Mental Health Care and Online Consultation during the COVID-19 Pandemic: A Literature Review ^†

Abstract

The outbreak of the COVID-19 pandemic had a negative effect on people’s mental health. Additionally, it resulted in many transformations in mental healthcare services delivery. Mental health professionals preferred to provide mental health services via telehealth in order to meet their clients’ mental health needs. The purpose of this literature review is to analyze and evaluate the concept of online consultation throughout the COVID-19 pandemic.

1. Introduction

The COVID-19 pandemic has had numerous political, economic, and societal ramifications [1,2]. It resulted in a lot of stress and had a negative impact on people’s mental health [3]. Isolation, social distance, job loss, dread of sickness, and death are all linked to the epidemic [4,5]. Before the COVID-19 epidemic, the consultation process was done in person [6,7].

The pandemic’s onset requires immediate and drastic adjustments in the administration of mental health care [8]. In such trying circumstances, mental health professionals make every attempt to communicate with their patients, but there are still challenges. Despite the fact that there was scientific knowledge on online consultation [9,10], therapists and clients faced numerous problems, including ethical concerns, technological access, and scientific understanding [3].

2. Methods

Our research group aims to investigate the experiences of Greek therapists (social workers, psychotherapists, psychologists, and others) with online consultations during the COVID-19 pandemic in a future field study. The present paper is a literature review with a typical narrative synthesis of previous studies on the topic of therapists’experiences with online consultation as a result of the COVID-19 pandemic. The literature review method seeks to identify what has been accomplished previously, allowing for consolidation, building on previous work, summation, avoiding duplication, and identifying omissions or gaps. Therefore, the goal of our review is to provide a brief overview of the challenges, perceived benefits, and prospects associated with online counseling. The following research questions have been considered: (a) the experiences with online consultation, (b) the advantages of online consultation, and(c) the difficulties of online consultation. A literature search was undertaken using the PubMed, Google Scholar, and Scopus databases to find research published in English in the last three years. Online consultation in mental health and COVID-19 and psychotherapists’ attitudes towardonline consultation and COVID-19 were employed as keywords. There was a total of 35 studies found. Twenty-nine of them were considered to better address the goals and objectives of the current study. Especially, we selected only those with qualitative or quantitative research data on online counseling throughout COVID-19. Narrative approaches for online consultation research, as well as research related to online counseling during the pre-COVID era, were omitted. The research team discussed and reviewed these studies in order to establish a consensus on their suitability for the specified research questions. Following the agreement, the outcomes of the investigations were re-examined and analyzed, resulting in the formation of theme groups. Finally, three themes were identified: (a) the experiences of online consultation, (b) the advantages of online consultation, and (c) the difficulties of online consultation.

3. Results and Discussion

3.1. Experiences of Online Consultation

Online consultation is distinguished from traditional consultation [11]. The formation of working alliances and cohesion differs between online and face-to-face consultations [12]. A successful online consultation requires prior scientific knowledge and experience. Psychotherapists’ opinions regarding online consultation are influenced by their past online consultation experiences, such as therapeutic modality, clinical experience, and special online consultation experience [13,14,15,16]. According to a poll conducted by the European Federation of Psychologists Associations, therapists’ prior experience with the online approach in Norway and Denmark was very good [17]. Positive experiences with the online method were supported by the Portuguese Psychologists Association [18]. France’s therapists, on the other hand, were less effective in online sessions due to a lack of prior experience [17].

Theoretical perspective influenced online consulting as well [14]. In an Italian study, for example, 71.1 percent of Gestalt psychotherapists agreed that they could not use some of their regular approaches for their therapeutic orientation because of the online process [14]. The transition experience of clients and therapists during the pandemic, as well as their geographic location, are also crucial factors for a successful consultation [13].

3.2. Advantages of Online Consultation

Online consultations let therapists and clients communicate more effectively [19]. Telepresence aided in the formation of a therapeutic relationship [20]. Clients pointed out that online therapy is a way to reduce stigma while simultaneously increasing access to mental health treatments [21,22]. People are in a safe portion of their house, which reduces stress in the waiting area and saves money and time [23,24]. Accessibility/geographic flexibility, convenience flexibility, and low-priced cost were all advantages of a successful online consultation [18].

3.3. Difficulties of Online Consultation

Both clients and therapists faced numerous technological and communicative problems [2,13,17]. Moreover, several experts reported feeling weary, disconnected, and insecure during the online session [13,14]. Many problems were caused by a lack of training and knowledge [17,18,25,26]. Additionally, clients cannot experience the sense of close contact and recognize and manage their difficulties, which puts serious obstacles into their treatment [27]. Others, particularly the most vulnerable groups, find it difficult to trust their therapists and develop a therapeutic relationship with them [23,27]. Many studies have reported ethical constraints and challenges in establishing a therapeutic relationship [25,28,29].

4. Conclusions

To summarize, distance counseling has numerous advantages: (a) on the one hand, it addressed serious issues in supporting patients with various mental health issues that they already had, as well as those caused by the pandemic: (b) on the other hand, it met the needs of reducing COVID-19 transmission. Future research is required. Ethical concerns and building therapeutic relationships are two specific research topics. The accessibility of vulnerable people to internet processes is also a critical issue that needs to be addressed in future studies.