Prior to 2020, Nina Shiffrin, PhD, a psychologist in Rockville, Maryland, conducted about 10% of her therapy sessions with patients online. Teletherapy was a flexible solution she used to accommodate the occasional adult patient unable to leave work at midday or children who couldn’t get to Shiffrin’s office on their own. But in March, when a state of emergency was announced in the United States because of the coronavirus and state governments began issuing stay-at-home orders, she quickly pivoted to move 100% of her patients to telehealth services.
Thousands of psychologists have made the same pivot. Many, like Shiffrin, are practitioners who are rapidly getting themselves—and their patients—up to speed on telehealth. Others are scientists who are rushing to adopt new data-gathering methodologies or to protect animal subjects, and educators who are becoming more versed in distance learning software and building online connections with students.
The common thread for all psychologists dealing with the new reality ushered in by the pandemic has been the need for flexibility and creativity. “We’re finding new ways to help, mostly small, but we’re doing what we can. Across my university faculty, staff and students have really pulled together,” says Jeff Zacks, PhD, head of the Dynamic Cognition Laboratory at Washington University in St. Louis.
Here’s a sample of what some psychologists have been experiencing and lessons they’ve learned.
Telehealth hassles and rewards
While many practitioners had some experience using telehealth platforms prior to the onset of the pandemic, few were using them as their exclusive means for conducting therapy sessions. In just a few weeks, that changed dramatically. Like Shiffrin, many practitioners moved their entire caseloads online as federal and state regulations changed to encourage expanded access to telehealth (see Technology expands to meet demand).
For some psychologists, issues with logistics, such as having a spotty internet connection or not having a laptop with a built-in camera, have proven challenging. And since patients may be dealing with the same issues, practitioners have, at times, had to play the dual role of health-care and IT service provider. There are also case-specific challenges that have forced psychologists to get creative. For example, practitioners have reported advising patients who live in close quarters with others to get in a car and drive to a parking lot for their telehealth sessions. “While not ideal, joining a session from the privacy of a car is preferable to potential eavesdropping by a roommate or partner,” says Kristi K. Phillips, PsyD, chair of APA’s Committee on Rural Health and a psychologist in Litchfield, Minnesota.
Meanwhile, providing online care to children comes with its own set of challenges. According to an APA fact sheet, without the control of the clinical setting, practitioners must pay close attention to the space on the other side of the screen as children may become more easily distracted or may require more room for hands-on activities. And psychologists working with vulnerable children must also be more vigilant about looking for warning signs of abuse and neglect during this time. Staying at home means these children aren’t regularly in contact with teachers or counselors, who are typically relied upon to spot such signs and are mandated to report them.
Despite such challenges, some practitioners are also experiencing pleasant surprises while shifting to telehealth. Several of Phillips’s patients, for example, have told her that learning to use Zoom during their telehealth sessions empowered them to use the platform to better connect with friends and family as well—for Phillips, an unexpected and rewarding side effect.
Others note that having a glimpse into where their patients live offers them insights that they previously wouldn’t have had access to. They’re getting to meet pets and siblings and are better able to see how a patient may behave in a less clinical setting. “It’s fun to get to see patients in their natural settings—I get to meet pets…children can show off their artwork or favorite toys,” says Shiffrin.
Studies on hold
Psychological scientists are also confronting major challenges as the COVID-19 crisis unfolds (see Researchers mobilize to study impact of COVID-19). Even labs that were already conducting a significant amount of online research are feeling the effects. Zacks’s Dynamic Cognition Laboratory, for example, has been conducting both small- and large-scale online studies for several years now, and it launched two new online studies in April, which likely won’t be severely affected by the pandemic. But Zacks has had to place fMRI and eye-tracking studies on hold because they rely on face-to-face interaction.
Besides the research studies that are taking a hit, Zacks and his colleagues are concerned about students who were assigned to participate in experiments as part of their learning coursework. “At my university, instructors have altered the assignments, and we’re making more experiments available online; these seem to be helping,” he says.
Many researchers and students question whether they’ll be able to continue to use funding for studies that now require altered (from in-person to online) data-gathering methodologies. Natalie Hong, a doctoral student in the clinical science program at Florida International University, had already secured funding from the National Institute of Mental Health for her dissertation project, which was designed to include an in-person group-based treatment beginning later this year.
“I am worrying about my options and the consequences for adjusting the in-person aspects of the study, if needed,” she says.
Meanwhile, other researchers simply have no online options. Researchers working with animals, for instance, are not able to interact with their subjects online. The setbacks go well beyond forfeiting data collection. Animal lineages that were created over months and even years—while being kept physically safe by essential staff—are now missing the meticulous level of attention provided by research staff and, as a result, may fall outside the parameters of experiments and be rendered unusable.
“This loss means much more to me than deficits of time and resources and is something animal researchers in particular will have to bear moving forward,” says Siara Rouzer, a behavioral neuroscience graduate student at Binghamton University in New York who uses rat models to study fetal alcohol disorders.
Empty classrooms
Psychology teachers and students have experienced massive changes as well. Fortunately, most academic institutions had e-learning capabilities in place prior to the COVID-19 pandemic. In these institutions, teachers have been able to draw heavily on support from their institutional technology office or instructional design team (see Enhancing online learning).
Regan Gurung, PhD, director of the general psychology program at Oregon State University and executive director of the Center for Teaching and Learning (CTL), says his university’s eCampus unit and CTL have been working long hours to help faculty get up and running with remote teaching.
Yet even with tools and tech support in place, there are formidable challenges for teachers. Helping students who have never used online learning resources and figuring out effective ways to keep track of students who are not participating are particular challenges, Gurung says. Other concerns include helping remote students learn from one another and promoting a sense of community among remote students.
Susan Nolan, PhD, a psychology professor at Seton Hall University, has gone from zero online teaching to 100% online teaching. She’s found that her students are adapting to the switch.
“Some have become anxious about making the technology work, but many of them seem to be adjusting well—using the chat function to comment on the course content, downloading the recorded lectures after the fact, even introducing their pets on video,” she says.
Teachers have been quick to assist fellow teachers, as well, including by sharing resources such as online lesson plans and lectures to use during the pandemic. On March 13, for example, the day the United States declared a state of emergency, David Kenny, PhD, of Wesleyan University, immediately took to Twitter: “During this health crisis, I am waiving all charges for the 40 webinars and 70 PowerPoints that I have posted. Feel free to use as needed. Most are on Dyadic Analyses & SEM.”
Overall, the rapid shift to working online has touched every corner of society, and psychology. While some psychologists were already familiar with working online before the pandemic, most are now fully embracing online platforms in a more comprehensive way out of necessity. “We’re all being creative to make sure everything we do is in the best interest of our patients, subjects and students,” Phillips says.
