Covid-19: the short group treatment online – Report from the webinar of Dr. Rebecchi, Mazzocco and Ascani
The last meeting, organized by Cognitive Studies to deepen some psychological aspects related to the Covid-19 emergency, had as protagonists Dr. Rebecchi, Mazzocco and Ascani. The June 5 webinar exposed a protocol for online group treatment in response to the discomfort of the pandemic and its aftermath.
The teachers provided the data of the scientific literature, clarified the reasons that led to the creation of the intervention and illustrated the protocol both in its organizational and operational aspects, also proposing experiential exercises.
Dr. Rebecchi explained how clinical and emergency psychology are the disciplines to refer to in responding to the numerous requests for help for the management of stress resulting from the pandemic context. The global impact of SARS-CoV-2 on public health is unprecedented and has challenged all clinicians: some diagnostic criteria have been skipped (for example, we can no longer speak of acute stress disorder for the duration of the phenomenon, not it is an event comparable to an earthquake) and the intervention settings have changed. The literature on this is in the production phase and there is not yet enough information about the virus, the consequences and the psychological impact in the short, medium and long term.
The idea of a protocol for cognitive-behavioral group treatment stems from Cognitive Studies. The reasons behind its realization are:
The CBT-Covid-19 groups aim to promote the management of stress deriving from the current emergency situation and are divided into 6 weekly meetings of 1.5 hours each. The groups consist of a maximum of 8 participants and two conductors. At the end of the cycle of meetings, 3 follow-ups were planned to monitor stress levels (at 1 month, 3 months and 6 months). The criteria for joining the group, necessary for evaluating efficacy and for being able to extend the protocol, are:
Furthermore, the willingness of the participants to work in 1 hour and a half every week online in a quiet and intimate space should not be underestimated.
The preliminary meeting and the 3 follow-ups foresee the compilation of a test battery, on the inTherapy platform, composed of:
All the meetings were designed with a similar architecture: a summary of the previous session, the review of the homework, an introduction regarding the objective of the meeting, a brainstorming on the previous sessions and on the topic of the day, the information, some experiential exercises and homework to consolidate learning.
The first meeting opens with the presentation of the participants and the group rules, necessary to guarantee sharing and privacy. After this first moment, we continue with the exploration, validation and normalization of emotional experiences, thoughts and reactions to the pandemic reported by each member of the group. The various stages that each person goes through when exposed to stressful (informative) events are explained and the reactions that emerged during exploration (cognitive, emotional and behavioral symptoms) are contextualized. The intervention ends with the exercise of the safe place, which will also be the homework of the week for the participants.
During the second meeting, the somatic indicators of dysregulation and the tolerance window are explained (Siegel, 2003) and some stress management techniques are introduced starting from the situations shared by the members of the group during the previous intervention. In order to respond to different needs and experiences, the exercises proposed and taught go in two different directions:
Meetings 3, 4 and 5 are dedicated to the emotions that most often accompanied the population during the health emergency phase from Covid-19: anxiety, depressive sensations and anger. In fact, cases of strong concerns about a possible infection, anxieties about an uncertain future, a deep sadness for isolation or for the difficulties in the management of children and disruptive anger due to the non-respect of the prevention rules are not rare.
Each of these meetings foresees a phase of brief information on the emotion and its characteristics, the construction of ABC starting from the episodes shared by the participants, the dispute of dysfunctional thoughts and the identification of alternative thoughts. During each intervention, moreover, useful strategies are provided to deal with the internal state under consideration:
During the last meeting, a summary of the previous interventions is carried out and an attempt is made to identify and learn old resources and new techniques to deal with difficult situations in a more functional way. Furthermore, starting from the problems that emerged in the cycle of meetings, a space will be dedicated to relapse prevention, identifying any signs of stress and possible alternative strategies.