Working Online During the Contemporary COVID-19 Pandemic1

Within the psychoanalytic school there has been substantial and ongoing debate about the efficacy of teleanalysis. However, as a result of the current COVID-19 pandemic and the online work with which the Jungian analytic community has now had to engage, this paper initially focuses on analysts’ actual experiences of working by teleanalysis. These experiences highlight a range of issues like “Zoom fatigue”, “online disinhibition”, dissonance, confidentiality, the frame and working with new patients. Alongside these issues, there were ample experiences by analysts of both productive psychotherapy apace with analytic work involving transference and countertransference phenomena, all indicating that a genuine and good enough analytic process can occur with teleanalysis. An overview of the research and literature both prior to the pandemic and as a result of it, confirms the validity of these experiences so long as analysts are cognizant of the specifics of such an online modality. Conclusions to do with the question, “what have we learned?”, alongside training, ethics and supervision issues are subsequently discussed.     

Reflections on the role of the analytic setting in the light of COVID-19

There have been many reflections, both individual and collective within our Institutes, on the effects on our work with patients caused by COVID-19 and the requirement to move suddenly from the setting of our own consulting rooms to working with patients online (see also, the previous issue of this Journal). This paper focuses on what we have learned from these experiences that can add to our knowledge about the role of the setting in analytic work. Drawing on Bleger’s (1967) seminal paper highlighting the usual setting as a mute projection carrier for primitive wishes and affects, the paper explores how different patients have reacted to the loss of the analyst as the guardian of the setting and in particular as an embodied presence. Some key questions and challenges for both patients and analysts during the pandemic, when ‘the setting begins to weep’, are explored.     

Keeping connected: Family therapists' experiences of working online during the COVID-19 pandemic

For this qualitative study, eight family therapists were interviewed about their experiences of practising online during the pandemic. Findings are organised using a framework of problems, possibilities, resources and restraints (PPRR, Neden & Burnham, 2007). Despite variation in therapist confidence in online practice, all participants found new possibilities in this way of working, including connecting family members across distance, increased co-construction within therapeutic relationships and engaging clients who would not usually attend appointments. Therapeutic alliance was generally possible to establish online, though felt more challenging with whole families than individuals. Problems and restraints included therapist fatigue, risk and safety management, and attuning to nuanced expression of emotion. Implications for practice and future research are proposed. It is suggested that systemic practice has unique qualities to offer the field of online psychotherapy.     

Understanding the online therapeutic alliance through the eyes of adolescent service users

Aims: The therapeutic alliance is a concept that has received a great deal of attention within face‐to‐face counselling. Furthermore, links have been made between the creation of strong alliances and successful therapeutic outcomes. This study examines the therapeutic alliance when counselling services are offered online to young people. Method: Fifteen young people took part in online interviews (utilising synchronous and asynchronous methods), and Grounded Theory techniques were utilised to analyse the data. Findings: A core category of ‘Client‐Service Match’ and three subcategories pertinent to the individuals’ experiences of creating good quality relationships with the counsellors were identified: (1) initial engagement, (2) developing rapport, and (3) establishing control. Discussion: The themes elicited are all relevant to the matching process and viewed as a chronological process similar to face‐to‐face counselling. However, unlike face‐to‐face work, specific nuances related to the online work arise that counsellors should be mindful of, including the rationale behind each individual's choice to approach services online, their own computer‐mediated communication skills, technical hurdles, and the perceived ‘power’ of the counsellor.     

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.     

One-to-one support for crisis intervention using online synchronous instant messaging: evaluating working alliance and client satisfaction

Young people are increasingly turning to online support, especially when traditional mental health services are not immediately available. Using a cross-sectional design, sociodemographic information and self-reported perceptions of the strength of the working alliance and client satisfaction were collected from a sample of participants (n = 78) who were users of a service providing free online support using synchronous instant messaging. The results reported a significant positive relationship between the strength of the working alliance and client satisfaction, suggesting that the strength of the working alliance remains a key component in counselling, even online. Participants, however, scored significantly lower on both the strength of the working alliance and client satisfaction, compared to participants in offline settings as reported in past studies.     

Clients' experiences of online therapy in the early stages of a COVID-19 world: A scoping review

The emergence of the COVID-19 pandemic in 2019 forced an abrupt shift in the modality through which psychotherapy was delivered and online therapy became the only viable option for clients. Research regarding experiences of online therapy during the early stages of the COVID-19 pandemic is minimal, however, and has largely focussed on therapists' experiences of delivering online treatment, as opposed to clients' experiences of receiving it. A scoping review was undertaken to establish what is known from the existing literature about clients' experiences of online therapy during the initial stages of the COVID-19 pandemic and identify gaps in the current knowledge. Searches were conducted across four academic databases: Scopus, EBSCO CINAHL Complete, EBSCO MEDLINE and OVID PsycInfo; the literature was excluded based on established PICOS criteria. Data were summarised through data charting and synthesised by way of inductive content analysis. A total of five articles were identified. All articles focussed on online therapy using video or audio conferencing, and four of the five studies examined clients with eating disorders. Inductive content analysis identified seven categories, as follows: preference for face-to-face therapy; appreciation of accessibility and convenience; online format hindered connection; positive experience of online therapy; individual client differences impacted experience; strong therapeutic alliance indicative of positive experience; and gratitude for continuation of treatment. Future research could explore clients' experiences of online therapy in a “post-pandemic” world and include a broader range of client populations and online therapy approaches in the COVID-19 context.     

Online disinhibition: heightened potential for professional conduct issues among clergy in the Church of England?

This article identifies the potential of online social networking encounters to heighten the risk of professional conduct issues among clergy in the Church of England. It first considers the difficulties in establishing what constitutes inappropriate conduct for clergy working in complex twenty-first century contexts, and then goes on to suggest that the online disinhibition effect might form a significant factor in problematic online encounters, drawing on the work of psychologist John Suler, and other previous research. It then considers the question of how online identity might mesh or jar with embodied identity for clergy, and concludes that awareness of the online disinhibition effect coupled with conscious integration of online involvements into their broader support networks, rather than compartmentalising them, form useful ways for clergy to undermine toxic online disinhibition.     

When all COVID breaks loose: Examining determinants of working parents' job performance during a crisis

As governments mandated organization and school closures due to COVID-19, working parents involuntarily found themselves trying to balance both work and child educational responsibilities from home while still endeavoring to remain productive at work. As such, we integrate the crisis management literature with boundary theory and the work–home resources model to propose and test a process model to better understand how abrupt shifts to remote work and school closures impact working parents' job performance during a crisis. Using data collected across four time periods beginning at the time when most states had issued “safer at home” orders, we examine a serial mediation model and find, consistent with predictions, that early experiences of boundary violations and job insecurity impact work–family balance self-efficacy, which in turn drives future job performance by way of its effects on working parents' subjective well-being. Implications for theory and practice are discussed.     

“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.     

Helping Couples in the Shadow of COVID-19

The pandemic caused by the SARS-CoV-2 virus (coronavirus) and the associated illness, COVID-19, has caused a level of worldwide upheaval unlike any most people now living have seen in their lifetimes. This crisis affects people in their most important, committed, and intimate relationships. Although this crisis has damaged the health and well-being of individuals, crushed economies, and led to an extensive period of uncertainty about the future, there may also be positive outcomes in the motivation people have to protect their relationships. In this paper, we focus on strategies that therapists and relationship educators can use to help couples preserve and protect their relationships during such a time. We describe four foundations of safety that allow relationships to thrive: physical, emotional, commitment, and community. We then highlight three keys from our body of work that can help guide individuals and couples in protecting their relationships on a day-to-day and moment-to-moment basis: (1) decide, don’t slide; (2) make it safe to connect; (3) do your part.     

Determinants of sanitary measures and lockdown compliance among health professionals during the COVID-19 pandemic

IntroductionCOVID-19 pandemic forced several countries to establish sanitary and lockdown measures to prevent the spreading of the virus. Only necessary workers were allowed to work, including health workers in hospitals.ObjectivesThis study explores the association between some variables and sanitary measures compliance among health workers during a pandemic.MethodA total of 299 Health workers were recruited online using social networks. Participants completed questionnaires evaluating personality, coping, Anxiety and depression, psychological flexibility and sanitary measures compliance.ResultsCorrelations indicated most observant participants were more likely to present efficient coping and more based on problem solving. Also, Honesty-Humility as a personality trait was positively correlated to a better compliance. Regressions indicated the perceived utility of sanitary measures was the strongest predictor for compliance among health workers. Honesty-Humility and sanitary risks perception were predictors for compliance.ConclusionsThis study conducted among health workers points indicates variables associated with higher compliance. Our results suggest compliance and non-compliance as health behaviours or risk behaviours are linked to perceived threats. This perception is linked to health workers’ knowledges, their coping strategies, and personality.     

阅读进度反馈信息对工作同盟和咨询效果的影响

进度反馈指将对当事人的标准化测量结果和解释反馈给咨询师的干预, 其目的在于矫正咨询师对咨询效果主观评估的偏差, 提高咨询效果。考虑到咨询师和当事人“面对面”的标准反馈程序不符合我国社会文化习惯, 采用多层结构方程模型, 分析了自然情境下非“面对面”的进度反馈对工作同盟和咨询效果的影响。结果发现, 在组间水平, 反馈组的工作同盟质量更好; 在组内水平, 工作同盟与症状是相互预测的关系。在结案时, 反馈组在抑郁症状和咨询的有帮助性上效果更好。结论是进度反馈对工作同盟和咨询效果有积极影响。研究从工作同盟和中国人的关系角度拓展了对进度反馈作用机制的认识, 为进度反馈的应用提供了基于实践干预有效的证据。     

Adolescents coping with the COVID-19 pandemic: ‘every day is like another Sunday’

COVID-19 has upended the way analysts and psychotherapists practice. Many use the phone for their sessions, many are using video platforms, and many use a combination of the two. Work with adolescents is very challenging in this new modality because of the loss of in-person connection and immediate non-verbal cues. The public health restrictions put in place to manage COVID-19 spread are at odds with the adolescent tasks of adventuring, experimenting and gaining new experiences. In addition, increased anxieties about infection, contamination and invasion are often manifest and adolescents can regress in the face of them. Using seminal ideas from Bion, this article looks at two process examples from adolescent boys who struggled with parts of themselves that felt disturbing and unacceptable. The author discusses the clinical exchanges in detail and offers ideas about the difficulty of creating psychic space when working virtually.     

Does remote work erode trust in organizations? A within-person investigation in the COVID-19 context

The global COVID-19 pandemic led to a widespread increase in remote work arrangements. This trend raised concerns regarding the potential negative ramifications it might have for organizational trust and cooperation. We explored the initial effect of COVID-19 induced remote work on trust in organizations: trust in co-workers, trust in the supervisor and in the organization at large. In a four-wave longitudinal survey of remote workers (N ∼ 1000) in the UK conducted between May 2020 and August 2020 (first COVID wave), we examined the association between the share of remote work (out of total working hours) and different forms of trust at work. The results showed that, for the same individual, increasing the share of working hours spent remotely was associated with more trust in the organization at large (but not in the supervisor and co-workers). Further, during the months where individuals spent more time working remotely, they experienced lower turnover intentions (but not less burnout or more work engagement, productivity, and satisfaction) compared to the months where they spent less time working remotely. The results contribute to the literature on flexible work arrangements, organizational trust, and other work outcomes.     

Regulation strategies during COVID-19 quarantine: The mediating effect of worry on the links between coping strategies and anxiety

IntroductionThe COVID-19 outbreak forced Italian citizens into a generalized quarantine from March to May 2020. The quarantine is a successful measure to reduce the virus's spread through physical and social distancing, but it can also have negative psychological consequences on the population. People experience high levels of worry and anxiety and have to cope with the consequences of the health emergency. The aim of this study was to preliminarily assess the causal relations among coping, worry and state anxiety at the time of COVID-19 first wave, and the mediation role of worry between coping and state anxiety.MethodsDuring March 2020, 1273 Italian citizens completed an ad hoc online survey composed of sociodemographic and preoccupation-related questions, and standardized self-report questionnaire (Brief COPE, Penn State Worry Questionnaire and State-Trait Anxiety Inventory-State form). Three separate mediation models were performed.ResultsThe relationship between coping strategies (i.e.: problem-focused coping, emotion-focused coping and dysfunctional coping) and state anxiety resulted to be mediated by worry. Dysfunctional and problem-focused coping had a negative effect on anxiety scores and this effect was amplified by high levels of worry. Emotion-focused coping reduced state anxiety scores through its effect on reducing the levels of worry, which in turn was related to a reduction in anxiety.ConclusionThe present study offers first evidence for the mediation role of worry in the relation between coping and anxiety during quarantine caused by COVID-19 pandemic. It supports the clinical importance of investigating people's coping strategies along with the levels of (cognitive) worry and their long-term effects on the psychological well-being during the outbreak, in order to deliver adequate personalized interventions. Psychological support should enhance emotion-focused coping strategies that have a protective effect on both worry and anxiety.     

Developing the Working Alliance in Marital Therapy; A Psychodynamic Perspective

A good working alliance in marital therapy is one in which the partners are actively collaborating with their therapist to work through conflicts. The therapist begins to develop the alliance by setting the frame of therapy and helping the couple understand the guidelines of treatment. The partners gradually identify with and emulate the therapist's working style and use of self as a reflective instrument. The working alliance can be weakened by empathic failures and strengthened by increased feelings of trust in the therapist and the process of treatment This paper looks at the development of the working alliance in marital therapy from a psychodynamic perspective. A clinical illustration is included.     

Misconceptions and realities about teaching online

This article is intended to guide online course developers and teachers. A brief review of the literature on the misconceptions of beginning online teachers reveals that most accept the notion that putting one’s lecture notes online produces effective learning, or that technology will make education more convenient and cost-effective for all concerned. Effective online learning requires a high level of responsibility for learning on the part of students and a reduction of the teacher-student power differential. This, in turn, has major implications for faculty and course development, student selection criteria, the cost of instruction, and the outcomes of education. Effective online teaching focuses on processes of learning rather than outcomes, and is consistent with modern principles of learning that emphasize focusing on issues of high interest to learners, teaching students to use skills of active and effective learning, providing prompt feedback, and enabling students to establish learning goals and employ alternative paths to achieving those goals. Multiple ways of operationalizing these goals online are presented. Tips are offered concerning selection of students who are capable of benefiting from the online experience, developing curriculum that is user-friendly, using resources that stimulate good writing and critical thinking, and limiting class size to a manageable number.     

Does disseminating (mis)information restore social connection during a global pandemic?

The COVID-19 pandemic impeded social interaction, negatively affecting well-being worldwide. To slow virus spread, practices were enacted to minimize face-to-face contact, leading to increased social disconnection. As people turned increasingly to online environments (e.g., social media) to fulfill needs for inclusion and belonging, misinformation regarding COVID-19 simultaneously ran rampant. The purpose of the current study was to examine whether impeded social inclusion may have contributed to the spread of misinformation. We recruited a sample of adult social media users in the United States (N = 431) and randomly assigned them to be either included, ostracized (i.e., ignored), or rejected (i.e., to receive explicitly negative attention). Participants subsequently rated their willingness to share COVID-19 claims via social media (in fact, all claims were false). Participants learned that sharing some claims would likely lead to high expected engagement from others on social media (e.g., “likes”), whereas some claims would likely lead to little expected engagement. While information sharing was low in our sample, participants were more willing to share claims that they believed would lead to higher levels of engagement—consistent with the idea that sharing information is motivated not only by the desire to educate others but also to elicit social connection. However, this behavioral intention was no more common among participants who had been momentarily ostracized or rejected online than among participants who had been included. Future research should continue to explore the link between social exclusion and the motivation to disseminate (mis)information beyond a pandemic-related context.     

Sober social networks: The role of online support groups in recovery from alcohol addiction

In the context of addiction research, positive recovery outcomes are affected by the quality of people's social interactions and perhaps to an even greater extent, by the defining norms of the groups they identify with—that is, using versus recovery groups. Here, we examine the role of online supportive networks in the process of recovery from alcohol addiction. We analyse the relationship between negative and positive aspects of recovery capital (i.e., self‐stigma, and respectively, positive recovery identity and self‐efficacy) as they relate to well‐being outcomes among alcohol users in an online recovery support group. Based on a computerised linguistic analysis of the naturally occurring data extracted from an online recovery support group (i.e., 257 posts made by 237 group members), we found that self‐stigma negatively predicts self‐efficacy and well‐being, and social identification with a recovery identity mediates these relationships. Overall, these findings highlight that positive engagement with supportive recovery networks is central to an effective and sustainable recovery.