Telepsychotherapy: a leaflet for psychotherapists in the age of COVID-19. A review of the evidence

ABSTRACT

COVID-19 outbreak imposes the adoption of extraordinary containment measures, including the strict necessity to limit interpersonal contact. Face-to-face psychotherapy collides with this requirement and, above all, it might endanger both therapists and patients’ safety. Telepsychotherapy might come to the aid, ensuring therapeutic continuity and the possibility to reach people who might benefit of extra psychological support. Infectious outbreaks have been indeed associated with major psychopathological outcomes. The aim of the present work is to review the most recent experimental evidence about telepsychotherapy, focusing on its effectiveness, possible determinants of efficacy and therapists/patients’ attitudes, to rapidly inform psychotherapists. Out of the 857 records found, 18 studies have been included in the review. Our results show that, despite therapists and public’s skepticism, telepsychotherapy is a trustworthy alternative to be adopted, which can be used efficaciously to treat common mental-health disorders such as anxiety, depression and post-traumatic distress. As well as in the traditional setting, a higher number of sessions and the proper management of patients’ expectations seem to be associated with better outcomes. On the contrary, low familiarity with web-based means of communication and technical issues might reduce specifically the effectiveness of telepsychotherapy.

KEYWORDS:

• Telepsychotherapy
• distance psychotherapy
• on-line psychotherapy
• COVID-19
• coronavirus

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Barbara Poletti

Barbara Poletti  Senior Researcher and Head of the Neuropsychology and Clinical Psychology Unit at IRCCS Istituto Auxologico Italiano of Milan. She is Chief of the Center for Relational Integrative Psychotherapy of Bergamo. She has a broad background in cognitive psychology, with specific training and expertise in neuropsychology, cognitive psychotherapy and the use of new technologies in neuropsychology and cognitive psychology fields. Her research activity is focused on psychological and cognitive correlates of main neurodegenerative disorders, elderly psychotherapy and psychotherapy of cognitive and motor neurodegenerative disorders.

Sofia Tagini

Sofia Tagini Registered Psychologists at the Order of Psychologists of Piemonte, Italy (n°9182) since October 2019. In December 2019 she got her PhD in Cognitive and Brain Sciences at the Center for Mind/Brain Sciences (CIMeC), University of Trento, Rovereto, Italy. Currently, she works as post-doctoral researcher at the Department of Neurology and Laboratory of Neuroscience, Istituto Auxologico Italiano, IRCCS, Milan, Italy. In-training psychotherapists at the Person-Centered Approach Institute in Milan, Italy.

Agostino Brugnera

Agostino Brugnera Post-doctoral researcher at the University of Bergamo (Italy). His work focuses on research methodology, interventions for the treatment of eating disorders and on cardiovascular stress responses.

Laura Parolin

Laura Parolin Associate Professor of Psychodynamic Psychology at the University of Milano-Bicocca, where she teaches Psychodiagnostic Assessment. She is also vice-president of the ItalianAssociation of Psychologists and president of the Lombardy Association of Psychologists. She received her MSc in Psychology and her PhD in Clinical Psychology from the University of Padua. Her doctoral and postdoctoral research career was dedicated mainly on clinical assessment and personality performance-based measures. In particular, her interest was oriented on Rorschach test, in collaboration with the research group of the University of Toledo (USA). More broadly, Laura Parolin research – which has been published in various international scientific journals - focuses on clinical assessment, testing, process and outcome psychotherapy research, mentalization and attachment in childhood, adolescence and parenthood. This research activity led her to join different national and international research groups.

Luca Pievani

Luca Pievani Lecturer and Director of the School of Integrative Psychotherapy, Bergamo, Italy. Psychologist, Cognitive-Relational Psychotherapists. Registered at the professional Order of Psychologists of Lombardia (n°7533). Chairman of the Psychology Association “Liberamente”. Head of the Centre of Psychology and Psychotherapy “Liberamente”. Subject expert in Clinical Psychology (M-PSI/08) at the Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy.

Roberta Ferrucci

Roberta Ferrucci Senior Researcher at University of Milan and Clinical Psychologist at “ASST Santi Paolo and Carlo” Hospital of Milan. She has a broad background in psychology, with specific training and expertise in neuropsychology, cognitive psychotherapy and neuromodulation. Research interests are in the field of the cognitive neurosciences, clinical neuropsychology and experimental psychopatology. She is interested in studying brain mechanisms and the neural activity underlying behaviour, emotion, memory, language and decisional processes.

Angelo Compare

Angelo Compare Associate Professor in Clinical Psychology at University of Bergamo, Italy. Moreover, he is Italian reference of SEPI (Society for Exploration for Psychotherapy Integration) and Italian member of eHealth working group of EFPA (European Federation of Psychology Association). He has a broad background and research interest in clinical and health psychology and process in psychotherapy.

Vincenzo Silani

Vincenzo Silani Professor of Neurology at the University of Milan Medical School, Director of the Department of Neurology-Stroke Unit and Laboratory of Neuroscience at the IRCCS Istituto Auxologico Italiano, Director of the “Dino Ferrari” Centre, and Director of the Residency program in Neurology. He graduated in 1977, obtained the Specialties of Neurology (1981) and Neurosurgery (1989). Post-doctoral Fellow at the Department of Neurology-Baylor College of Medicine in Houston (1979-81), he was Visiting Professor in Neurology (1999), Chairman of the European ALS Consortium (EALSC) (2005-2007), Director of the European Neurological Society (ENS) - Subcommittee for Motor Neuron Disease (2008-2013), Co-Director of the European Academy of Neurology (EAN) Subspeciality Panel ALS and FTD (2013-2019). He is Member of the American Academy of Neurology (AAN), European Academy of Neurology (EAN) (FEAN in 2016), Society of Neuroscience USA, and Italian Society of Neurology and of Dementia (SinDEM). He is Chairman of the Italian Consortium for Genetics in ALS (SLAGEN) and Member of the USA NEALS Consortium (2017). Prof. Silani is internationally recognized as a leading scientist in neurodegenerative diseases and, more specifically, ALS, FTD, and PD. He is author of more than 300 papers with an H-index (Scopus) of 57.