Evaluation of doctors' experience of psychodynamic psychotherapy training at Leeds and York Partnership NHS Foundation Trust during the COVID‐19 pandemic

Developing psychotherapeutic competencies is an essential part of psychiatric training. All Core Trainees at Leeds and York Partnership NHS Foundation Trust (LYPFT) saw a patient for psychodynamic psychotherapy until 2020. Due to the pandemic, all face‐to‐face appointments at the LYPFT Medical Psychotherapy Service were paused from March 2020. Patients could choose whether to continue therapy remotely or defer therapy. Supervision was also moved to a remote format. Face‐to‐face therapy sessions resumed from August 2020, with new infection control procedures. This project aimed to establish doctors' experience of training in delivering psychodynamic psychotherapy at LYPFT during the pandemic. A two‐step methodology was used: an online survey including qualitative and quantitative analysis of the impact of the pandemic;and semi‐structured interviews with thematic analysis. The online survey had a response rate of 68%. Four patients deferred therapy;the mean deferral length was two months. Ten respondents had sessions cancelled due to infection/self‐isolation. Thirteen respondents (commencing therapy pre‐pandemic) delivered therapy face‐to‐face (without personal protective equipment [PPE]). During the pandemic five respondents delivered therapy via phone, six face‐to‐face with PPE. Thirteen were concerned about attaining psychotherapy competencies. Thematic analysis of the interviews identified three main themes (with subthemes). Challenges of delivering therapy during the pandemic were identified, as well as areas of good practice and opportunities. [ FROM AUTHOR] Copyright of British Journal of Psychotherapy is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Lost and Found in Psychotherapy During COVID-19.

The authors discuss the loss of the traditional setting for psychotherapy caused by the COVID-19 pandemic, a natural experiment lasting 2 years, and the finding of new channels of communication for therapy using video and telephone platforms as well as outdoor therapy spaces. The manuscript explores the experience of both patients and therapists with these new channels and investigates how the external features of the therapy frame can be subjectively experienced by different people and within different therapeutic relationships. Through patient surveys, case vignettes, and discussions with colleagues, the authors conclude that for a large group of psychotherapy patients the new channels worked as well as and sometimes even better than the old in-person appointments and that an occasional in-person "booster" session can strengthen the therapeutic alliance of ongoing teletherapy.

Therapeutic encounters at the onset of the COVID-19 pandemic: psychodynamic therapists' experiences of transition to remote psychotherapy

The COVID-19 pandemic crippled many parts of society as it spread throughout the world beginning in early 2020. Overnight, whole societies were forced to change their way of life, because of social distancing and lockdowns. For therapists, the pandemic meant that in-person sessions were no longer possible and many switched to different forms of synchronous remote communication by telephone, online audio or video link. The aim of this study was to explore psychodynamic therapists' experiences over time of forced transitions to telepsychotherapy. Five therapists were interviewed at the beginning of the pandemic and at a one-year follow-up. The data were analysed by applying thematic analysis with a phenomenological approach. Initially, the therapists struggled with technical and safety issues. The loss of the therapy room and of access to non-verbal nuances contributed to impaired contact with the patients and more superficial conversations. The therapists experienced that the very nature of psychodynamic psychotherapy was affected, even if telepsychotherapy could give some new opportunities. One year later many of the difficulties remained, but the therapists developed better coping strategies and were back to the therapy focus. One implication of this study is that telepsychotherapy needs to be integrated into psychotherapy training and supervision.Copyright © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Trainee psychologists' experiences of learning and conducting psychodynamic therapy via telepsychology

Despite extensive research on telepsychology, less attention has been devoted to psychodynamic therapy (PDT), especially trainee psychologists' experience of learning and conducting online PDT. Using inductive thematic analysis, this study explored the experiences of student psychologists learning and conducting PDT via video-based web platforms. Semi-structured interviews were conducted with 10 Australian trainee psychologists, all completing the psychodynamic component of their clinical psychology training. Interviews addressed participants' experiences of online PDT learning and psychotherapy practice, generating five main themes: (1) technological barriers and their impacts, (2) overcoming telepsychology limitations through awareness and adaptation, (3) benefits of telepsychology, (4) effectiveness of psychodynamic telepsychology, and (5) experience of online psychotherapy learning. Participants reported that the paucity of sensory information, client resistance, distraction, problems maintaining therapy boundaries, supervisor opposition, and technological limitations made online PDT difficult to conduct and less effective than in-person treatment. However, some participants noted that the anxiety of commencing PDT delivery was reduced online, and that the 'layer of separation' assisted countertransference management. Notwithstanding its inherent limitations, online PDT was perceived to be relatively effective, but this requires specific training in adapting traditional psychodynamic techniques. Furthermore, PDT may be effectively learned online, but is an inferior alternative to in-person training.

Impacts of the COVID-19 pandemic on pregnant and postpartum women: Where is the village?

As the COVID-19 pandemic took hold of the United States, pregnant women and mothers of infants were among those most affected by fears of the virus, the disruption of health care systems, social isolation, and the collapse of social supports. This article describes how a group of psychoanalysts and psychoanalytic therapists in a community outreach initiative, the SPRING Project, worked to meet these mental health needs by providing affordable psychotherapy at this critical time. Two case reports highlight the ways the pandemic magnified postpartum distress as well as the relevance and efficacy of a psychodynamic clinical approach in resolving such distress. In addition, the author chronicles how early in the pandemic the SPRING Project launched support groups for pregnant women. Participants in this virtual village helped offset the painful isolation of these women and supported their emotional development during their pregnancies. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Online group psychodynamic psychotherapy-The effectiveness and role of attachment-The results of a short study.

The role of remote treatment, including psychotherapy, has increased during the COVID-19 pandemic. The results of research in this area are promising, initially pointing to similar effectiveness for online psychotherapy as that of face-to-face psychotherapy. A significantly smaller amount of research has been conducted on online group psychotherapy, in particular, in the psychodynamic paradigm. Many authors have drawn attention to the need to conduct further research, considering specific patient features, for example, personality traits, attachment style, age, and other demographic variables. This study conducted pre- and post-treatment (10 weeks) and a 6-week follow-up, on the effectiveness of online synchronous group psychodynamic psychotherapy (via Zoom) taking into account patients' attachment styles. Four main hypotheses were tested: H1: Patients will obtain a lower score in the attachment's dimensions of anxiety and avoidance; H2: Patients will get a lower level of symptoms and sense of loneliness; H3: Patients will have increased self-esteem; and H4: The anxiety and avoidance dimensions of the attachment will be predictors for the effectiveness of online psychodynamic group psychotherapy. Twenty-two outpatients participated in the study, out of which 18 suffered from neurotic, stress-related, and somatoform disorders (F40-F48), and four suffered from a depressive episode (F32.0, F32.1) according to ICD-10. The results of the pre-treatment test showed a reduction in the global severity of psychiatric symptoms (d = -0.526) and depressive symptoms (d = -0.5), as well as an increase in self-esteem (d = 0.444) and feelings of loneliness (d = 0.46). A change in the attachment dimension, anxiety (d = -0.557) and avoidance (d = -0.526), was also observed. The above results were maintained in the follow-up test conducted after 6 weeks. Additionally, a reduction in the symptoms of social phobia was observed. Attachment dimensions were not a predictor of the effectiveness of psychotherapy, but a decrease in avoidance during therapy was a predictor of increased symptoms of pain. The results of the research are promising in terms of psychiatric symptoms and increased self-esteem. During therapy, there may be a favorable change in attachment dimensions, but this variable was not shown to be a predictor of results. These results suggest that more controlled research is required.

Schema focused and mentalization based therapy - an integrative proposal

Schema Focused Therapy (henceforth SFT) is an integrative theory of therapy, which includes aspects of various different therapeutic approaches, but does not stress mentalization. Mentalization Based Therapy (henceforth MBT) focuses on mentalization, but lacks several causes for impaired mentalization found in SFT. The current article aims to fill these respective gaps. To this end, an assimilation of mentalization into SFT is suggested, causes of impaired mentalization are collected from SFT, and practical implications are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (French) ABSTRAIT Cette etude a explique l'importance de l'approche de la therapie breve axee sur les solutions (SFBT) dans le traitement des individus pour trouver des solutions a la fois apres et pendant l'apparition de l'anxiete psychologique, l'application de la SBFT peut etre effectuee de maniere pratique, efficace et efficiente. Cette etude utilise une analyse comparative, qui fait reference a diverses publications pertinentes entre SFBT et l'anxiete psychologique, en particulier dans l'epidemie de COVID-19 sous la forme d'articles de revues scientifiques, d'ouvrages de reference et d'autres informations provenant de sources fiables. Les resultats ont revele qu'il existe une correlation significative entre les theories, les hypotheses de base et les concepts lies au processus d'intervention SFBT dans le but d'aider les individus a trouver des solutions aux problemes qui sont ou seront vecus. Cette etude peut alors constituer une reference scientifique pour l'application de l'approche SFBT dans le but d'ameliorer la capacite a trouver des solutions. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (German) ABSTRAKT Diese Studie erlauterte die Bedeutung des Ansatzes der losungsorientierten Kurzzeittherapie (SFBT) im Umgang mit Einzelpersonen, um Losungen sowohl nach als auch wahrend des Auftretens von psychischer Angst zu finden. Die Anwendung von SBFT kann praktisch, effektiv und effizient erfolgen. Diese Studie verwendet eine vergleichende Analyse, die sich auf verschiedene relevante Literatur zwischen SFBT und psychischer Angst bezieht, insbesondere zum COVID-19-Ausbruch in Form von Artikeln in wissenschaftlichen Zeitschriften, Nachschlagewerken und anderen Informationen aus vertrauenswurdigen Quellen. Die Ergebnisse zeigten, dass es eine signifikante Korrelation zwischen Theorien, sowohl Grundannahmen als auch Konzepten im Zusammenhang mit dem SFBT-Interventionsprozess gibt, um Einzelpersonen dabei zu helfen, Losungen fur Probleme zu finden, die auftreten oder auftreten werden. Diese Studie kann dann als wissenschaftliche Referenz fur die Anwendung des SFBT-Ansatzes zur Verbesserung der Losungsfahigkeit dienen. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (Italian) RIASSUNTO Questo studio ha spiegato l'importanza dell'approccio Solution-Focused Brief Therapy (SFBT) nel trattare con gli individui per trovare soluzioni sia dopo che durante il verificarsi di ansia psicologica, l'applicazione di SBFT puo essere eseguita in modo pratico, efficace ed efficiente. Questo studio utilizza l'analisi comparativa, che fa riferimento a varie pubblicazioni rilevanti tra SFBT e ansia psicologica, in particolare nell'epidemia di COVID-19 sotto forma di articoli di riviste scientifiche, libri di consultazione e altre informazioni da fonti attendibili. I risultati hanno rivelato che esiste una correlazione significativa tra le teorie, sia i presupposti di base che i concetti relativi al processo di intervento SFBT nel tentativo di aiutare le persone a trovare soluzioni ai problemi che sono o saranno vissuti. Questo studio puo quindi essere un riferimento scientifico per l'applicazione dell'approccio SFBT come sforzo per migliorare la capacita di trovare soluzioni. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (Spanish) RESUMEN Este estudio explico la importancia del enfoque de la Terapia Breve Centrada en Soluciones (SFBT) en el trato con las personas para encontrar soluciones tanto despues como durante la ocurrencia de la ansiedad psicologica, la aplicacion de SBFT se puede hacer de manera practica, efectiva y eficiente. Este estudio utiliza un analisis comparativo, que se refiere a varias publicaciones relevantes entre SFBT y la ansiedad psicologica, especialmente en el brote de COVID-19 en forma de articulos de revistas cientificas, libros de referencia y otra informacion de fuentes confiables. Los resultados revelaron que existe una correlacion significativa entre las teorias, tanto los supuestos basicos como los conceptos relacionados con el proceso de intervencion de SFBT en un esfuerzo por ayudar a las personas a encontrar soluciones a los problemas que experimentan o experimentaran. Este estudio puede entonces ser una referencia cientifica para la aplicacion del enfoque SFBT como un esfuerzo para mejorar la capacidad de encontrar soluciones. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Mitfuhlen: A feeling space to think in

In the article, author shares her experience of working as a student counselor at a university during pandemic. Author wishes to explore a particular approach to the therapeutic endeavor which author will call 'Mitfuhlen'. It is a German word whose most literal translation means 'feeling with'. Author will describe how Mitfuhlen enables the therapeutic couple to share feelings together in order that they can be thought about together. Author will propose that the practice of Mitfuhlen creates a venue that is co-created by the therapist and patient, and facilitated by the frame and setting. Author will describe this venue as a 'feeling space to think in'. Author will explore this approach using a particular example from clinical work with a university student. Author is doing so because it was with this student that author used the term 'feeling space to think in' for the first time. The adaptation of the seemingly straightforward word, Mitfuhlen, 'feeling with', to the therapeutic setting offers an additional tool to the therapist's repertoire. Certainly it is closely allied to other techniques, yet it makes a valuable contribution towards models of working with transference. Perhaps most significantly, Mitfuhlen enables the therapist to approach the analytic situation as one in which experience is mutually shared in order that change may occur. Although my work with Cathy was curtailed by time constraints and carried out digitally from a great distance, author is certain that a creative dynamic was at work between us which enabled me to recognize therapy as a 'feeling space to think in'. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

The Inanimate Third: Going Beyond Psychodynamic Approaches for Remote Psychotherapy during the COVID-19 Pandemic.

The COVID-19 pandemic exposed the field of psychotherapy to the need to provide treatment remotely. We discuss the question of whether remote therapy can be curative and if the electronic device used to manage these sessions unites or separates the therapist and the patient. We term the electronic device as 'the inanimate third' in the therapeutic process and discuss the objectivity of the device as opposed to the subjective emotional processes involved. We deal with emotional themes relevant to the COVID-19 pandemic and associated social distancing practices, such as longing, loneliness, the perception of the future and the lost past, and the efficacy of the therapeutic stimulation of fantasy and hope. We also evaluate the possibility of existing transference and countertransference processes while working remotely. We suggest the term 'social paradox' to describe the situation in which an objective entity such as the digital media symbolizes both distance and intimacy as well as separation and unity. We conclude by stating that containment of the social paradox by the therapeutic dialogue is possible as the existence of the dialogue eliminates elements of the paradox.

Vicissitudes of Death Anxiety During the COVID-19 Pandemic.

The author, an experienced psycho-oncologist, offers clinical insights that consider the importance of death anxiety in psychodynamic psychotherapy treatments during the COVID-19 pandemic. He reviews the contributions of Ernst Becker, Wilfred Bion and Sheldon Solomon, and formulates ideas of his own based on decades of experience treating patients with cancer. This short essay focuses on how to help patients during the COVID-19 pandemic work through fear and uncertainty while developing adaptive skills.

Therapeutic Alliance in COVID-19 Era Remote Psychotherapy Delivered to Physically Ill Patients With Disturbed Body Image.

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.