Satisfaction With Tele-Psychotherapy Among Students of Mashhad University of Medical Sciences During the COVID-19 Pandemic

Khalil Kimiafar, Masoumeh Sarbaz, Ali Darroudi, Atefeh Sadat Mousavi, Marziyeh Raei Mehneh, Seyyedeh Fatemeh Mousavi Baigi, Mojtaba Esmaeili



Introduction: Previous experiences have shown that mental health is one of the areas that is quickly affected during an epidemic. Students, in particular, require guidance and consultation with psychologists in various aspects of their lives. This study aimed to investigate the satisfaction and effectiveness of tele-psychotherapy among students at Mashhad university of medical sciences during the COVID-19 pandemic.

Material and Methods: This cross-sectional study was conducted from September 2022 to March 2023. A standard questionnaire developed by Ghalibaf et al. was used. Three experts in related fields confirmed the content validity of the questionnaire, and its internal consistency was assessed using Cronbach's alpha coefficient. Questionnaires were distributed to all students from affiliated faculties at Mashhad university of medical sciences who had utilized tele-psychotherapy during the COVID-19 pandemic. Descriptive statistics were used to summarize and analyze the data, while analytical statistics provided a basis for inference and interpretation.

Results: The majority of students reported engaging in informal counseling through virtual communication methods such as chat and voice (47.7%), while video communication methods like video conferences were less commonly used (0.05%). Overall, most students (50%) expressed moderate overall satisfaction with tele-psychotherapy. However, only a small percentage (16.7%) agreed or strongly agreed that they would continue with this style of counseling in the future. Gender was found to have a significant relationship with satisfaction in tele-psychotherapy (p<0.001), with female students reporting higher levels of satisfaction. Additionally, confidence in the confidentiality of conversations on the Internet also had a significant relationship with satisfaction in tele-psychotherapy (p<0.001).

Conclusion: The COVID-19 pandemic necessitated a sudden shift from face-to-face psychotherapy consultations to tele-psychotherapy for students, presenting them with unique challenges. The results of our study demonstrate that tele-psychotherapy can be a satisfactory option for ensuring continuity during crises. Furthermore, tele-psychotherapy offers flexibility in terms of time and location, allowing for quicker appointments if more frequent sessions are required or during emergencies.


Teleconsultation; Telepsychotherapy; Digital Mental Health; Telemedicine; Mental Health Services


Rajkumar RP. COVID-19 and mental health: A review of the existing literature. Asian J Psychiatr. 2020; 52: 102066. PMID: 32302935 DOI: 10.1016/j.ajp.2020.102066

diCarlo F, Sociali A, Picutti E, Pettorruso M, Vellante F, Verrastro V, et al. Telepsychiatry and other cutting‐edge technologies in COVID‐19 pandemic: Bridging the distance in mental health assistance. Int J Clin Pract. 2021; 75(1): e13716. PMID: 32946641 DOI: 10.1111/ijcp.13716

Garfan S, Alamoodi AH, Zaidan BB, Al-Zobbi M, Hamid RA, Alwan JK, et al. Telehealth utilization during the COVID-19 pandemic: A systematic review. Comput Biol Med. 2021; 138: 104878. PMID: 34592585 DOI: 10.1016/j.compbiomed.2021.104878

Appleton R, Williams J, San Juan NV, Needle JJ, Schlief M, Jordan H, et al. Implementation, adoption, and perceptions of telemental health during the COVID-19 pandemic: Systematic review. J Med Internet Res. 2021; 23(12): e31746. PMID: 34709179 DOI: 10.2196/31746

Jehi T, Khan R, Dos Santos H, Majzoub N. Effect of COVID-19 outbreak on anxiety among students of higher education: A review of literature. Curr Psychol. 2023; 42: 17475–89. PMID: 35018081 DOI: 10.1007/s12144-021-02587-6

Peixoto MR, Ferreira JB, Oliveira L. Drivers for teleconsultation acceptance in Brazil: Patients’ perspective during the COVID-19 pandemic. Revista de Administração Contemporânea. 2022; 26(2): 1-22.

Schuh W. College student preferences of telepsychiatry. J Am Coll Health. 2023; 71(3): 798-805. PMID: 33891516 DOI: 10.1080/07448481.2021.1908305

Cormi C, Sanchez S, de l’Estoile V, Ollivier L, Letty A, Berrut G, et al. Telepsychiatry to provide mental health support to healthcare professionals during the COVID-19 crisis: A cross-sectional survey among 321 healthcare professionals in France. Int J Environ Res Public Health. 2021; 18(19): 10146. PMID: 34639447 DOI: 10.3390/ijerph181910146

Banbury A, Nancarrow S, Dart J, Gray L, Parkinson L. Telehealth interventions delivering home-based support group videoconferencing: Systematic review. J Med Internet Res. 2018; 20(2): e25. PMID: 29396387 DOI: 10.2196/jmir.8090

Aborujiah A, Mohammad Nassr R, Al-Othmani A, Awang Long Z, Nizam Husen M. Post acceptance model for online teleconsultation services: An empirical study in Malaysia. International Journal of Electrical and Computer Engineering Systems. 2021; Special Issue: 59-69.

Kamel Ghalibaf A, Karimi H, Rastegar Moghadam N, Bahaadinbeigy K. Evaluation of satisfaction and efficiency in remote psychotherapy: Patient and psychotherapist perspectives. Journal of Health Administration. 2015; 18(61): 92-105.

Mazziotti R, Rutigliano G. Tele–mental health for reaching out to patients in a time of pandemic: Provider survey and meta-analysis of patient satisfaction. JMIR Ment Health. 2021; 8(7): e26187. PMID: 34114956 DOI: 10.2196/26187

Shore JH, Brooks E, Savin D, Orton H, Grigsby J, Manson SM. Acceptability of telepsychiatry in American Indians. Telemed J E Health. 2008; 14(5): 461-6. PMID: 18578681 DOI: 10.1089/tmj.2007.0077

Markowitz JC, Milrod B, Heckman TG, Bergman M, Amsalem D, Zalman H, et al. Psychotherapy at a distance. Am J Psychiatry. 2021; 178(3): 240-6. PMID: 32972202 DOI: 10.1176/appi.ajp.2020.20050557

Huscsava M, Plener P, Kothgassner OD. Teletherapy for adolescent psychiatric outpatients: The soaring flight of so far idle technologies during the COVID-19 pandemic. Digital Psychology. 2020; 1(2): 32-5.

Carlbring P, Andersson G, Cuijpers P, Riper H, Hedman-Lagerlöf E. Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: An updated systematic review and meta-analysis. Cogn Behav Ther. 2018; 47(1): 1-18. PMID: 29215315 DOI: 10.1080/16506073.2017.1401115

Andersson G, Cuijpers P, Carlbring P, Riper H, Hedman E. Guided Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: A systematic review and meta-analysis. World Psychiatry. 2014; 13(3): 288-95. PMID: 25273302 DOI: 10.1002/wps.20151

Bouchard S, Allard M, Robillard G, Dumoulin S, Guitard T, Loranger C, et al. Videoconferencing psychotherapy for panic disorder and agoraphobia: Outcome and treatment processes from a non-randomized non-inferiority trial. Front Psychol. 2020; 11: 2164. PMID: 32973638 DOI: 10.3389/fpsyg.2020.02164

Mohr DC, Vella L, Hart S, Heckman T, Simon G. The effect of telephone-administered psychotherapy on symptoms of depression and attrition: A meta-analysis. Clin Psychol (New York). 2008; 15(3): 243-53. PMID: 21369344 DOI: 10.1111/j.1468-2850.2008.00134.x

Simpson SG, Reid CL. Therapeutic alliance in videoconferencing psychotherapy: A review. Aust J Rural Health. 2014; 22(6): 280-99. PMID: 25495622 DOI: 10.1111/ajr.12149 [PubMed]

Stoll J, Müller JA, Trachsel M. Ethical issues in online psychotherapy: A narrative review. Front Psychiatry. 2020; 10: 993. PMID: 32116819 DOI: 10.3389/fpsyt.2019.00993

Stefan R, Mantl G, Höfner C, Stammer J, Hochgerner M, Petersdorfer K. Remote Psychotherapy during the COVID-19 pandemic; experiences with the transition and the therapeutic relationship: A longitudinal mixed-methods study. Front Psychol. 2021; 12: 743430. PMID: 34899484 DOI: 10.3389/fpsyg.2021.743430

Isaacs Russell G. Remote working during the pandemic: A second Q&A with Gillian Isaacs Russell. Br J Psychother. 2021; 37(3): 362-79. PMID: 34548730 DOI: 10.1111/bjp.12654

Lavergne JA, Kennedy ML. Telepsychiatry and medical students: A promising mental health treatment for medical student use both personally and professionally. Curr Psychiatry Rep. 2021; 23(6): 31. PMID: 33851272 DOI: 10.1007/s11920-021-01248-6

Hadler NL, Bu P, Winkler A, Alexander AW. College student perspectives of telemental health: A review of the recent literature. Curr Psychiatry Rep. 2021; 23(2): 6. PMID: 33404975 DOI: 10.1007/s11920-020-01215-7

Ghaddaripouri K, Abbaszadeh A. Attitude, awareness, and knowledge of telemedicine among medical students: A systematic review of cross‐sectional studies. Health Sci Rep. 2023; 6(3): e1156. PMID: 36992712 DOI: 10.1002/hsr2.1156

Mousavi Baigi SF, Sarbaz M, Ghaddaripouri K, Ghaddaripouri M, Mousavi AS, Kimiafar K. Attitudes, knowledge, and skills towards artificial intelligence among healthcare students: A systematic review. Health Sci Rep. 2023; 6(3): e1138. PMID: 36923372 DOI: 10.1002/hsr2.1138

Mousavi Baigi SF, Moradi F, Vasseifard F, Mohammad Abadi F, Mazaheri Habibi MR. The effect of nutrition training on knowledge of students at university of medical sciences. Topics in Clinical Nutrition. 2022; 37(3): 236-41.

Sarbaz M, Monazah FM, Eslami S, Kimiafar K, Mousavi Baigi SF. Effect of mobile health interventions for side effects management in patients undergoing chemotherapy: A systematic review. Health Policy and Technology. 2022: 11(4): 100680.

Mousavi Baigi SF, Sarbaz M, Ghaddaripouri K, Noori N, Kimiafar K. The effect of tele-rehabilitation on improving physical activity in patients with chronic obstructive pulmonary disease: A systematic review of randomized controlled clinical trials. Frontiers in Health Informatics. 2022; 11: 113.

Mousavi Baigi SF, Sarbaz M, Marouzi P, Kimiafar K. Evaluating the impact of digital game on learning medical terminology of paramedical students: Protocol for a randomized controlled trial. Stud Health Technol Inform. 2022; 295: 51-4. PMID: 35773804 DOI: 10.3233/SHTI220658

Mousavi Baigi SF, Mousavi AS, Kimiafar K, Sarbaz M. Evaluating the cost effectiveness of tele-rehabilitation: A systematic review of randomized clinical trials. Frontiers in Health Informatics. 2022; 11: 118.

Mousavi Baigi SF, Raei Mehneh M, Sarbaz M, Norouzi Aval R, Kimiafar K. Telerehabilitation in response to critical coronavirus: A systematic review based on current evidence. Journal of Isfahan Medical School. 2022; 40(678): 498-508.

Mousavi AS, Mousavi Baigi SF, Dahmardeh F, Raei Mehneh M, Darrudi R. Teleophthalmology: A systematic review of randomized controlled trials. Frontiers in Health Informatics. 2023; 12: 141.

Mousavi Baigi SF, Mousavi Baigi SM, Mazaheri Habibi MR. Challenges and opportunities of using telemedicine during COVID-19 epidemic: A systematic review. Frontiers in Health Informatics. 2022; 11: 109.

Ghaddaripouri K, Mousavi Baigi S, Noori N, Mazaheri Habibi M. Investigating the effect of virtual reality on reducing the anxiety in children: A systematic review. Frontiers in Health Informatics. 2022; 11: 114.

Tajan N, Devès M, Potier R. Tele-psychotherapy during the COVID-19 pandemic: A mini-review. Front Psychiatry. 2023; 14: 1060961. PMID: 37476543 DOI: 10.3389/fpsyt.2023.1060961

Bayles M. Is physical proximity essential to the psychoanalytic process? An exploration through the lens of skype? The International Journal of Relational Perspectives. 2012; 22(5): 569–85.

Roesler C. Tele-Analysis: The use of media technology in psychotherapy and its impact on the therapeutic relationship. J Anal Psychol. 2017; 62(3): 372-94. PMID: 28504335 DOI: 10.1111/1468-5922.12317



  • There are currently no refbacks.