The UKCP call for the participation in the Survey on Delivering Therapy during Covid-19 has been answered by just under 800 respondents. Therapy practitioners who participated in the survey were asked to fill out the questionnaire and provide comments on their experience in the midst of the pressures of the early stages of lockdown. Currently, UKCP has a plan to send out further pulse surveys at regular intervals, so as the epidemic continues, the therapists’ responses to the changing situation can also be closely monitored. The UKCP Chief Executive, Sarah Niblock, who commissioned the survey, chose to quote one particular respondent in her recent email to the membership, who stated that: ‘there is a huge demand upon us at this time and a corresponding huge opportunity for us as therapists to provide people with a much-needed alternative way to respond to crisis. Not with anxiety and alarm but through our own capacity to manage uncertainty and equanimity.’
The detailed quantitative results of the survey can be seen on the following website:
https://www.surveymonkey.com/results/SM-D6RSS3GX7/. To summarise, the number of people whose practice had been adversely affected by a reduction in numbers of clients was slightly less than those whose therapeutic work had either not been, or only mildly reduced, and those who agreed that online therapy could be as effective as face to face work was equal to those that didn’t.
Prof Sarah Niblock says in her email that the above brief ‘summary of the freeform comments didn’t do justice to the breadth and depth of the feedback, amounting to 40 A4 pages’. She coded data based on recurring themes as a researcher would – but she reported she also felt a range of emotions as she read the content, from awe (a lot of), to sadness as well as some humour. Much comments centred on how respondents had worked with grace, love and agility to provide continuity of care for clients and service users. While many began remote working as a ‘needs must’ necessity, they had looked for and found positives, speaking of breakthroughs, greater intimacy and a corresponding resilience shown by clients. Respondents and their clients had worked creatively in partnership to find the best ways to work. However, they also highlighted the ethical, technical, financial and modality-specific challenges; reported tiredness and transference, difficult client material and working with vulnerable clients/service users.
Many of respondents found online work exhausting by virtue of having to work harder to identify non-verbal cues. But the necessary self-care came at a cost when needing to space out or shorten sessions. Working with client after client presenting the same material was often wearing, especially when it was also their lived reality, and where they might have concerns about their own health and that of loved ones. Holding their anxiety along with the clients’ was an acute experience for many. Working from home was also tough, whether that was down to cohabiting, cramped conditions, noisy neighbours or the pressures of caring for and home schooling children. Many of the respondents were worried about what the future might hold for them. They were daunted by the scale of current and impending mental health need in the UK.
They were wondering whether they would need to invest in expensive retraining to take on new clients. Quite a number of respondents said they had been pleasantly surprised at how well online delivery had worked with certain clients and that they envisioned providing blended therapy after lockdown. Many respondents shared poignantly how they were often the only point of human contact per week with vulnerable and isolated clients, and that access to Wi-Fi and a sliver of privacy is a privilege in 2020’s Britain. Covid-19 has exposed the barriers to accessing psychotherapy for particular client groups. Respondents working in the NHS described the barely tolerable pressure of being on the frontline, but also the daily uncertainty of whether services will be retained. They talked about cuts to services and bullying.
For your information, since the questionnaire was launched, UKCP has uploaded guidelines for remote therapy that can be accessed on their website.
The above text was composed on the basis of the updates from the UKCP Chair Sarah Niblock.