Mental health and people who have had COVID-19: Drawing on reliable information

Here, Dr. Rogers is drawing on a systematic review. When thinking about engaging in meaningful action, we need to first ask whether we are drawing on reliable information. Many of you have commented on wanting to watch fewer news feeds, and being careful where you get your information from.

In scientific research, we draw on what are called Levels of evidence.

For example, researchers can study one person in a single case study, a large group of people in cohort studies, or we can compare two different groups under experimental conditions in what’s called a randomised control trial (RCT). The RCT is used widely in medication research, and any potential COVID-19 vaccine will be trialed in such a way – one group will be given the vaccine, and another will be given a potentially beneficial alternative or a placebo.

In psychotherapy research, however, we aren’t always aware of the “active ingredients” of the therapy:

• Was it that piece of goal-setting that worked?
• Was it when the therapist validated the patient’s fear?
• Was it the therapy relationship overall?

In psychotherapy research, there is an important place for smaller, more detailed studies to understand what works in therapy. While a range of therapies, including CBT and psychodynamic therapy, have been evidenced in larger trials, researchers are still working on what exactly it is about that different therapies that work for people like Kevin.

Now, with the coronavirus epidemic, we can’t put people in a group and randomly give them coronavirus or a placebo, as this is highly unethical! But we can follow large cohorts and compare them to unaffected areas.

Importantly, there is a big difference between “my friend says the pandemic is good for our health” and a review like the one that Dr. Rogers draws upon. Importantly, this review still has limits in its reliance on previous coronavirus epidemics.

We are currently facing this particular disease at a particular time, with a particular socioeconomic and political situation, access to particular news and information, and populations with particular health conditions. This is why we say that research guides our understanding, rather than dogmatically prescribes how we should act – there are lots of factors to consider.

And, even when we use reliable information, it can become distorted, amended, and altered to fit different narratives. This often happens in the media, for instance, when some research is ignored entirely, and other research makes the headlines.

So, if we are thinking about informed action that draws on new information, the first step is to reflect on where we draw our information from:

• Are we looking at first-hand data?
• Is it reliable and valid?
• Do the authors have any competing motives?

And, when we are taking in the information we can also reflect:

• Am I looking for and finding information that confirms what I already think?
• Is this information making me uncomfortable so that I would prefer to discount it?

Let’s now take a closer look at Kevin’s story, and how psychotherapies have approached the task of engaging in meaningful action.