(Vi)-rushed Into Online Group Schema Therapy Based Day-Treatment for Older Adults by the COVID-19 Outbreak in the Netherlands

Highlights • Therapists were positively surprised by the online capabilities and resilience of older patients to adapt to the online treatment program. Prejudices on limited effectiveness of online psychotherapy in older adults were counteracted. • COVID-19 related social distancing measures appeared to trigger feelings of rejection in patients with borderline personality traits, while it falsely validated indoor behavior of patients with avoidant personality traits. • Patients felt being taken seriously, especially because during the online group sessions they all received detailed comments on their homework (sent by email and discussed online). • Where the non-verbal sessions initially felt relaxing and fun, patients told us that these sessions also stimulated their mutual responsiveness (in schema therapy language ‘facilitated their happy child mode’).
Background – Societal measures in context of the COVID-19 outbreak forced us to transform our schema therapy-based day-treatment for older adults with chronic affective disorders and personality problems into an online program. The objective of this paper is to present first impressions of this transformation. Methods – Using over-the-phone instructions initially, all patients were able to participate with the online therapy program. To reduce screen-time for patients, the non-verbal therapies were shortened. Four patients, aged 64-70 years, started our online program. Results – Therapists were positive about the online capabilities and resilience of patients to adapt to the new situation. Prejudices on limited effectiveness of online psychotherapy were counteracted. Sending homework by email and mail seems to facilitate therapy adherence. Non-verbal therapy could be important to stimulate the online group process. Conclusions – We were positively surprised by the online capabilities of our geriatric mental health care patients and encourage further formal effectiveness studies.