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      Plantão psicológico cognitivo-comportamental na pandemia da CoViD-19 Translated title: Cognitive behavioral psychological duty in the CoViD-19 pandemic

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          Abstract

          O Serviço de Intervenção Cognitivo-Comportamental (SICC) desenvolveu um protocolo de plantão psicológico que integra o projeto CO-VIDA UNICAP, coordenado pelo Instituto Humanitas. A intervenção realizada através do subprojeto PSI CO-VIDA tinha como foco a atenção pontual no momento da pandemia à comunidade acadêmica e à população geral, no intuito de amenizar o sofrimento psíquico. Este trabalho objetiva apresentar o protocolo de atendimento e o perfil da clientela atendida entre abril e junho de 2020, além da pesquisa de satisfação realizada após os atendimentos on-line na plataforma Google Meet. Um protocolo cognitivo-comportamental de quatro fases foi desenvolvido para aplicação individual com duração média de 30 minutos. Seis psicólogos capacitados realizaram 29 atendimentos e os dados analisados indicam que a maioria dos participantes foi do sexo feminino, estudantes da instituição e já tinham alguma experiência de tratamento psicológico e/ou psiquiátrico anterior. As demandas mais frequentes foram ansiedade, estresse, tristeza, conflito familiar, dificuldades acadêmicas e procrastinação, bem como orientações para prevenção da saúde mental. Os achados corroboram com dados da literatura sobre os efeitos psicológicos da pandemia. No geral, os feedbacks indicaram uma elevada satisfação com os atendimentos e com os benefícios percebidos pós-intervenção.

          Translated abstract

          The Cognitive Behavioral Intervention Service has developed a psychological duty protocol that integrates the UNICAP CO-VIDA project, coordinated by the Humanitas Institute. The activities developed through the PSI CO-VIDA subproject focused on timely attention at the time of the pandemic to the academic community and the general population in order to alleviate psychic suffering. This paper aims to present the intervention protocol and the profile of the clientele served in addition to the satisfaction survey conducted after online calls on the Google Meet platform. A four-phase cognitive-behavioral protocol was developed for individual application with an average duration of 30 minutes. Six trained psychologists performed 28 services and the data analyzed indicate that the majority of the participants were female, students of the institution and already had some experience of previous psychological and/or psychiatric treatment. The most frequent demands were anxiety, stress, sadness, family conflict, academic difficulties and procrastination, as well as guidelines for the prevention of mental health. The findings corroborate data from the literature on the psychological effects of the pandemic. In general, feedbacks indicated a high level of satisfaction with the assistance and with the benefits perceived after the intervention.

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          Most cited references24

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          The outbreak of COVID-19 coronavirus and its impact on global mental health

          The current outbreak of COVID-19 coronavirus infection among humans in Wuhan (China) and its spreading around the globe is heavily impacting on the global health and mental health. Despite all resources employed to counteract the spreading of the virus, additional global strategies are needed to handle the related mental health issues. Published articles concerning mental health related to the COVID-19 outbreak and other previous global infections have been considered and reviewed. This outbreak is leading to additional health problems such as stress, anxiety, depressive symptoms, insomnia, denial, anger and fear globally. Collective concerns influence daily behaviors, economy, prevention strategies and decision-making from policy makers, health organizations and medical centers, which can weaken strategies of COVID-19 control and lead to more morbidity and mental health needs at global level.
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            The impact of the COVID-19 pandemic on suicide rates

            Leo Sher (2020)
            Abstract Multiple lines of evidence indicate that the COVID-19 pandemic has profound psychological and social effects. The psychological sequelae of the pandemic will probably persist for months and years to come. Studies indicate that the COVID-19 pandemic is associated with distress, anxiety, fear of contagion, depression, and insomnia in the general population and among health care professionals. Social isolation, anxiety, fear of contagion, uncertainty, chronic stress, and economic difficulties may lead to the development or exacerbation of depressive, anxiety, substance use, and other psychiatric disorders in vulnerable populations including individuals with pre-existing psychiatric disorders and people who reside in high COVID-19 prevalence areas. Stress-related psychiatric conditions including mood and substance use disorders are associated with suicidal behavior. COVID-19 survivors may also be at elevated suicide risk. The COVID-19 crisis may increase suicide rates during and after the pandemic. Mental health consequences of the COVID-19 crisis including suicidal behavior are likely to be present for a long time and peak later than the actual pandemic. To reduce suicides during the COVID-19 crisis it is imperative to decrease stress, anxiety, fears and loneliness in the general population. There should be traditional and social media campaigns to promote mental health and reduce distress. Active outreach is necessary, especially for people with a history of psychiatric disorders, COVID-19 survivors, and older adults. Research studies are needed of how mental health consequences can be mitigated during and after the COVID-19 pandemic.
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              Family violence and COVID‐19: Increased vulnerability and reduced options for support

              Introduction Family violence refers to threatening or other violent behaviours within families that may be physical, sexual, psychological, or economic, and can include child abuse and intimate partner violence (Peterman et al. 2020, van Gelder et al. 2020). Family violence during pandemics is associated with a range of factors including economic stress, disaster‐related instability, increased exposure to exploitative relationships, and reduced options for support (Peterman et al. 2020). Due to the social isolation measures implemented across the globe to help reduce the spread of COVID‐19, people living in volatile situations of family violence are restricted to their homes. Social isolation exacerbates personal and collective vulnerabilities while limiting accessible and familiar support options (van Gelder et al. 2020). In many countries, including Australia, we have already seen an increase in demand for domestic violence services and reports of increased risk for children not attending schools (Duncan, 2020), a pattern similar to previous episodes of social isolation associated with epidemics and pandemics (Boddy, Young & O’Leary 2020). In Australia, as stay‐at‐home orders came into force, the police in some parts of the country reported a 40% drop in crime overall, but a 5% increase in domestic abuse call‐outs (Kagi 2020). At the same time in Australia, Google reported a 75% increase in Internet searches relating to support for domestic abuse (Poate 2020). This pattern is repeated internationally. Reports of domestic abuse and family violence have increased around the world since social isolation and quarantine measures came into force. Recently, anecdotal evidence from the United States, China, Brazil, and Australia indicates increases in intimate partner, women, and children violence due to isolation and quarantine (Campbell 2020; Peterman et al. 2020; van Gelder et al. 2020). China, the first country to impose mass quarantine in the Wuhan province, saw reported domestic abuse incidents rise threefold in February 2020 compared to the previous year (Allen‐Ebrahimian 2020). As Europe imposed quarantine measures in an effort to slow the tide of infection, the Italian government began commissioning hotels to provide shelter to the increasing number of people fleeing abusive situations (Davies & Batha 2020). Similarly, France reported a 32% ‐ 36% increase in domestic abuse complaints following the implementation of self‐isolation and quarantine measures (Reuters News Agency 2020). France also began commissioning hotels as shelters for those fleeing abuse. As quarantine measures extended to the United States, individual states reported similar increases in domestic abuse incidents ranging from 21% to 35% (Wagers 2020). Back in Europe, the UK has also seen concerns about increase in family violence (Bradbury‐Jones & Isham 2020). There have been reports of homicide associated with family violence in several countries (Bradbury‐Jones & Isham 2020; Reuters News Agency 2020). The National Domestic Abuse Hotline in the UK saw a 25% increase in calls since stay‐at‐home measures were implemented (Kelly & Morgan 2020), recording at least eight family violence‐related deaths (Knowles 2020). Isolation and family violence As the novel coronavirus outbreak has intensified globally, countries are adopting dedicated measures to slow the spread of the virus through mitigation and containment (van Gelder et al. 2020; Campbell 2020). Social distancing and isolation are central to the public health strategy adopted by many countries, and in many settings, penalties are in place for any person who breaches these imposed restrictions. Social isolation requires families to remain in their homes resulting in intense and unrelieved contact as well as the depletion of existing support networks, such as through extended family as well as through social or community‐based support networks for families at risk. Additionally, isolation places children at greater risk of neglect as well as physical, emotional, sexual, and domestic abuse (National Society for the Prevention of Cruelty to Children [NSPCC] 2020). Due to (necessary) imposed social distancing and isolation strategies, and the resulting shortages of essential resources and economic consequences of these measures, people globally are living under stressful conditions. While social isolation is an effective measure of infection control, it can lead to significant social, economic, and psychological consequences, which can be the catalyst for stress that can lead to violence. A perfect storm Isolation paired with psychological and economic stressors accompanying the pandemic as well as potential increases in negative coping mechanisms (e.g. excessive alcohol consumption) can come together in a perfect storm to trigger an unprecedented wave of family violence (van Gelder et al. 2020). In Australia, as social distancing measures came into place, alcohol good sales rose more than 36% (Commonwealth Bank Group 2020), and as restaurants, bars, and pubs closed, people are now drinking more within the confines of their homes. Unemployment figures around the world have rapidly risen into the double digits, with millions signing up for welfare payments and a worldwide recession predicted in the near future (Kennedy 2020). Substance misuse, financial strain, and isolation are all well‐known domestic abuse risk factors (Richards 2009). During isolation, there are also fewer opportunities for people living with family violence to call for help. Isolation also helps to keep the abuse hidden with physical or emotional signs of family violence and abuse less visible to others (Stark 2009). COVID‐19 and coercive control Reports show that COVID‐19 is used as a coercive control mechanism whereby perpetrators exert further control in an abusive relationship, specifically in the use of containment, fear, and threat of contagion as a mechanism of abuse. In Australia, charities providing support to people experiencing domestic abuse have highlighted concerns specifically related to reports from people whose intimate partners are using COVID‐19 as a form of abuse. There have been reports of misinformation used by intimate partners related to the extent of quarantine measures (Gearin & Knight 2020) and other forms of COVID‐19‐related abuse (Fielding 2020). Further, there are reports that those experiencing domestic abuse may be afraid to go to hospital for fear of contracting COVID‐19 (Fielding 2020). Reimagining support networks for people living with family violence during these challenging times We recognize that these are challenging times for all of us, but especially for the most vulnerable families and children. The United Nations Secretary‐General Antonio Guterres recently called for countries to prioritize support and set up emergency warning systems for people living with family violence (News Wires 2020). Pharmacies and grocery stores in France are now providing emergency warning systems to help enable people to indicate that they are in danger and need support (Guenfound 2020), through the introduction of code words to alert staff they need help (Davies & Batha 2020). Domestic abuse support agencies in some areas have published specific guidance on domestic abuse in COVID‐19 focussing on what friends and family can do to support people who are isolated (Domestic Violence Resource Centre Australia [DVRCA] 2020). Charities are also recognizing the role that neighbours can play in supporting people living with family violence, providing advice on what to listen for and look for while they themselves are home, and encouraging conversation with neighbours (Gerster 2020). Conclusion The fear and uncertainty associated with pandemics provide an enabling environment that may exacerbate or spark diverse forms of violence. Actions such as social distancing, sheltering in place, restricted travel, and closures of key community resources are likely to dramatically increase the risk of family violence (Campbell, 2020). Governments and policymakers must create awareness about an increased risk of violence during pandemics and highlight the need for people to keep in touch with each other (while observing precautionary measures) and the great importance of reporting any concerns of abuse. It is important to remember that maintaining social connectedness is an important strategy during times of isolation (Usher et al. 2020), even more so with family or friends you suspect may be at risk of family violence. In addition, information about services available locally (e.g. hotlines, tele‐health, respite services, shelters, rape crisis centres, and counselling) must be made known to the general public through a range of sources, including social media, the mainstream media, and health facilities. Mental health professionals can support people by providing first‐line psychological support, including listening empathetically and without judgment, enquiring about needs and concerns, validating peoples’ experiences and feelings, enhancing safety, and connecting people to relevant support services (WHO 2020).

                Author and article information

                Journal
                rbtc
                Revista Brasileira de Terapias Cognitivas
                Rev. bras.ter. cogn.
                Federação Brasileira de Terapias Cognitivas (Rio de Janeiro, RJ, Brazil )
                1808-5687
                1982-3746
                June 2021
                : 17
                : 1
                : 58-65
                Affiliations
                [3] Recife Pernambuco orgnameUniversidade Católica de Pernambuco orgdiv1Especialização em Terapia Cognitivo- Comportamental Brasil
                [4] Recife Pernambuco orgnameUniversidade Católica de Pernambuco orgdiv1Departamento de Psicologia Brasil
                [2] Recife Pernambuco orgnameUniversidade Católica de Pernambuco orgdiv1Serviço de Intervenção Cognitivo-Comportamental Brasil
                [1] Recife Pernambuco orgnameUniversidade Católica de Pernambuco orgdiv1Programa de Pós-graduação em Psicologia Clínica Brasil
                Article
                S1808-56872021000100008 S1808-5687(21)01700100008
                10.5935/1808-5687.20210008
                69c42ffd-31ea-4717-ae44-bdf90e15e87d

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 12 December 2020
                : 01 September 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 24, Pages: 8
                Product

                SciELO Periódicos Eletrônicos em Psicologia

                Categories
                Relato de pesquisa

                care in crisis,plantão psicológico,atendimento em crise,Pandemias,psychological duty,Pandemics

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