Commentary: The psychological and social impact of COVID-19: New perspectives of well-being.

Introduction

This paper builds on the article by Saladino et al. (2020), contributes to its goal of identifying new perspectives of intervention based on digital devices for mental health. The purpose is to broaden the discussion on the feasibility of telepsychology, its main benefits and the importance of training generations of psychotherapists in this new technological context. This will further enrich the perspective of its implementation from its massive use during the COVID-19 pandemic, for different disorders and comorbidities, specifically in Latin American countries.

Telepsychology in the COVID-19 pandemic

The registered increase in emotional problems derived from COVID-19 has been more evident in people who already had a mental problem (with or without a diagnosis) (CDC, 2020; Rodríguez-Hernández et al., 2021; World Health Organization, 2021). The most prevalent problems during the pandemic that impacted this area of health were stress, depressive and anxious symptoms, insomnia, post-traumatic stress, suicidal ideation, domestic violence, as well as problems derived from low activity physics or teleworking (Galea et al., 2020; Mahase, 2020; Pierce et al., 2020; World Health Organization, 2020; Domínguez-Rodríguez et al., 2022; Kaluza and van Dick, 2022).

Given the mental health demands during the COVID-19 pandemic, telepsychology was a necessary element to provide services to the population (Ammar et al., 2021). Health professionals with or without training and experience, implemented online services (Tavares et al., 2020; Yuchang et al., 2022). It is known that before the pandemic only 39% of therapists used telepsychology (early adopters), and during the pandemic it increased to 85–98% (Pierce et al., 2020; Rodríguez-Ceberio et al., 2021).

Since the 1990s, the advantages and possibilities of online services have been recognized, as well as their possible limitations, ethical issues or even less positive effects, which can lead to direct effects on the patient and even on the therapist, for example when the psychotherapist in charge is not properly trained (Dworschak et al., 2022; Garcia et al., 2022) who must have a protocol of care in case of emergency, which consists of having a trusted contact or channeling institution, since the patient, in a moment of crisis where their life is in danger, could just disconnect (American Psychological Association, 2013).

Considerations of the new era of telepsychology

Secondary effects of the pandemic (World Health Organization, 2020) included the clear increase in the use of online interventions, which might be classified as: therapist-administered treatment, treatments with a minimal assistance of the therapist and totally self-applied treatments (Glasgow and Rosen, 1982).

Telepsychology is effective in the assessment and treatment of different clinical conditions, such as depression and anxiety (Karyotaki et al., 2021; Pauley et al., 2021) substance abuse and eating disorders (Taylor et al., 2021). Also, in interventions for emotional care in COVID hospitals (Landa-Ramírez et al., 2021; Sampaio et al., 2021) and grief (Dominguez-Rodriguez et al., 2021), among others. Some meta-analyses reveal its efficacy is comparable to traditional face-to-face treatments (Cuijpers et al., 2009; Andersson et al., 2019; Sora et al., 2022).

During this pandemic period, the use of telepsychology spread throughout the world, with high-income countries being the most successful in implementing it; however, in regions with economic and technological limitations, such as Latin America, it is important to continue increasing efforts for greater reach and coverage (Argüero et al., 2021; Landa-Ramírez et al., 2021; Domínguez-Rodríguez et al., 2022). And, although there is clarity about the advantages of its use, such as reduced costs and travel time, comfort, efficiency, reduction of the stigma of going to an office and preference for the use of technology; the need to address situations of confidentiality, acceptance, closeness, and compliance with general ethical standards in telepsychology has also been highlighted (Lin et al., 2022; Sora et al., 2022; Yuchang et al., 2022). This is directly related to generating more research and training of professionals.

Based on the needs of the massive incorporation of telepsychology, the importance of developing more learning and training spaces in this area is recognized (Callan et al., 2017; Saladino et al., 2020; Baier and Danzo, 2021; Rotger and Cabré, 2022). Therapists who used this tool during the pandemic identified the need to be trained in all that telepsychology implies, to avoid falling into ethical-legal problems or to attend emergencies (e.g., in situations of suicide attempts; Perry et al., 2020; Sampaio et al., 2021), since it is generally known that there is a close relationship between the skills of the therapist, the methodology used and the remote work strategies, to predict the success of online therapy (Yuchang et al., 2022). Telepsychology training should also include stress regulation and empathy skills, as well as supervision as a measure to prevent burnout (Prime et al., 2020; Garcia et al., 2022).

Discussion

In general, for many people, telepsychology is the key to start or continue with their psychological treatments. However, it is known that a large extent of this derived from the need for the service, without knowing or being clear about the procedures or advantages. Governmental strategies are required to allow the regulation of telepsychology as part of daily consultation activities, with supervised spaces designed by experts, under scientifically validated schemes (Pierce et al., 2020; Garcia et al., 2022). In regions such as Latin America, the incorporation of telepsychology will favor mental and physical wellbeing with access to mental health that will allow greater coverage and scope, especially if the design and development of interventions is based on the specific needs and characteristics of the patients (Domíngez-Rodríguez and De la Rosa-Gómez, 2022).

It is clear that as technology advances, health care will be directly benefited (De la Rosa-Gómez et al., 2022). However, at the same time, research, training, and dissemination of telepsychology, which represents a strategy to reach more people in an effective and efficient way, whether for emergency situations or for daily psychotherapy services, will have to be strengthened. It is important that clinics and training schools adopt telepsychology best practices guidelines and not only as a temporary solution to provide services in emergency situations. By doing so, institutions will be better positioned to meet the needs of the populations they serve (Baier and Danzo, 2021).

Author contributions

LF-P and AD contributed to the conception of the General commentary and oriented to contribute to Telepsychology topics. DD-S emphasized ethical risk issues in the population. Together LF-P, AD, and DD-S wrote the first draft of the manuscript. Finally, PV-M and AH-P contributed to the revision of the manuscript, read, and collated citations and references. LF-P revised the submitted version. All authors contributed to the article and approved the submitted version.

Funding

This work was supported by UNAM-PAPIIT (IT300721).

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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