Resuming In-Person Psychotherapy Sessions with Perinatal Women amid the COVID-19 Pandemic: A Multistakeholder Perspective
Bibliographic record
Abstract
Abstract BACKGROUND: During the COVID-19 pandemic, essentially all outpatient psychotherapy with perinatal patients transitioned to telemedicine. The aim of this study was to examine how to resume in-person psychotherapy with perinatal patients within the Scaling Up Maternal Mental healthcare by Increasing access to Treatment (SUMMIT) trial as the pandemic abates. METHODS: We conducted focus groups and individual interviews with perinatal participants (n=23), providers (n=28), and a range of stakeholders (n=18) who participated in the SUMMIT trial from August 2020 to March 2021. Content analysis was used to examine (1) previous barriers that impacted perinatal participants access or decision to access in-person healthcare during COVID-19; (2) perceived future barriers for perinatal participants to attend in-person sessions; and (3) potential facilitators to resuming in-person sessions with perinatal participants. RESULTS: Perinatal participants (69.6%) and providers (57.1%) reported that COVID-19 previously impacted perinatal SUMMIT patients’ access or decision to access in-person healthcare. Specifically, “external barriers” such as institutional regulations due to COVID-19 (100% perinatal participants and 68.8% providers) and “internal barriers” such as concerns about being exposed to COVID-19 (75.0% perinatal participants and 56.3% providers) impacted perinatal participants access to in-person care. Perceived barriers to resuming in-person psychotherapy sessions included concerns about virus exposure in a hospital setting (77.8% stakeholders, 73.9% perinatal participants, 71.4% providers); virus exposure while taking public transportation (50.0% stakeholders, 26.1% perinatal participants, 25.0% providers). Stakeholders (50.0%) were more likely than providers (25.0%) and participants (13.0%) to endorse wearing a mask during sessions as a barrier. Key facilitators to resuming in-person psychotherapy sessions were the implementation and effective communication of robust safety protocols (72.2% stakeholders, 47.8% perinatal participants, 39.3% providers) and providing alternative locations to where sessions are delivered, e.g., using large rooms (44.4% stakeholders, 32.1% providers, 17.4% perinatal participants). CONCLUSION: The results suggest that a significant majority of perinatal participants experienced barriers to accessing in-person healthcare during the pandemic, and concerns about contracting the virus within and en route to the hospital remain while the COVID-19 pandemic persists. To overcome these barriers, our study suggests that implementing and effectively communicating robust safety protocols may be the most effective methods to address these concerns when resuming in-person psychotherapy sessions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.016 | 0.020 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.010 | 0.005 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.002 | 0.007 |
| Research integrity | 0.002 | 0.006 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".