TABLE 3.

Goals, content, strategies, and techniques used in each session of the psychotherapeutic program.

Session number	Session goals	Session content	Strategies and techniques
1	Form the basis for therapeutic alliance validate the patient’s suffering offer closeness and support	Introductions exploration of the patient’s current experience space identification of the areas of suffering brief recapitulation of the patient’s psychological functioning pre-COVID	Collection of information regarding health conditions, clinical severity, length, and type of hospitalization float back of stressful events related to COVID-19 (situations, places, people, images) identification of variables that regulate symptomatology and functional mechanisms that underlie the lack of wellbeing
2	Learn how to regulate disruptive emotions reach the level of resilience that is necessary to face the current adversities	Attempt to define shared goals for the therapeutic process create an initial diagnostic framework identify unprocessed or unregulated emotions	Psychoeducation on the meaning of emotions, their manifestation in the body (e.g., heartbeat, breath, muscles, bowels) and on the functioning of the worried mind (e.g., anxious and catastrophic thoughts)
3	Practice emotion regulation consolidate the sense of self-efficacy and self-control identify resources and vulnerabilities	Validate the intrapsychic and interpersonal resources associated with a greater degree of adaptation to the stressful situation, including: a flexible personality; positive beliefs about the self; identity roles and acceptance and commitment skills; work functioning; solid network of friends; family/loved ones	Bringing the mind back to the “here and now” versus the past and the future, and other mindfulness concepts sensory-motor techniques (e.g., tolerance window, grounding, posture modification, breathing) stabilization techniques, for example “safe place” body scanning and guided relaxation techniques enhancement of resilience
4–6	Address areas of clinical concern investigate defense mechanisms	Traumatic and post-traumatic symptoms validation, regulation techniques and resource consolidation exploration of sensations, emotions, movements, thoughts (such as hyperarousal, intrusiveness/surrendering, avoidance, hyper-compensation)	Imagery rescripting with a support figure that is able to mitigate the guilt/shame preponderance security, protection and care for one’s own needs cognitive restructuring on “beliefs,” cognitive biases, compassionate self-representation recognition of improvements that were made by the patients with their own resources.
		Grief navigate the phases of emotional processing: narration of the event; grounding, emotional regulation; modulation of motivational and affective systems; evolution of defense mechanisms from the most primitive (dissociation, denial) to the most advanced (depression)	Vocalization of suffering and emotional expressiveness awareness on defense mechanisms that tend to repress the memory processing of abandonment feelings and blaming tendencies representation remodeling with the respect to the relationship with the lost ones, with the goal of mitigating suffering
		Triggered or exacerbated psychiatric symptoms contextualizing the occurrence of known or new psychiatric symptoms assigning meaning to the worsening of such symptoms	Retracing the patient’s history mentalization mood modulation and emotional self-regulation
7	Integrate the lived experience in the cohesive narrative of the self	Recognize patient’s emotions/behaviors experienced during the acute phase as their own.	Validation of mental states and thought patterns experienced during the acute phase experience reformulation recognizing dualism whenever rethinking about the lived experiences – promoting dialectical thinking acceptance of new limitations and life adaptations
8	Discuss internal working models or relational patterns that have emerged during therapy closure	Summary of the therapeutic strategies that have been discussed during the sessions	Psychoeducation on relapse prevention description of risk mitigation strategies