Abstract
BackgroundThe COVID-19 pandemic has directly impacted the field of child and adolescent psychiatry, affecting all aspects of the lives of children and their families and increasing their risk of distress and mental health issues, especially among children with preexisting psychiatric disorders. Child and adolescent psychiatrists (CAPs) across the world have had to adapt their practice, due to lockdown and social distancing measures. This study aimed to explore how CAPs experienced their clinical practice in these singular conditions.MethodsThis exploratory international qualitative study used the Inductive Process to analyse the Structure of lived Experience (IPSE) approach, which is a five-stage inductive process used to explore the lived experience of participants in depth and to analyze their structure of lived experience. This study took place from March through July 2020 through individual in-depth video interviews. The sample size was determined according to the principles of theoretical sufficiency.Results39 CAPs from 26 countries participated (age range 32–70 years; 23 women). Data analysis produced a structure of lived experience comprising three central axes of experience: (1) lost in space, lost in time, describing CAPs’ experience of disorganization of their clinical practice in the dimensions of lived time and lived space, (2) the body—of CAPs and patients—underlining their disconcerting experience of both sensory aspects and the non-embodied encounter during clinical practice, and (3) unpleasant emotions, with angst and loneliness the two main feelings coloring their clinical practice experience.ConclusionsThis analysis of the structure of lived experience of CAPs went beyond the sole context of the pandemic and revealed key aspects of what usually organizes CAP clinical practice. It identified two blind spots or conceptual voids within the child and adolescent psychiatry field: first, the intrinsic therapeutic function of a CAP clinical practice and, second, the important diagnostic and therapeutic function of the embodied encounter during CAP consultations. Beyond the context of COVID-19, further research should investigate these aspects to better define what a CAP does in practice and to increase both attractiveness and recruitment in this specialty.
Highlights
The COVID-19 pandemic has directly impacted the field of child and adolescent psychiatry, affect‐ ing all aspects of the lives of children and their families and increasing their risk of distress and mental health issues, especially among children with preexisting psychiatric disorders
The aim of this qualitative study was to explore the lived experience of clinical practice during this pandemic among Child & adolescent psychiatrist (CAP) across the globe. Capturing this experiential knowledge was seen not as an end but rather as a means of eliciting concrete proposals to improve CAP clinical practice both during singular and more normal conditions. This exploratory international qualitative study used the inductive process to analyze the structure of lived experience (IPSE) approach [27], a qualitative method developed for conducting clinical medical research that offers concrete proposals
We included 39 CAPs from 26 countries, including 23 women; respondents ranged in age from 32 to 70 years (Fig. 2)
Summary
The COVID-19 pandemic has directly impacted the field of child and adolescent psychiatry, affect‐ ing all aspects of the lives of children and their families and increasing their risk of distress and mental health issues, especially among children with preexisting psychiatric disorders. Several studies have shown a Sibeoni et al Child and Adolescent Psychiatry and Mental Health (2021) 15:68 higher risk of distress, domestic violence, child abuse, and mental health issues among families, directly related to the pandemic. They have shown impacts related to the pandemic concerning anxieties, and social and economic effects [1, 2]. While some scholars have reported positive outcomes and opportunities due to this extraordinary situation [14], most studies among children with and without preexisting psychiatric conditions have reported negative mental health impacts [15, 16]
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