional differences in people's reports of anxiety in China over two years from 2020 to 2021 (N = 1186). People in areas with a history of rice farming reported more anxiety than people in wheat-farming areas. Next, we explored more proximal mechanisms that could help link the distal, historical factor of rice farming to people's modern experience of anxiety. Rice areas scored higher on collectivism and tight social norms than wheat areas, and collectivism, rather than norm tightness, mediated the rice-anxiety relationship. These findings advance our understanding of the distal sources of cultural differences, the proximal mechanisms, and mental health problems during the pandemics.     

Who drops-out? Do measures of risk to self and to others predict unplanned endings in primary care counselling?

Aims: Unplanned endings, where clients unilaterally end therapy, are of concern for psychological therapy services generally as they raise questions about the appropriateness of the treatment and it's delivery for some clients. Limited available data indicates that those who drop-out often have more severe symptoms at entry, and have poorer clinical outcomes. This raises further questions about risk to self and others for those clients who leave therapy prematurely and how these clients might be identified and kept engaged. Method: This paper uses a large dataset of CORE data collected routinely in a primary care counselling service between 2000 and 2003. Logistic regression was utilised to consider different measures of risk and other client characteristics recorded at assessment to predict drop-out from the service. Results: These indicate that younger age, greater psychological distress at assessment, an addiction problem and greater risk to others, are associated with an unplanned ending. However, no reliable logistic regression model could be produced. This may be partly due to data quality issues or important characteristics not being available in the data. Implications for practice: The paper concludes that counsellors should actively seek to minimise unplanned endings, as amongst them may be represented the more distressed and risky clients referred to primary care counselling.     

Changes in loneliness and coping strategies during COVID-19

The social distancing measures implemented to slow the spread of COVID-19 impacted many aspects of people's lives. Previous research has reported negative consequences of these measures for people's psychological well-being, and that people differed in the impact on their psychological well-being. The present study aimed to describe the different coping strategies Dutch people used to deal with these measures and to link these strategies to loneliness. In addition, the study aimed to examine mean-level changes in loneliness and to explore individual differences in loneliness change. We used data from 2009 participants of a panel study of representative Dutch households. We assessed coping strategies used during the first wave of the COVID-19 pandemic in May 2020 and examined changes in loneliness between October 2019 (before COVID-19) and May 2020 (during the first wave of COVID-19). First, results showed that most people employed specific coping strategies. The most frequently used social strategies were chatting and (video)calling; the most frequently used non-social strategies were going outside, doing chores, watching TV, reading and self-care. Second, people who used more coping strategies reported lower levels of loneliness. Third, analyses revealed an average increase in loneliness between October 2019 and May 2020. Fourth, we observed two significant interaction effects, showing a stronger positive link between the number of social coping strategies and initial loneliness levels among those with a partner or living with others than for those who were single or lived alone. Yet, no moderating effects on changes in loneliness were found: people using more coping strategies did not differ in loneliness changes from people using fewer coping strategies. Together, findings suggest that loneliness increased in the Netherlands during the first phase of COVID-19 and that, while people's coping strategies were related to loneliness levels, they did not buffer against loneliness increases.     

Psychological impact of coronavirus-related social isolation in Colombia after a year of lockdown

Several repercussions of the COVID-19 pandemic and its subsequent isolation period have been reported worldwide. In this paper, we analyze the behavioral and emotional effects of 1 year of coronavirus-related lockdown in Colombia. A cross-sectional correlational design was used on a sample of 1853 participants from different regions, and with different levels of education, income, and employment situations. We applied the fear of coronavirus scale, the use of preventive behaviors scale, and a scale to measure pleasant and unpleasant emotions based on the circumplex model of affect. Our data shows that women, participants who were unemployed during the lockdown, and participants that study or work in legal, computational, or related fields, have been more affected in terms of unpleasant emotions. In addition, we observed a trend towards a relation between higher income and educational levels with lower degrees of fear, higher degrees of pleasant emotions, and a greater use of preventive behaviors related to the pandemic.     

Individual differences and changes in personality during the COVID-19 pandemic

This article reports the results of an eleven-wave longitudinal study of personality change conducted between December 2019 and December 2022 with 1328 participants in Germany. Based on theories of personality change, we investigated trajectories of big five personality factors (i.e., extraversion, agreeableness, conscientiousness, emotional stability, and openness) across the COVID-19 pandemic. In addition, we examined whether demographic characteristics (i.e., age, sex), self-reported health status (i.e., physical, mental), and socioeconomic status (i.e., education, income, industry) moderated these trajectories. There was evidence for increases in extraversion, conscientiousness, and emotional stability and decreases in openness across time. The magnitude of these effects suggests between d = 0.027 to 0.138 standard deviation changes in these personality characteristics across the 3-year timeframe of this study. Evidence for moderating effects of age, sex, health, and socioeconomic status was mixed, but indicates differential patterns of personality change for certain individuals. Overall, findings suggest that changes in big five personality factors across the COVID-19 were present, albeit on average relatively weak, but still higher than anticipated given the timeframe. Moreover, certain demographic and health variables were associated with differential trajectories of personality over time.     

Mental health counselling in the Black American Church: reflections and recommendations from counsellors serving in a counselling ministry

The goal of this study was to examine the relationship between “The Black Church”, the mental health needs of its members, and addressing those needs from the perspective of counsellors within the church. Four in-depth interviews were conducted with members of the mental health counselling team at one large, African American-serving church in the Midwest to explore their thoughts about their church pastor’s desire to expand their current ministry to a fully operating counselling centre. The findings suggest that “the Black Church” not only has a role and responsibility in addressing the mental health needs of African Americans within and outside of the church but can also use religiosity as a facilitator rather than a barrier to mental health service use among African Americans.     

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.     

Self-compassion,coping strategies and gender differences in psychology,counselling and psychotherapy practitioners during COVID-19: Lessons learnt

Effective coping strategies can protect against the adverse effects of stress. This study investigated self-compassion's ability to predict approach and avoidance coping in psychology, counselling and psychotherapy practitioners (PCPPs) during COVID-19, and whether this differed between genders. To date, no research has investigated this relationship, despite positive associations being drawn in other populations. Three hundred and nineteen PCPPs completed an online survey including the Brief COPE and Self-Compassion Short Form. Self-compassion significantly predicted greater use of approach coping and reduced use of avoidance coping. The predictive ability of self-compassion was slightly better in female practitioners. Self-judgement arose as a prominent subscale of self-compassion across genders, increasing both approach and avoidance coping. Implications for future research and practice are discussed, concerning barriers to self-compassion and the requirement of therapeutic programmes and psychoeducation as a prerequisite for effective coping strategies in the PCPP population.