SARS-CoV-2 infection has become one of the most challenging diseases faced worldwide. The pandemic status, the absence of available treatments and the social isolation measures to reduce further infections are likely to have important effects on mental health, especially in highly exposed populations such as health workers. Therefore, it is a current public health priority to provide remote evidence-based psychotherapies and psychiatric treatments to reduce the burden of emotional distress and to prevent negative future consequences. Despite that, there are few protocols and therapists trained to deliver those types of treatments.
TelePSI is a project funded by the Brazilian government with the collaboration of several academic institutions that aims to reduce the impact of SARS-CoV-2 related distress in health workers in Brazil. Two large clinical trials were designed to (1) investigate the therapeutic and (2) the preventative effects of brief models of Telepsychoeducation, Cognitive Behavioral Telepsychotherapy and Interpersonal Telepsychotherapy of reducing symptoms of anxiety, depression and irritability in this population.
The training center developed for these clinical trials is an open web-site that comprises of seven training manuals: Telepsychoeducation with and without supporting videos, Interpersonal Telepsychotherapy, Cognitive Behavioral Telepsychotherapy, Supervision in Telepsychotherapy and Telepsychiatry. The manuals have two versions: one focused on support for health workers and another focused on support for the general population. The manuals have the support from 16 psychoeducational videos, 6 cognitive-behavioral therapy based videos and 6 interpersonal therapy based videos to be used as training support to the developed protocols or as stand-alone guidance.
From May 17th until August 08th, we provided a total of 631 training sessions at the training center. The training consisted of teaching classes about each technique, specificities of the protocol and simulated sessions with actors. At the end of each training participants were assessed with a 15-question test for which certification was issued for those achieving a score above 70%. A total of 422 scored above the cut-off and were certified. There were people certified all over the country in 24 out of the 26 Brazilian's states. The satisfaction assessment about the training revealed that 51% were very satisfied, 44% were satisfied and 5% were less than satisfied with the training. The Net promoter Score was 80.7 (promoters 83.2%, neutral 13.6% and detractors 2.5%).
Availability of evidence-based therapy manuals (Watts et al., 2020) and appropriate psychotherapeutic training is an essential part of preparing a mental health response to a pandemic. TelePSI provides free online resources for mental health professionals based on evidence to reduce burden during and after the pandemia. There are at least 16 countries in the world in which Portuguese is spoken and these materials might be useful in other countries with appropriate cultural adaptations. All resources are available for free on the project website. https://sites.google.com/hcpa.edu.br/telepsi/.
Disclosure of interest
The authors declare that there is no conflict of interest.
Authors contributions
Dr. Salum designed the study, analyzed the data, draft the initial version of the manuscript, and incorporated contributions from co-authors. Dr. Dreher designed the study, draft the initial version of the manuscript, and incorporated contributions from co-authors. Dr. Spanemberg, Dr. De Souza, Dr. Teodoro, Dr. Marques, Dr. Harzheim, Ms. Teixeira, Dr. Simioni, Dr. Motta, Dr. Kristensen, Dr. Costa, Dr. Fleck, and Dr. Manfro participated in the study design and execution, revised the draft, and have contributed with substantial intellectual content.
Funding
This work was funded by the Brazilian Ministry of Health (TED no. 16/2020).
Acknowledgments
This project was only possible due to the effort and collaboration of many people and institutions. Therefore, we would like to thank the following people. Hospital de Clínicas de Porto Alegre: Lúcia Maria Kliemann, Rafael Leal Zimmer, José Roberto Goldim, Patrícia Ashton Prolla, Ana Margareth Siqueira Bassols, Fernanda Lucia Capitanio Baeza, Ana Soledade Graeff-Martins, Anne Orgler Sordi, Melina Nogueira de Castro, Tauana Terra, Luis Augusto Paim Rohde, Ives Cavalcante Passos, Lisieux Elaine de Borba Telles, Jorge Gustavo Azpiroz Filho, Marianna de Barros Jaeger, Marco Antonio Knob Caldieraro, Paola Paganella Laporte, Francine Gonçalves, Natasha Fonseca, Maria Paz Hidalgo, Felipe Gutiérrez Carvalho, Natan Pereira Gosmann, Vivian Vaz, Alice Xavier, Patrícia de Saibro, Daniel Dallavalle, Felix Henrique Paim Kessler, Malu Joyce de Amorim Macedo, Mariane Bagatin Bermudez, Márcia Ziebell Ramos, Marcelo Rodrigues Gonçalves, Rodolfo Souza da Silva, Ana Célia da Silva Siqueira, Roberto Nunes Umpierre and Nadine Clausell. Pontifícia Católica Universidade do Rio Grande do Sul: Laura Krüger Pelissari, Laura Vargas Fleith and Pedro Marques da Rosa. Universidade Federal de Ciências da Saúde de Porto Alegre: Analuiza Camozzato. Universidade de São Paulo: Eurípedes Constantino Miguel Filho, Flávio Guimarães-Fernandes, André Russowsky Brunoni, Alice de Mathis, Priscila Chacon, Felipe Corchs, Rodolfo Furlan Damiano, Emilio Abelama Neto, Luca Schilling Gonçalves and Talita Di Santi. Universidade Federal de São Paulo: Jair de Jesus Mari, Ary Gadelha de Alencar Araripe Neto, Rodrigo Affonseca Bressan, Pedro Mario Pan and Marcelo Feijó de Mello. Pan-american Health Organization/WHO: Katia de Pinho Campos and Catarina Dahl. Sociedade Brasileira de Psicologia(SBP): SBP's working group for facing the COVID-19 pandemic, Katie Almondes and Rita Zoega. Associação de Psiquiatria do Rio Grande do Sul: Flávio Milman Shansis. Universidade Federal do Paraná: Marco Antônio Bessa and Raffael Massuda. Universidade Estadual de Campinas: Neury José Botega. Centro de Estudos em Psiquiatria Integrada: Marco Antônio Pacheco. Liga de Psiquiatria e Saúde Mental da UFCSPA/UFRGS: Vitor Locatelli Hoerlle, Letícia Fabrício Ponsi and Guilherme Matheus Langa. The Funn Club, Yoho Arsenal and Agência LVL.
Reference
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