962537 letter2020

ISP0010.1177/0020764020962537International Journal of Social PsychiatrySimon

E CAMDEN SCHIZOPH

Letter to the Editor

A quick review of recommendations and evidences on telepsychotherapy and digital psychiatry for researchers and mental health professionals in the time of COVID-19

International Journal of Social Psychiatry 1­–2 © The Author(s) 2020 Article reuse guidelines: sagepub.com/journals-permissions https://doi.org/10.1177/0020764020962537 DOI: 10.1177/0020764020962537 journals.sagepub.com/home/isp

Patricia D. Simon  To address the global impact on mental health brought by the COVID-19 pandemic (Torales et al., 2020), the need for further research and immediate solutions to this problem has been raised by Grubic et al. (2020). To address these issues, mental health professionals resorted to delivering interventions remotely. In the context of an evidence-based practice model, I would like to present some recommendations and evidences from the literature on the practice of telepsychotherapy and digital psychiatry. Positive outcomes associated with the use of digital psychiatry include increased medication adherence, appointment adherence, fewer relapses and re-hospitalizations (Merchant et al., 2020). General, dynamic, and supportive therapy were mostly offered during the pandemic as part of communitybased remote interventions (James, 2020) and only a few adopted a specific model of support. Those that did employed techniques often associated with short-term therapy such as Cognitive Behavioral Therapy, Motivational Interviewing, Solution-Focused Therapy, and Problem-Solving Therapy. There is some evidence for internet Cognitive Behavioral Therapy (iCBT) being as effective as clinician-delivered CBT for a wide range of mental and physical health conditions (Reay et al., 2020). Other digital interventions that had efficacy evidence were interpersonal psychotherapy, acceptance and commitment therapy, and psychodynamic approaches. As interventions that focus on increasing social support proved to be very useful in the time of COVID-19, familyfocused therapies offered through an online platform are also recommended (DeLuca et al., 2020). Some action points raised regarding the use of digital interventions included ensuring the safety of health apps, increasing availability of free resources especially for vulnerable groups, translating traditionally-delivered evidence-based treatments to a virtual platform, and developing cost-effective, preventive, self-management interventions to decrease the burden on professionals (Inkster et al., 2020). Cost-effective interventions are especially important for resource-constrained and developing countries. While evidence exists for the benefits of digital interventions on clinical populations living with severe mental disorders, digital psychiatry

evaluation research in low-income and middle-income countries remains to be scarce and open for exploration (Merchant et al., 2020). Reports of people increasingly turning to smartphone mental health apps to help them deal with pandemic-imposed psychological trauma are a bit problematic (Marshall et al., 2020) because of the inherent limitations involved in the use of such apps without the guidance of a professional. These are just some of the things that clinicians need to be aware of. Despite mixed findings about user experience and therapeutic alliance (Matheson et al., 2020), digital interventions are generally feasible and acceptable with providers and clients of varying etiologies (Reay et al., 2020). Some advantages include their flexibility, time efficiency, capacity to reach wider audiences and to allow seamless continuation of treatment despite the pandemic. However, we still have a long way to go in terms of translating traditionally delivered evidence-based treatments to a virtual platform while ensuring fidelity and efficacy of interventions applied. The abrupt increase in the use of technologyassisted interventions thus highlights key priorities for policy and further research on the feasibility and effectiveness of tele-mental health care. Funding The author received no financial support for the research, authorship, and/or publication of this article.

ORCID iD Patricia D. Simon

https://orcid.org/0000-0003-4783-9121

References DeLuca, J. S., Andorko, N. D., Chibani, D., Jay, S. Y., Rakhshan Rouhakhtar, P. J., Petti, E., Klaunig, M. J., Thompson, E. C.,

Department of Psychology, De La Salle University, Manila, Philippines Corresponding author: Patricia D. Simon, Department of Psychology, De La Salle University, 2401 Taft Avenue, Malate, Manila, Metro Manila 1004, Philippines. Email: [email protected]

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