Psychodynamic Therapist's Subjective Experiences With Remote Psychotherapy During the COVID-19-Pandemic-A Qualitative Study With Therapists Practicing Guided Affective Imagery, Hypnosis and Autogenous Relaxation.

The COVID-19-pandemic brought massive changes in the provision of psychotherapy. To contain the pandemic, many therapists switched from face-to-face sessions in personal contact to remote settings. This study focused on psychodynamic therapists practicing Guided Affective Imagery, Hypnosis and Autogenous Relaxation and their subjective experiences with psychotherapy via telephone and videoconferencing during the first COVID-19 related lockdown period in March 2020 in Austria. An online survey completed by 161 therapists produced both quantitative and qualitative data with the latter being subject to a qualitative content analysis. Our research suggests that telephone and videoconferencing are considered valuable treatment formats to deliver psychodynamic psychotherapy. However, therapists' experiences with remote psychotherapy are multifaceted and ambiguous. In particular, the findings raise questions concerning the maintenance of the therapeutic alliance, the development of the analytic process, the sensitivity to unconscious communication, and the indication for certain types of patients that still need further investigation. Our research indicates that the long-standing reticence toward remote treatments offers among psychodynamic therapists is becoming more differentiated and partially dissolves as therapists gain experiences in their use. Attitudes are becoming more open. At the same time, the way is being prepared to take a closer look at the specific processes and dynamics of remote psychotherapy and to examine them critically in future studies.

Healthcare for migrants and for marginalized individuals: The Marienambulanz in Graz, Austria.

The Marienambulanz in Graz, which was founded in 1999, is an outpatient clinic aiming to provide free medical services for marginalized groups. Medical and socioeconomic data of patients at the outpatient clinic have been collected electronically since 2003. The purpose of this study was to find out which persons were treated at the Marienambulanz in the last seven years (2003-2009) and to find out the most frequent reasons for attending the Marienambulanz. We analysed existing medical data descriptively in order to find out the four most frequent reasons for going to the outpatient clinic, the nationality of the patients and whether or not the patients had insurance coverage. Since 2003, 3,652 patients (2,342 men and 1,310 women) have been treated at the Marienambulanz. The majority of patients came either for an initial medical examination, for medication or for further thorough examinations including advice about general health and - if necessary - for childcare. Interestingly, more than 60% of the patients were insured. The Marienambulanz provides medical assistance for uninsured persons and for marginalized insured persons who do not make use of the regular health care system. It can be argued that the regular Austrian health care system fails to provide health care for marginalized groups. The Marienambulanz in Graz, as a low-threshold institution, serves the purpose of bridging the gap to the regular health care system for marginalized groups.