Telephone-based psychological crisis intervention: the Portuguese experience with COVID-19

ABSTRACT

Portugal is one of the European countries that implemented early protective measures in the context of the COVID-19 pandemic. Portugal declared a state of emergency on 18 March, and a set of regional and national preventive public health measures was progressively implemented. Studies on the psychological impact of pandemics show evidence of the negative impact on mental health. Of particular concern are individuals with previous fragility (e.g. personal, family or occupational) and those undergoing life transitions. In this paper, we present a telephone-based psychological crisis intervention that was implemented to provide brief, appropriate, and timely psychological help. This intervention follows standard models of crisis intervention and is structured in five phases and five different intervention modules to take into account the impact of the pandemic on the mental health of specific risk groups. With these support services, we hope to help our community better cope with the immediate impact of the pandemic and to contribute to preventing serious mental health problems in the medium and long term.

KEYWORDS:

• COVID-19
• psychological impact
• psychological intervention
• crisis intervention
• telephone-based intervention

Acknowledgments

This study was partially conducted at the Psychology Research Centre (PSI/01662), University of Minho, and supported by the Portuguese Foundation for Science and Technology and the Portuguese Ministry of Science, Technology and Higher Education (UID/PSI/01662/2019), through the national funds (PIDDAC).

We acknowledge Associação de Psicologia da Universidade do Minho (APsi-UMinho) and APsi-UMinho collaborators for supporting the telephone-based psychological crisis intervention: Ana Daniela Silva, Ana Isabel Gonçalves, Ana Rita Pereira, Andreia Milhazes, Ângela Ferreira, Alexandra Vieira, Célia Sampaio, Carina Magalhães, Cátia Braga, Delfina Fernandes, Dulce Lopes, Dulce Pinto, Inês Castro, Inês Marques, Gabriela Santana, Joana Andrade, Joana Coutinho, Joana Guimarães, Joana Soares, Joana Teixeira, Joana Torres, João Batista, João Tiago Oliveira, Mariana Leite, Marta Sousa, Patrícia Mendes, Sara Lima, Soraia Mesquita, Teresa Castanho.

We would like to thanks P5 and affiliated Psychologists: Liliana Amorim, and Inês Fernandes.

We gratefully acknowledge OutSystems for the financial support through OutSystems COVID-19 Community Response Program.

Disclosure statement

No potential conflict of interest was reported by the authors.

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Notes on contributors

Eugénia Ribeiro

Eugénia Ribeiro, PhD, is the coordinator of the Psychotherapy and Psychopathology Research Lab of the Research Center in Psychology of University of Minho (UMinho). She is the coordinator of the Psychological Intervention of the Psychological Association (APsi-UMinho). Currently, she is the Master in Psychology’s Director at UMinho. She is member of the Society for Psychotherapy Research and the Portuguese Society of Constructivist Psychotherapies. She is member of the editorial committee of international journals, International Journal of Clinical and Health Psychology and Psychotherapy Research, and Associate Editor of Psychotherapy Research. Her academic career has been dedicated to the study of the relational processes in psychotherapy, both from a macro and micro-analytical perspective. In recent years, its research program has been developed around the phenomenon of therapeutic collaboration and responsiveness, based on the model of therapeutic collaboration and its coding system (Therapeutic Collaboration Coding System) developed by her team.

Adriana Sampaio, MD, PhD, is the lab director of the Psychological Neuroscience Lab (https://psychologicalneurosciencelab.weebly.com) in the School of Psychology, University of Minho, Portugal. She is the President of the APsi-UMinho. Her main research is in the field of developmental cognitive neuroscience, namely in the structural and neurofunctional and genetic basis of (ab)normal cognitive and emotional processes. In particular, using cutting edge technologies that combine morphometric with functional neuroimaging measures, her work aims to map specific neurodevelopmental processes associated with normal higher cognitive function and their age-related trajectories, by looking at the dynamic interplay between genetic, biological, and environmental factors that shape brain development. As part of her work, Adriana Sampaio has published more than 100 articles in ISI journals, collaborating with several research teams (Spain, France, United Kingdom, Brazil and USA). She is the principal investigator of several projects funded by FCT and Fundação Bial. She was also awarded for her work in the area of research in Psychology.

Miguel M. Gonçalves is Professor of Psychology at School of Psychology, University of Minho, Portugal. His main research interests focus on narrative and dialogical processes in psychotherapy. He and his team have developed the concept of innovative moment, as events in psychotherapy in which novelties to a previous problematic pattern emerge and contribute to meaningful change. This concept has been inspiring his research projects from the past few years, allowing the study of change, ambivalence to change and resolution of ambivalence. Despite his main research interest on psychotherapy, the concepts and methods his team developed to study the psychotherapy process, have been applied on other related domains, like vocational counseling and academic underachievement.

Maria do Céu Taveira is a teacher at the Department of Applied Psychology, at the School of Psychology, University of Minho, in Portugal. She is also member of the Research Center of Psychology at the same university, coordinating a research group on career development and counseling. Her main research interests are career exploration, career self-management and academic and work adaption processes. Actually, she is a member of the Executive Board of the Psychology Association of the University of Minho.

Jácome Cunha is an Assistant Professor at University of Minho, Department of Computer Science, and an integrated member of the research center HASLab/INESC TEC. His research is mainly focused on aiding end users being more effective and efficient when developing their software systems. In particular, he has made several contributions to improve the effectiveness and efficiency of spreadsheet users. More recently he has also worked on improving software energy consumption through the analysis and transformation of its source code. Currently he is focused on making data science more accessible for end users. He obtained his PhD degree in Computer Science from the University of Minho in 2011. Afterward, he was a post-doctoral fellow jointly at University of Minho and Oregon State University, and was also an Invited Professor at ESTG - Polytechnic Institute of Porto. Between 2014 and 2018 he was an Assistant at NOVA University of Lisbon.

Ângela Maia is Vice President of the School of Psychology, and coordinates the Research Unit on Victims, Offenders and the Justice System in the Research Centre for Psychology, University of Minho. She had projects funded by the Foundation of Science and Technology and Government Departments. Those projects are on the impact on trauma on health and violence, and she authored/co-authored national and international publications. She has been member of the board of the International Society of Behavioral Medicine and is member of the Scientific Council of Stress Resource Center of the Ministry of Defense.

She is interested in understanding the impact of exposure to adversity, potentially traumatic experiences and associated factors, as well as pathways from victimization to delinquency.

Marlene Matos Assistant Professor at the School of Psychology, University of Minho. Professor of Psychology and Criminology. In research, she has worked mainly in the fields of Victimology, Forensics and Justice Psychology. Author of many publications at national and international level in those fields. Member of the Ethics Committee for Research in Social and Human Sciences at the same University. Psychotherapist, forensic expert and scientific supervisor in university community center (APsi-UMinho).

Sónia Gonçalves is Assistant Professor at the School of Psychology, University of Minho. Actually she’ is also clinical supervisor at the Psychological Association of the University of Minho. Her main research areas of interest are Eating Behavior and Eating Disorders and Non-suicidal self injury behavior.

Bárbara Figueiredo is associate Professor with Habilitation in Clinical Psychology. Director of the Psychology Research Centre (CiPsi), Coordinator of the Psychology Association Babies and Young Children Unit (APSI) and of the Family and Human Development Research Group, at the University of Minho, School of Psychology. Member of the Order of Portuguese Psychologists, specialist in Clinical and Health Psychology and advanced specialist in Psychotherapy. President of the Portuguese speaking group of the International Marcé Society for Perinatal Mental Health. Associate Editor of the Infant Behavior and Development (Elsevier) and the Psychology: Research and Review (Springer). Member of the ProChild - Against Poverty and Social Exclusion Collaboratory Laboratory. Bárbara Figueiredo has been developing and implementing both research and intervention in the field of family and human development, on parenting, parent-infant relationships, and mother, father and infant mental health.

Teresa Freire, PhD in Psychology, belongs to the Department of Applied Psychology in the School of Psychology. She leads the Research Group on Positive Development and Optimal Functioning in the Center for Research in Psychology. She is a psychologist in the Psychological Association of the University of Minho, in clinical and health psychological intervention for children and adolescents. She is the scientific coordinator of the Peer Tutoring and Mentoring Project in the University of Minho and is also a staff member of the Centre IDEA-UMinho (Innovation and Development of Teaching and Learning).

Tércio Soares is a Lead Product Manager working at OutSystems. He holds a degree in Mathematics and Computer Sciences by University of Minho (2007). Tércio has started his career as a software developer and since 2011 has accumulated experience in team and product management. Over the years has successfully released to the market several new products. He is also involved in the supervision of master thesis and under-graduated students from university.

Maria Do Céu Taveira

Eugénia Ribeiro, PhD, is the coordinator of the Psychotherapy and Psychopathology Research Lab of the Research Center in Psychology of University of Minho (UMinho). She is the coordinator of the Psychological Intervention of the Psychological Association (APsi-UMinho). Currently, she is the Master in Psychology’s Director at UMinho. She is member of the Society for Psychotherapy Research and the Portuguese Society of Constructivist Psychotherapies. She is member of the editorial committee of international journals, International Journal of Clinical and Health Psychology and Psychotherapy Research, and Associate Editor of Psychotherapy Research. Her academic career has been dedicated to the study of the relational processes in psychotherapy, both from a macro and micro-analytical perspective. In recent years, its research program has been developed around the phenomenon of therapeutic collaboration and responsiveness, based on the model of therapeutic collaboration and its coding system (Therapeutic Collaboration Coding System) developed by her team.

Adriana Sampaio, MD, PhD, is the lab director of the Psychological Neuroscience Lab (https://psychologicalneurosciencelab.weebly.com) in the School of Psychology, University of Minho, Portugal. She is the President of the APsi-UMinho. Her main research is in the field of developmental cognitive neuroscience, namely in the structural and neurofunctional and genetic basis of (ab)normal cognitive and emotional processes. In particular, using cutting edge technologies that combine morphometric with functional neuroimaging measures, her work aims to map specific neurodevelopmental processes associated with normal higher cognitive function and their age-related trajectories, by looking at the dynamic interplay between genetic, biological, and environmental factors that shape brain development. As part of her work, Adriana Sampaio has published more than 100 articles in ISI journals, collaborating with several research teams (Spain, France, United Kingdom, Brazil and USA). She is the principal investigator of several projects funded by FCT and Fundação Bial. She was also awarded for her work in the area of research in Psychology.

Miguel M. Gonçalves is Professor of Psychology at School of Psychology, University of Minho, Portugal. His main research interests focus on narrative and dialogical processes in psychotherapy. He and his team have developed the concept of innovative moment, as events in psychotherapy in which novelties to a previous problematic pattern emerge and contribute to meaningful change. This concept has been inspiring his research projects from the past few years, allowing the study of change, ambivalence to change and resolution of ambivalence. Despite his main research interest on psychotherapy, the concepts and methods his team developed to study the psychotherapy process, have been applied on other related domains, like vocational counseling and academic underachievement.

Maria do Céu Taveira is a teacher at the Department of Applied Psychology, at the School of Psychology, University of Minho, in Portugal. She is also member of the Research Center of Psychology at the same university, coordinating a research group on career development and counseling. Her main research interests are career exploration, career self-management and academic and work adaption processes. Actually, she is a member of the Executive Board of the Psychology Association of the University of Minho.

Jácome Cunha is an Assistant Professor at University of Minho, Department of Computer Science, and an integrated member of the research center HASLab/INESC TEC. His research is mainly focused on aiding end users being more effective and efficient when developing their software systems. In particular, he has made several contributions to improve the effectiveness and efficiency of spreadsheet users. More recently he has also worked on improving software energy consumption through the analysis and transformation of its source code. Currently he is focused on making data science more accessible for end users. He obtained his PhD degree in Computer Science from the University of Minho in 2011. Afterward, he was a post-doctoral fellow jointly at University of Minho and Oregon State University, and was also an Invited Professor at ESTG - Polytechnic Institute of Porto. Between 2014 and 2018 he was an Assistant at NOVA University of Lisbon.

Ângela Maia is Vice President of the School of Psychology, and coordinates the Research Unit on Victims, Offenders and the Justice System in the Research Centre for Psychology, University of Minho. She had projects funded by the Foundation of Science and Technology and Government Departments. Those projects are on the impact on trauma on health and violence, and she authored/co-authored national and international publications. She has been member of the board of the International Society of Behavioral Medicine and is member of the Scientific Council of Stress Resource Center of the Ministry of Defense.

She is interested in understanding the impact of exposure to adversity, potentially traumatic experiences and associated factors, as well as pathways from victimization to delinquency.

Marlene Matos Assistant Professor at the School of Psychology, University of Minho. Professor of Psychology and Criminology. In research, she has worked mainly in the fields of Victimology, Forensics and Justice Psychology. Author of many publications at national and international level in those fields. Member of the Ethics Committee for Research in Social and Human Sciences at the same University. Psychotherapist, forensic expert and scientific supervisor in university community center (APsi-UMinho).

Sónia Gonçalves is Assistant Professor at the School of Psychology, University of Minho. Actually she’ is also clinical supervisor at the Psychological Association of the University of Minho. Her main research areas of interest are Eating Behavior and Eating Disorders and Non-suicidal self injury behavior.

Bárbara Figueiredo is associate Professor with Habilitation in Clinical Psychology. Director of the Psychology Research Centre (CiPsi), Coordinator of the Psychology Association Babies and Young Children Unit (APSI) and of the Family and Human Development Research Group, at the University of Minho, School of Psychology. Member of the Order of Portuguese Psychologists, specialist in Clinical and Health Psychology and advanced specialist in Psychotherapy. President of the Portuguese speaking group of the International Marcé Society for Perinatal Mental Health. Associate Editor of the Infant Behavior and Development (Elsevier) and the Psychology: Research and Review (Springer). Member of the ProChild - Against Poverty and Social Exclusion Collaboratory Laboratory. Bárbara Figueiredo has been developing and implementing both research and intervention in the field of family and human development, on parenting, parent-infant relationships, and mother, father and infant mental health.

Teresa Freire, PhD in Psychology, belongs to the Department of Applied Psychology in the School of Psychology. She leads the Research Group on Positive Development and Optimal Functioning in the Center for Research in Psychology. She is a psychologist in the Psychological Association of the University of Minho, in clinical and health psychological intervention for children and adolescents. She is the scientific coordinator of the Peer Tutoring and Mentoring Project in the University of Minho and is also a staff member of the Centre IDEA-UMinho (Innovation and Development of Teaching and Learning).

Tércio Soares is a Lead Product Manager working at OutSystems. He holds a degree in Mathematics and Computer Sciences by University of Minho (2007). Tércio has started his career as a software developer and since 2011 has accumulated experience in team and product management. Over the years has successfully released to the market several new products. He is also involved in the supervision of master thesis and under-graduated students from university.