key: cord-0979142-g9pt05bn authors: Fadhel, Fahmi Hassan title: Psychological Intervention in Crisis Related to the COVID-19 Outbreak Epidemic: Theoretical Approach date: 2020-12-21 journal: nan DOI: 10.1016/j.medpal.2020.08.009 sha: 9e040f35ce8ddf26e4d9d12c38a2236a2f1ce4af doc_id: 979142 cord_uid: g9pt05bn Reports have shown that medical staff involved in treating people with the Coronavirus are more vulnerable to the risk of transmission, and need psychological intervention services to help them overcome fear, anxiety, and psychological pressures. Aims: This study aims to provide a brief perception of psychological intervention, to provide counseling and psychotherapy for medical staff during the outbreak of the COVID -19. Methods: This study is based on a theoretical perspective on a program in psychological intervention during crises resulting from the spread of the Corona virus. Result: The basic idea in this perspective included: Building a psychological intervention team. Training of psychologists to provide counseling and psychotherapy services for medical staff while treating patients with Coronavirus, establish a hotline for counseling and psychotherapy online, and Promote healthy awareness among the population. Conclusions: The psychological effects of Coronavirus become more rapid and impactful in this time, it may cause secondary disaster due to stress even after the virus has ended. We need to look carefully at the lack of objective measures, such as the lack of specialized and qualified staff in psychotherapy to provide mental health services in these critical times, the small number of facilities equipped for psychotherapy in public hospitals, as well as the absence of the importance of psychological intervention in such cases, and other deficiencies or weaknesses that must be changed. More mental health services must be provided for health care staff to be able to complete their work successfully with minimal fatigue and psychological damage. The psychological effects of Coronavirus become more rapid and impactful in this time, it may cause secondary disaster due to stress even after the virus has ended. We need to look carefully at the lack of objective measures, such as the lack of specialized and qualified staff in psychotherapy to provide mental health services in these critical times, the small number of facilities equipped for psychotherapy in public hospitals, as well as the absence of the importance of psychological intervention in such cases, and other deficiencies or weaknesses that must be changed. Intervention psychologique en cas de crise liée à l'épidémie d'épidémie de COVID-19: approche théorique Abstrait: Des rapports ont montré que le personnel médical impliqué dans le traitement des personnes atteintes du coronavirus est plus vulnérable au risque de transmission et a besoin de services d'intervention psychologique pour les aider à surmonter la peur, l'anxiété et les pressions psychologiques. Objectifs: Cette étude vise à fournir une brève perception de l'intervention psychologique, à fournir des conseils et une psychothérapie au personnel médical lors de l'épidémie du COVID -19. Méthodes: Cette étude se fonde sur une perspective théorique sur un programme d'intervention psychologique lors de crises résultant de la propagation du virus Corona. Résultat: L'idée de base dans cette perspective comprenait: Construire une équipe d'intervention psychologique. Formation de psychologues pour fournir des services de conseil et de psychothérapie au personnel médical tout en traitant les patients atteints de coronavirus, mettre en place une ligne directe pour le conseil et la psychothérapie en ligne et promouvoir une saine sensibilisation de la population. The epidemic outbreak of serious diseases is one of the public health problems that affect mental health and social stability. Exposure to traumatic events and persistent crisis leads in the long-term to problems associated with mental health and psychological adjustment. 1 Some of the traumatic events generate another series of public health damage, and lead to multiple crisis that place human life within a series of factors against his adaptation, which drives him to address these events. So, if he fails to cope with traumatic events, he becomes more likely to risk some mental disorders, such as anxiety, depression, post-traumatic stress, or adjustment disorders. 2 He also becomes more susceptible to some physical illness, for example, digestive disorders, heart disease and cancer. 3, 4 The emerging Coronavirus (COVID -19) appeared in China in December 2019 and then spread widely in the world, including most of the Arab countries. This was accompanied by a media race to publishing the news of the spread of the virus, caused a lot of anxiety and fear among people in the world. And this was reinforced by Chinese reports which confirmed that the infection had been transferred to medical care workers and to inpatients in mental health hospitals, and delaying information about the infection increased the chance of infection in the early stage. 5 Meanwhile, With the spread of electronic media and the use of social media platforms to transmit news, the psychological effects of epidemic Coronavirus become more rapid and impactful, and cannot be ignored. These psychological effects may "cause secondary disaster due to stress and psychological distress even after the virus is over". 5 According to medical reports, the psychological disturbance, especially fear, anxiety and depression, affects the patient's immunity to the virus and may be among the health factors that weaken the patient's ability to resist the virus and its pathological symptoms. 6 Reports have shown that medical staff involved in treating people with the Coronavirus are more vulnerable to the risk of transmission, and need psychological intervention services to help them overcome fear, anxiety, and psychological pressures that will weaken their ability to continue to confront the virus. A study in Saudi Arabia indicated that most of the participants (91%) said that working in the field of caring for patients with (MERS) virus were at risk of infection, and 54% showed fear of infection with the virus. 7 Therefore, people living with COVID -19 and the medical staff need psychological interventions by professionals of counseling and psychotherapy. Some people with corona virus may undergo rehabilitation programs to reduce the symptoms of poor adaptation and other psychiatric symptoms. In fact, societies need therapists and psychiatrists to make significant efforts in early intervention with groups most vulnerable to mental health problems and prepare them psychologically and socially to overcome the psychological consequences of corona virus, and immunize them against the long-term negative effects. Recent studies have shown that 'the rapid transmission of COVID -19 could exacerbate the risk of mental health problems among the population'. 8 And 'as a result of the rapidly increasing numbers of confirmed cases and deaths, both medical staff and the public have been experiencing psychological problems, including anxiety, depression, and stress'. 9, 10 The medical staff bear many burdens and tasks during this widespread epidemiological outbreak of the novel coronavirus, and they spend long hours serving patients, which leads to some psychological problems, foremost among which is concern about exposure to infection, as well as psychological fatigue, a decrease hours of sleep, and prolonged absence of family and children. 11, 10 In this case, they desperately need psychological intervention services to help them build successful strategies to cope with the problems and pressures they are exposed to during the confrontation with the Coronavirus. There is also an urgent need for mental health care in a timely manner to deal with the outbreak of the virus. 12 Although "maintaining the mental health of workers is essential to improving control of infectious diseases". 10 However, "the best mental health approach during the epidemic season is still unclear" 10 , and needs a lot of efforts to bridge the gap in this area. Especially since there are a few psychotherapists who are able to psychologically interfere in these conditions. We need to look carefully at the lack of objective measures in the Arab countries, such as the lack of specialized and qualified staff in psychotherapy and psychiatry to provide mental health services in these critical times, the small number of facilities equipped for psychotherapy in public hospitals, as well as the absence of the importance of psychological intervention in such cases, and other deficiencies or weaknesses that must be changed. And also, the skills of Psychologists in diagnosing and treatment of mental illnesses must be improved. Most countries where the virus have spread need to build a program for psychological intervention in the crisis resulting from outbreak of the coronavirus, which includes providing psychological support to the medical staff involved in confronting the virus, and for people with coronavirus and have mental disorders. The justifications of this proposal can be summarized as follows: 1. There are not enough psychotherapists and psychiatrists to work in this case. 2. There are no proper facilities in public hospitals to provide mental health services and crisis intervention. 3. I believe that the hospital management systems (whether mental health hospitals or public hospitals) in the Arab countries are still currently ineligible to responding well in the epidemic outbreak of the emerging coronavirus. 4. There are no national plans has yet been announced in any of these countries to improve mental health and intervene in the crisis among healthcare Workers or patients with Coronavirus. So, we believe that this deficiency is addressed through the following procedures: An important step in the face of COVID -19 is the building of teams for psychological intervention, consisting mostly of a group of experts in treatment and psychological intervention and carefully selected with the capabilities and expertise that qualify them for an immediate response to the problems resulting from the outbreak of the virus. The intervention team should provide appropriate psychological support to individuals in the event of severe psychological stress, and help integrate environmental resources, and return to the previous job performance as quickly as possible. Achieving the tasks specified in the intervention programs requires the provision of abbreviated psychotherapy services, psychiatric treatments, family intervention, and directing individuals towards appropriate community resources. Treating mental disorders requires the participation of a large number of psychologists who need training in this new field. Every psychologist needs to know a lot about effective response methods in this case, because many specialists have not received adequate training to deal with this type of victims. 13, 14 Also, traditional psychotherapy methods must adapt to the current conditions that have resulted from the spread of COVID-19. The psychological intervention team supervises the psychologists during providing mental health and crisis intervention services, which include: 1-Psychological assessment: a comprehensive evaluation of the psychological and social condition, the sources of support available to the individual, and the degree of his need for treatment or psychological counseling. There are a number of evaluation models available in the field, such as the Biopsychosocial-cultural model. 15 And the Triage Assessment System (TAS). 16 This model sorts cases according to the priority of their need for psychological intervention depending on the severity of the disorder. An individual becomes a priority for treatment when all sources of support and treatment are ineffective. It is assumed that reactions to the events of the crisis appear in three areas which are the emotional domain, the behavioral field, and the cognitive domain. Failure to evaluate any of these three areas leads to the collapse of the crisis resolution process, and additional problems may result. 17 2-Counseling and psychotherapy services: According to the results of the psychological evaluation, the therapist determines the client's needs for counseling or psychological treatment and the approach that suits the type of problem, such as behavioral, cognitive-behavioral treatment, or others, and the psychological intervention should be as brief as possible. 3-Hotlines psychological counseling: Psychologists provide psychological support and advice via telephone or Internet for those who do not need direct psychological intervention. And if the work environment is not safe, Online psychotherapy is recommended. 4-Promote healthy awareness among people: through explanatory publications on the importance of psychological factors in overcoming COVID-19 symptoms, reducing people's fear, and fighting rumors. 5-Looking for other sources to support physicians and psychotherapists: by encouraging healthy people to volunteer, general, and private doctors to help. We hope that these steps in psychological intervention help medical staff and relieve symptoms of mental disorders in people with coronavirus (COVID-19). The psychological effects of Coronavirus become more rapid and impactful in this time, and it may cause secondary disaster due to stress and psychological distress even after the virus has ended. There is a lack of qualified psychiatric staff to provide mental health services in an emergency, especially during the outbreak of the Coronavirus. And that most public hospitals in the Arab countries are not equipped to provide treatment and psychological intervention services in similar crises. More mental health services must be provided for health care staff to be able to complete their work successfully with minimal fatigue and psychological damage. This proposal is based on scientific reports that emphasized the need for psychological services and crisis intervention at an early stage of the virus outbreak to relieve mental disorders among medical staff and all groups of society. However, it should be emphasized that mental health services do not replace isolation measures and precautionary steps aimed at preventing the transmission of infection between medical teams and psychotherapists. Social support, coping, life events, and posttraumatic stress symptoms among former peacekeepers: a prospective study Psychopathology: symptoms, causes, diagnosis, treatment. 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