The Use of New Digital Information and Communication Technologies in Psychological Counseling during the COVID-19 Pandemic
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Instruments
2.3. Procedure
2.4. Statistical Analysis
3. Results
3.1. ICTs in Psychological Counseling and Therapy before the COVID-19 Pandemic
3.1.1. Use of ICTs in Psychological Counseling and Therapy
3.1.2. Tools and Technological Devices Used
3.1.3. Psychologists’ Perceptions about Their Experiences and about Clients’ Adherence
3.1.4. Advantages and Challenges of ICTs Use
3.2. ICTs in Psychological Counseling and Therapy during the COVID-19 Pandemic
3.2.1. Use of ICTs in Psychological Counseling and Therapy
3.2.2. Readiness for the Use of ICTs
3.2.3. Tools and Technological Devices
3.2.4. Impact of the COVID-19 on the Psychologists’ Practice
3.2.5. Psychologists’ Perception about Their Experiences and about Clients’ Adherence
3.2.6. Advantages and Challenges of the ICTs Use
3.3. Variables Associated with Psychologist’ Attitudes and Practices
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Appendix A
The Use of New Digital Information and Communication Technologies in Psychological Counseling during the COVID-19 Pandemic
Informed Consent
Socio-demographic and professional data
- Gender:
- Man
- Woman
- Other
- Age (years):
- Education:
- Graduation
- Master’s
- PhD
- Year of completion of the course [please consider the first degree that have allowed you to practice Psychology in Portugal (e.g., Pre-Bologna graduation; Post-Bologna Master’s Degree)]:
- Number of years of professional experience [please count from the moment you started the practice of Psychology services]:
- Distrit(s) in which you practice Psychology:
- Aveiro
- Beja
- Braga
- Bragança
- Castelo Branco
- Coimbra
- Évora
- Faro
- Guarda
- Leiria
- Lisboa
- Portalegre
- Porto
- Santarém
- Setúbal
- Viana do Castelo
- Vila Real
- Viseu
- Are you a specialist in Clinical and Health Psychology accredited by the Portuguese Psychologists Association?
- Yes
- No(Note: In case the answer above is Yes, the next question appears)
- Do you have an advanced specialty recognized by the Portuguese Psychologists Association?
- Yes
- No
- If yes, which one(s) of them? (you can choose several)
- Neuropsychology
- Psychogerontology
- Justice Psychology
- Sports Psychology
- Psychotherapy
- Sexology
- Other
- Select the age group(s) of the population your work with most often (you can choose several):
- Children
- Adolescents
- Adults
- Elderly
- Indicate which psychological disorders you assess and intervene most often (you can choose several):
- Neurodevelopment disorders
- Mood disorders
- Anxiety disorders
- Personality disorders
- Substance-related disorders and addictive behaviours
- Sleep disorders
- Neurocognitive disorders
- Other(s): (please specify)
Use of Digital Technologies in Psychological CounsellingWe ask you to consider your entire professional career as a psychologist, prior to the confinement measures imposed by the declaration of the State of Emergency in Portugal, to answer the following questions. - Have you used digital tools to conduct at-distance psychological counselling?
- Never
- Rarely
- Sometimes
- Often
- Always
(Note: If the previous answer was Never or Rarely, the next question appears. If the answer is no, after responding to 10.1, the participants go directly to question no. 15)- 10.1.
- Which are the main reasons for you having never or rarely used this kind of tools?
- I don’t know how to apply them in my work
- I don’t consider them efficient (i.e., the adequate use of the necessary resources for the intervention/treatment)
- I don’t consider them effective (i.e., the ability of a given program to produce benefit when applied under ideal conditions)
- I find them very impersonal
- I don’t consider them safe enough
- I don’t consider them ethical enough
- I find them very expensive
- Other(s): (please specify)
- Which tool(s) have you already used in at-distance psychological counselling?
- E-mail
- Audio-conference (e.g., Skype, Facetime, Zoom)
- Videoconference (e.g., Skype, Facetime, Zoom)
- Online platforms
- Online forum
- Chat
- Social networks (e.g., Facebook, Twitter, WhatsApp, Instagram, LinkedIn)
- Smartphone and tablet apps
- Virtual rooms (e.g., Second Life)
- Telephone calls
- Other(s): (please specify)
- Which device(s) have you already used to maintain at-distance psychological counselling?
- Computer
- Tablet
- Telephone/smartphone
- Other(s): (please specify)
- How do you rate your experience using this type of tools for conducting at-distance psychological counselling before the imposition of confinement measures by the declaration of the national state of emergency?
- Very negative
- Negative
- Neither negative nor positive
- Positive
- Very positive
- How do you rate your clients’ involvement in therapeutic activities that use this kind of tools before the imposition of confinement measures by the declaration of the national state of emergency?
- Very low
- Low
- Moderate
- High
- Very high
- What are the advantages that you have already benefited from, or that you consider you could have benefited from, by using this type of tools in psychological counselling, before the imposition of confinement measures by the declaration of the national state of emergency?Geographic flexibility, both for professionals and clients (i.e., they can interact from any location)
- Time flexibility
- Cost-benefit ratio
- To be able to reach new groups of people in need of psychological counselling
- Easy access to some target groups (e.g., people with anxiety, people with disabilities, refugees)
- New business areas
- None
- Other(s): (please specify)
- Which are the challenges that you have faced or feared to face with the use of this kind of tools in psychological counselling processes before the imposition of the confinement measures by the declaration of the national state of emergency?
- Reduced therapeutic adherence
- Difficulty in establishing or maintaining the therapeutic relationship
- Significant decrease or increase in the frequency of the sessions
- Temporal management of the sessions
- Setting boundaries
- Interruption of the sessions
- Less client involvement in and commitment to the session
- Lack of non-verbal communication
- (Possible) misunderstandings
- Difficulty in therapeutically approaching a problem/topic
- Lack of security
- Reduced privacy
- Ethical concerns
- None
- Other(s): (please specify)
Considering the challenges imposed to all psychologists by the COVID-19 pandemic situation (SARS-CoV-2), we ask you to answer the following questions according to your current professional practices. - Have you continued to provide psychological counselling to your clients regularly?
- Yes
- No
(Note: If the answer to the previous question is no, the next question appears, and the participant has finished his/her questionnaire)- 17.1.
- Which are the reasons that have led you to suspend your professional activity?
- Have you consulted any supporting documents or guidelines for at-distance psychological counselling or psychological counselling in crisis and catastrophe situations?
- Yes
- No
(Note: If the answer to the previous question is yes, the next question appears)- 18.1.
- Please insert the name and/or link of the document(s) you consulted.
- Currently, which percentage of your clients do you continue to monitor regularly when compared to the period before the declaration of the state of emergency in Portugal?
- Between 0% and 25%
- Between 26% and 50%
- Between 51% and 75%
- Between 76% and 100%
- If there was a significant reduction in the percentage of clients that you regularly monitor, which are the main reasons that you identify for this to have happened?
- The frequency of the psychological counselling sessions with each client that you continue to monitor
- Diminished a lot
- Diminished
- Remained the same
- Increased
- Increased a lot
- The duration of the psychological counselling with each client that you continue to monitor
- Diminished a lot
- Diminished
- Remained the same
- Increased
- Increased a lot
- Which tool(s) do you use to provide regular at-distance psychological counselling to your clients?
- E-mail
- Audio-conference (e.g., Skype, Facetime, Zoom)
- Video-conference (e.g., Skype, Facetime, Zoom)
- Online platforms
- Online forum
- Chat
- Social networks (e.g., Facebook, Twitter, WhatsApp, Instagram, LinkedIn)
- Smartphone and tablet apps
- Virtual rooms (e.g., Second Life)
- Telephone calls
- Other(s): (please specify)
- Which device(s) have you already used to maintain at-distance psychological counselling?
- Computer
- Tablet
- Telephone/smartphone
- Other(s): (please specify)
- How do you rate the therapeutic adherence of your clients currently, when compared to in-presence sessions?
- Much smaller
- Smaller
- More or less the same
- Greater
- Much greater
- How do you rate the therapeutic relationship with your clients currently, when compared to in-presence sessions?
- Much worse
- Worse
- More or less the same
- Better
- Much better
- How do you rate the results of each therapeutic session currently, when compared to in-presence sessions?
- Much worse
- Worse
- More or less the same
- Better
- Much better
- How do you rate the feedback of your clients, when compared to in-presence sessions?
- Much worse
- Worse
- More or less the same
- Better
- Much better
- In case you consider that you have adopted some additional precautions in at-distance psychological counselling, when compared to those you adopt in relation to the use of digital technologies in the context of your social relationships, please indicate them.
- What are the advantages that you identify in at-distance psychological counselling?Geographic flexibility, both for professionals and clients (i.e., they can interact from any location)
- Time flexibility
- Cost-benefit ratio
- To be able to reach new groups of people in need of psychological counselling
- Easy access to some target groups (e.g., people with anxiety, people with disabilities, refugees)
- New business areas
- Other(s): (please specify)
- Which are the difficulties that you face in promoting at-distance psychological counselling sessions?
- Reduced therapeutic adherence
- Difficulty in establishing or maintaining the therapeutic relationship
- Significant changes in the frequency of the sessions
- Temporal management of the sessions
- Setting boundaries
- Interruption of the sessions
- Less client involvement in and commitment to the session
- Lack of non-verbal communication
- (Possible) misunderstandings
- Difficulty in therapeutically approaching a problem/topic
- Lack of security
- Reduced privacy
- Ethical concerns
- Other(s): (please specify)
- What are the difficulties that are reported by your clients in relation to maintaining at-distance psychological counselling?
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n/% | |
---|---|
M/SD | |
Gender | M: n = 19, 17.6% |
F: n = 89, 82.4% | |
Age | M = 37.2; SD = 10.0 |
Education | Graduation: n = 26, 24.1% |
Master: n = 69, 63.9% | |
PhD: n = 13, 12.0% | |
Professional Experience | M = 11.5; SD = 8.6 |
Clinical and Health Specialty | Y: n = 60, 55.6% |
N: n = 48, 44.4% | |
Advanced Specialties | Neuropsychology: n = 6, 5.6% |
Psychogerontology: n = 0 | |
Justice Psychology: n = 2, 1.9% | |
Sports Psychology: n = 0 | |
Psychotherapy: n = 13, 12.0% | |
Sexology: n = 1, 0.9% | |
Others: n = 9, 8.3% | |
Population | Children: n = 46, 42.6% |
Adolescents: n = 52, 48.1% | |
Adults: n = 81, 75.0% | |
Elderly: n = 24, 22.2% | |
Psychological Disorders | Neurodevelopment disorders: n = 24, 22.2% |
Mood disorders: n = 72, 66.7% | |
Anxiety disorders: n = 91, 84.3% | |
Personality disorders: n = 37, 34.3% | |
Substance-related disorders and addictive behaviors: n = 21, 19.4% | |
Sleep disorders: n = 23, 21.3% | |
Neurocognitive disorders: n = 30, 27.8% | |
Others: n = 10, 9.3% |
Before the COVID-19 | n (%) | During the COVID-19 Confinement Period | n (%) | |
---|---|---|---|---|
ICTs use (n = 108) | never rarely sometimes frequently always | 37 (34.3%) 26 (24.1%) 26 (24.1%) 14 (13.0%) 5 (4.6%) | yes (sessions continued) no (sessions discontinued during this period) | 91 (84.3%) 15 (15.7%) |
Tools (n = 71 before) (n = 91 after) | video conferences telephone calls e-mails social networks audio conferences online intervention platforms smartphones/tablet apps online forums chats short-message services virtual rooms | 50 (70.4%) 41 (57.7%) 31 (43.7%) 23 (32.4%) 14 (19.7%) 6 (8.5%) 6 (8.5%) 4 (5.6%) 3 (4.2%) 2 (1.8%) 1 (0.9%) | video conference telephone calls social networks e-mails audio conference smartphones/tablet apps online intervention platforms chats online forums virtual rooms | 71 (78.0%) 48 (52.7%) 35 (38.5%) 33 (36.3%) 16 (17.6%) 7 (7.7%) 3 (3.3%) 3 (3.3%) 1 (1.1%) 1 (1.1%) |
Devices (n = 71 before) (n = 91 after) | computer telephone/smartphone tablets | 62 (87.3%) 58 (81.7%) 9 (12.7%) | computer telephone/smartphone tablets | 80 (87.9%) 66 (72.5%) 9 (9.9%) |
Psychologists’ experiences/results (n = 71 before) (n = 91 after) | positive neither negative nor positive very positive very negative or negative | 37 (52.1%) 21 (29.6%) 13 (18.3%) 0 (0%) | more or less the same better results worse results | 65 (71.4%) 4 (4.4%) 22 (24.2%) |
Clients’ involvement/adherence (n = 71 before) (n = 91 after) | moderate high low involvement very low very high | 28 (39.4%) 18 (25.4%) 12 (16.9%) 7 (9.9%) 6 (8.5%) | more or less the same decreased improved significantly decreased significantly improved | 52 (57.1%) 24 (26.4%) 10 (11.0%) 5 (5.5%) 0 (0.0%) |
Advantages (n = 108) | geographic flexibility scheduling flexibility reaching new groups easier access to some target-groups cost-benefit relationship new business areas no advantages other | 74 (68.5%) 55 (50.9%) 36 (33.3%) 28 (25.9%) 27 (25.0%) 10 (9.3%) 12 (11.1%) | geographic flexibility scheduling flexibility reaching new groups cost-benefit relationship easier access to some target-groups new business areas no advantages other | 73 (80.2%) 57 (62.6%) 30 (33.0%) 24 (26.4%) 21 (23.1%) 11 (12.1%) 2 (2.2%) |
Challenges (n = 108) | establishing/maintaining the therapeutic relationship non-verbal communication therapeutic adherence client engagement privacy session interruption ethical concerns misunderstandings difficulties approach some problems/topics sessions’ frequency lack of security establishment of boundaries time management no challenges other | 67 (62.0%) 66 (61.1%) 52 (48.1%) 50 (46.3%) 35 (32.4%) 29 (26.9%) 23 (21.3%) 22 (20.4%) 20 (18.5%) 20 (18.5%) 19 (17.6%) 19 (17.6%) 12 (11.1%) 4 (3.7%) | non-verbal communication privacy establishing/maintaining the therapeutic relationship session interruptions therapeutic adherence some problems/topics ethical concerns patient engagement in the sessions other | 58 (63.7%) 36 (39.6%) 34 (37.4%) 31 (34.1%) 22 (24.2%) 19 (20.9%) 19 (20.9%) 18 (19.8%) |
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Dores, A.R.; Geraldo, A.; Carvalho, I.P.; Barbosa, F. The Use of New Digital Information and Communication Technologies in Psychological Counseling during the COVID-19 Pandemic. Int. J. Environ. Res. Public Health 2020, 17, 7663. https://doi.org/10.3390/ijerph17207663
Dores AR, Geraldo A, Carvalho IP, Barbosa F. The Use of New Digital Information and Communication Technologies in Psychological Counseling during the COVID-19 Pandemic. International Journal of Environmental Research and Public Health. 2020; 17(20):7663. https://doi.org/10.3390/ijerph17207663
Chicago/Turabian StyleDores, Artemisa R., Andreia Geraldo, Irene P. Carvalho, and Fernando Barbosa. 2020. "The Use of New Digital Information and Communication Technologies in Psychological Counseling during the COVID-19 Pandemic" International Journal of Environmental Research and Public Health 17, no. 20: 7663. https://doi.org/10.3390/ijerph17207663