Implementation Science of Telepsychotherapy for Anxiety, Depression, and Somatization in Health Care Workers Dealing with COVID-19

Introduction: Cognitive behavioral therapy (CBT) has proven to be effective in treating affective and somatic symptoms, which are among the leading mental health problems of health care workers (HCWs) dealing with COVID-19 (HCW-COVID-19). However, efforts to develop and evaluate the strategies required to promote its implementation in clinical practice are still scarce, particularly in low- and middle-income countries.Objective: To describe and evaluate the implementation process and clinical impact of a brief, remote, manualized CBT-based intervention for moderate anxiety, depressive, and somatic symptoms among Mexican HCW-COVID-19 >= 18 years old.Methods: The implementation process comprises community engagement, intervention systematization and education, leadership engagement, and team-based coaching as main strategies. A total of 26 participants completed self-report measures of symptoms before and after treatment, and a subsample of 21 answered a final questionnaire on the acceptability of the intervention. Therapists registered the techniques used in each case, regardless of whether they were part of the intervention manual.Results: The number of sessions was 4.6 (2.43). The most frequently employed techniques were those included in the intervention manual, especially identifying and modifying maladaptive thoughts, used to treat 70% of HCW-COVID-19. Supplementary techniques were implemented to enhance treatment or meet HCW-COVID-19s special needs (such as workplace issues, insomnia, COVID-19 status, and bereavement). The intervention had a significant effect (delta Cohen's coefficients >= 1), and the majority of HCW-COVID-19 were "totally satisfied" with its contents and considered it "not complex" (95.2% and 76.1%, respectively).Conclusions: Telepsychotherapy for anxiety, depression, and somatization in HCW coping with health emergencies in middle-income countries is a feasible, clinically valuable, and acceptable form of treatment.