On the Front Lines of the Pandemic: Derner School of Psychology Jumps Into Teletherapy

When COVID-19 closed Adelphi’s campus in March, the PhD candidates in the Gordon F. Derner School of Psychology who staff the University’s Center for Psychological Services found themselves on the front lines of a new type of treatment in an epochal event: teletherapy during a global pandemic.

The doctoral students and their faculty mentors began seeing patients—Adelphi students and staff as well as members of the surrounding community—via the videoconferencing app Zoom.

“The moment of switching was not too difficult,” said Jonathan M. Jackson, PhD, director of the center, of the technological requirements of teletherapy. “Adapting to the new environment has been harder. It takes a whole new skill set to form a relationship with someone on-screen and, in many ways, this work is much harder than meeting in person.”

The student therapists are helping their patients navigate profound difficulties related to COVID-19: job loss, financial problems, the anxiety caused by a changed world and the day-to-day stresses of living under quarantine.

The challenge now is to prepare doctoral students for a future in which teletherapy is a fixture in mental health care. It’s also teaching them to handle the toughest of mental health needs in real time, not in theory. “Down the line, they will know that they have had field training in a once-in-a-century crisis,” Dr. Jackson said.

Pre-COVID patients, post-COVID problems

The experience has been profound for the 80 Derner students and their faculty supervisors.

“For the first three weeks after the closure, the clinic phone went dead. The emails stopped,” Dr. Jackson said. “I thought something was wrong because we typically receive 30 new service requests a week.”

Patients began trickling in around the fourth week, he said, and by mid-May they were streaming in at the old, pre-COVID levels but with new, post-COVID problems.

“People were in shock,” Dr. Jackson explained. “They were unable to understand what was happening to them.” Once clients realized the abnormal conditions of life during a pandemic were the new normal, he said, they realized they could use some help coping.

Dr. Jackson and his student trainees are continuing to see patients who came to the clinic before the pandemic. They’ve also begun work with new patients who are coming to the clinic for the first time because of the coronavirus crisis.

“The people we’re seeing had conditions before. Now their coping resources are strained,” Dr. Jackson said. “We help them with symptom management. We help them connect with community and personal resources so they can recover. We help them live through the uncertainty.”

Given what some people have been through, Dr. Jackson also expects to see healthcare workers and family members of coronavirus patients presenting with traumatic stress reactions.

New skills for a new era

Providing mental health care via teletherapy has meant the student trainees must adopt a new approach. Teletherapy requires therapists to be more animated and to project emotion more than they did before. “Sitting there listening attentively isn’t enough. You have to learn to present yourself more on camera,” Dr. Jackson explained.

The faculty members have been meeting virtually with student trainees weekly to coach them on how to be more animated on camera with patients and how to ask more questions. Trainees also have to learn to watch and listen to their patients on camera, paying close attention to nuances in tone of voice and subtle facial expressions—things that can be challenging on low-quality video and audio.

“We will be introducing more formal training in the use of teletherapy in the fall,” Dr. Jackson said.

Dr. Jackson said he wasn’t a fan of remote therapy before this crisis forced it. “I felt my students were missing too much and couldn’t get the information they needed to help someone who, for example, was depressed,” he says. “Now I’m a convert. We’re reaching a lot of people.”

Dr. Jackson said teletherapy will be more widely accepted when this is all over. And Adelphi-trained mental health professionals will have been among the first to use the new approach.

“My PhD students have shown remarkable resilience,” Dr. Jackson said. “This is hard work. But they will be able to look back and say ‘Wow, look at what I learned.’ We never planned for it, but we’re training a new generation of practitioners who can work remotely.”