Impact of the COVID-19 pandemic on outpatient psychotherapy for children and adolescents

Abstract

Background: Since the start of the COVID-19 pandemic there is a growing body of evidence showing its negative impact on the mental health of children and adolescents. However, little is known about whether and how this impacts the psychotherapeutic care for children and adolescents. Objective: The mental health of children and adolescents as well as their psychotherapeutic care since the onset of the COVID-19 pandemic were investigated from the perspective of child and adolescent psychotherapists (CAPs). Material and methods: We conducted an online survey with 324 CAPs from all over Germany. Participants were asked to compare the last 6 months with a 6-month period 2 years ago. The survey used 5‑point and 7‑point Likert scales, questions with single and multiple choice options as well as numeric and open answer formats. Results: Since the beginning of the pandemic waiting times have nearly doubled. CAPs offered more treatment sessions and, in particular, more initial consultations were carried out. Therapy extensions were more frequent and therapy terminations occurred less often. In about half of the patients, a pandemic-associated aggravation of symptoms occurred. All of the reported mental disorders occurred more often, in particular depression, anxiety disorders, media addiction, sleep, adjustment, obsessive-compulsive and eating disorders. More telephone and video sessions were carried out than before the pandemic. The pandemic resulted in a closer cooperation with parents but a decreased cooperation with other disciplines. Conclusion: The pandemic had a significant impact on the mental health of and the psychotherapeutic care for children and adolescents in Germany. An adaptation of the mental health system to the increased need for therapy is proposed in order to limit future mental and economic harm.