Outcomes in clients transitioning from in-person counselling to telehealth counselling with trainees

The onset of the 2020 COVID-19 pandemic necessitated a rapid transition of mental health services from in-person to telehealth counselling. Despite the far-reaching impact of this transition, we know little about the impact of this transition on outcomes for clients working with counsellor trainees. The present study utilised longitudinal data collected from a counselling training centre at a major U.S. university to compare client ratings of depression, anxiety and working alliance across 1) in-person services delivered (i.e. pre-pandemic) and 2) telehealth services delivered after the pandemic began (i.e. intra-pandemic) among the same group of clients. Results support our hypothesis that changes in clients' self-reports would be generally equivalent across in-person and telehealth services. Depression and anxiety symptoms decreased, and working alliance tended to increase during both in-person and telehealth care; however, these trends were only statistically significant during telehealth services. Limitations related to sample size (N = 15 clients; up to 17 sessions per client) and low statistical power are discussed. Nonetheless, this study supports the growing body of literature supporting the efficacy of telehealth counselling services. We provide suggestions for future telehealth research and discuss implications for counsellor training.     

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.     

The psychological benefit of future vividness in goal persistence: An illustrative case of the class of 2020 before & during COVID-19

Graduating during COVID-19, the Class of 2020 had difficulty pursuing their future goals. This research examined the likelihood of academic and career goal change early in the pandemic, disparities in persistence by socioeconomic status (SES), and how psychological resources mitigated goal change during the early stages of the pandemic. This 4-year study surveyed students in the Class of 2020 eight times from their first week in college (Fall 2016) to their last semester before graduation (Spring 2020; N = 115; 20% below middle SES, 80% middle SES or above). Even in the first weeks of COVID-19, a quarter of students changed goals. Lower SES students were less likely to persist in their post-graduation plans. Nevertheless, students who entered college with a vivid image of their future were more likely to have secured a graduate school or job prospect prior to COVID-19, and, in turn, were less likely to change goals.     

Difficulties,uncertainty, and opportunity: The experience of the COVID-19 pandemic by early to late adolescence in the Czech Republic

The pandemic created an unfamiliar situation for adolescents, especially within the school context. Drawing on the theory of cognitive appraisal, according to which people evaluate the benefit, harm, and threat of a certain event, this study explored Czech adolescents' experiences of the COVID-19 pandemic. We conducted six focus groups with early (11–12 years), middle (14–15 years), and late (18–19 years) adolescents. Using thematic analysis, we identified three themes—pandemic as difficulties, uncertainty, and a (un)seized opportunity. While some younger participants initially perceived the pandemic as exciting, others struggled immediately with isolation, online learning, and disrupted daily activities. The feelings of distressing uncertainty, but also the appraisal of the pandemic as an opportunity to utilize free time differently, which in some cases faded over time, prevailed among late adolescents. This study captured the effects of the pandemic and its appraisals on adolescents' subjective well-being and the shift in the thinking of early and late adolescents.     

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.     

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.     

When work came home: Formation of feeling rules in the context of a pandemic

The shift of middle-class jobs to home settings, which occurred as a result of COVID-19 health measures that also closed schools and daycares, introduced dynamic changes to everyday life. We investigate these changes drawing on data from our study in which participants in Nova Scotia, Canada, who were working at home due to the pandemic, wrote journal entries in response to weekly prompts. Participants not only documented changes to their routines and challenges of managing work and parenting simultaneously and in the same physical space, but also reflected on their conflicted emotions about life during the pandemic and their vision for life as things return to “normal.” Their narratives prompt us to consider these experiences and emotions in relation to Arlie Hochschild's scholarship on feeling rules, emotion work, and gender and work more broadly. We find that from our participants’ struggle to meet existing expectations on activities and emotion while simultaneously managing new sets of protocols and feeling rules what emerges is a resistance to norms of busyness, productivity, and exhaustion.     

2009年贵阳市住院儿童手足口病病原学及临床特点

为了解贵阳地区2009年4月~9月儿童手足口病的病原学及临床特点。从住院的820例手足口病患儿中采集部分伴有重症倾向的244例患儿的肛试子和咽试子标本进行RT-PCR技术检测,并进行临床观察。218例检测到肠道病毒,占89.34%,其中138例为EV71,占63.30%。72例为CA16,占33.02%,两者之比1.92:1。不同年龄组的病原构成差异有统计学意义(P0.01)。重症病例EV71感染明显高于轻症病例,两者在临床特征方面差异有统计学意义(P0.01)。2009年贵阳市住院儿童手足口病的主要病原是EV71和CA16;1岁~3岁的患儿EV71感染明显高于CA16,EV71比CA16更易引重症手足口病,重症病例与轻症病例在临床表现上有明显差异。     

Exercise as a coping strategy and its impact on the psychological well-being of Japanese community-dwelling older adults during the COVID-19 pandemic: A longitudinal study

This study aimed to examine the prevalence of exercise as a coping strategy among Japanese community-dwelling older adults and its impact on their psychological well-being during the COVID-19 pandemic. In October 2019 (baseline [BL]), 720 community-dwelling older adults living in an urban area in Japan participated in a comprehensive health survey. Of these, 618 responded to a mail survey (follow-up [FL]) in June 2020, after the first state of emergency was lifted. Their psychological well-being was assessed using the WHO-5 Well-Being Index (WHO-5). Exercise as a coping strategy during the stay-at-home period was determined at FL by asking respondents whether they had engaged in 1) walking and 2) at-home exercise and strength training to maintain their physical and mental health. Each type of exercise’s impact and the effective exercise combinations were examined. Time and group interaction effects on the WHO-5 scores were investigated using a two-way analysis of covariance. Of the final sample, 65.1% engaged in walking. The WHO-5 mean scores at BL and FL were 16.7 and 15.4 for the walking group and 16.7 and 14.5 for the non-walking group, respectively; interaction for time and group was significant. Additionally, 56.4% of the participants engaged home training. The WHO-5 mean score at BL and FL were 17.5 and 15.5 for the home training group and 15.7 and 14.5 for the no home training group, respectively; there was no significant interaction. Older adults who engaged in both walking and home training received higher score on the WHO-5 than those who engaged in only one activity at FL. The decline in psychological well-being was most attenuated in the walking only group compared to the at-home exercise and strength training groups. Exercise as a coping strategy during the stay-at-home period was associated with psychological well-being, with different impacts observed depending on the type of activity.     

With crisis comes opportunity: Building ethical competencies in light of COVID-19

ABSTRACT

The emergence of the coronavirus disease 2019 (COVID-19) pandemic has wide-ranging implications for the field of professional psychology. As clinical practice has rapidly adapted to ensure continuity of care, doctoral students have encountered unique opportunities for ethics-related competency development across practicum training settings. This article discusses the relevant American Psychological Association (APA) Ethics Code standards and additional ethical considerations facing trainees as they navigate their foundational clinical experiences and develop as professional psychologists in light of a pandemic.