The Effects of COVID-19 on Children, Adults, and Therapists

Dr. Katie Aafjes-van Doorn, assistant professor, Clinical Psychology PsyD Program; Dr. Vera Békés, assistant professor, Clinical Psychology PsyD Program; Dr. Tracy A. Prout, associate professor, School-Clinical Child Psychology PsyD Program; and Dr. Jordan Bate, assistant professor, School-Clinical Child Psychology PsyD Program of the Ferkauf Graduate School of Psychology have been researching the effects of COVID-19 on four groups: parents, children 6-12 years of age, therapists, and the general population.


Photo array: Bekes, Prout, Bate, van-Doorn


They have recently published four papers on what they have discovered (with a fifth pending by Dr. Bate), adding their insights to the ever-enlarging understanding about how the novel coronavirus has impacted our personal well-being, our families, as well as professional experiences:

Dr. Leslie Halpern, dean of Ferkauf, is extremely proud of the work they have been doing. “Exemplifying the outstanding work being done by the faculty of the Ferkauf Graduate School of Psychology, the cutting-edge research of Drs. Aafjes-van Doorn, Békés, Prout, and Bate offers critical insights into the impact COVID-19 is having on children’s and adults’ psychological functioning, and the provision of psychotherapy via teletherapy. Importantly, their findings inform researchers and clinicians alike about the risk and protective factors that affect one’s coping with COVID-19 related stressors and reveals teletherapy to be an accepted and effective modality for treating emotional and behavioral problems.”

Parents and Children

Dr. Bate and Dr. Borelli studied parent-child relationships and parent and child distress during the COVID-19 pandemic. They studied 158 parents with a child between the ages of 6 and 12. The parents reported on their own symptoms of distress along with symptoms experienced by their eldest child between the ages of  6-12. Parents also reported on the quality of the parent-child relationship, an important factor in child development and children’s ability to cope with distressing events like the current pandemic.

Their study is currently being reviewed for publication.

They wanted to see how stressors associated with COVID-19, such  as  the interruption of in-person education, socialization and other activities as a result of social distancing are impacting children and their families. The aim of this study was to test the hypotheses that that school-aged children’s internalizing, externalizing and trauma-related symptoms during the pandemic are associated with their parents’ symptoms of depression and traumatic-stress,  but that and that a more optimal parent-child relationship quality (operationalized as lower conflict and greater closeness) would moderate the relationship between parents’ distress and their children’s distress.

The results are not surprising. Parents endorsed elevated anxiety, depression and post-traumatic stress “higher than rates reported outside of the pandemic context.” Furthermore, their symptoms were positive predictors of their children’s internalizing, externalizing, inattention symptoms, which were also found at higher rates in this sample compared to studies from non-pandemic times.

“Our findings,” said Dr. Bate and Dr. Borelli, “provide a snapshot of the psychological toll of the COVID-19 pandemic on parents and children…High levels of parent-child conflict and less closeness exacerbate the association between parents and children’s mental health difficulties during this current pandemic.” Because COVID-19 “challenges feelings of security for both parents and children,” one of the best gifts that therapists can give these families is to make sure that “therapeutic spaces [are] safe havens.”


During the COVID-19 pandemic, many people across the world were advised to work from home in an effort to slow down the spreading of the virus. Within the field of psychotherapy, this meant that many psychotherapists, used to seeing their patients in person, had to shift to providing therapies online via videoconferencing, regardless of their previous experience or attitudes toward online psychotherapy.

The papers dealing with the COVID-19 effects on the delivery of therapy surveyed therapists in general and psychodynamic therapists in particular to see what effects this change had on their work. What the researchers found was that there was a “silver lining” to the switch therapists had to make to online therapy.

Overall, their study found that even with long-standing concerns about the use of the technology,  a sense of rapid transition and uncertainty during the pandemic, and apprehension about handling technical and communication challenges, the therapists perceived their patients to have a good experience with online therapy and thus might be inclined to consider online psychotherapy again in the future.

“Given that we’ve theorized that being forced to use technological innovations will have a negative impact on the users’ attitudes, the psychotherapists’ positive attitude toward online psychotherapy is remarkable,” said Dr. Aafjes–van Doorn.  “Although therapists are experiencing vicarious trauma – that is, feeling burdened by the traumatic material shared by their patients during the pandemic – providing online therapy might thus not be as detrimental as sometimes thought, as therapists and their patients are likely to have had relatively positive therapeutic experiences and might have a more positive mindset toward remote therapy going forward.”

General Population

In this study, Dr. Prout, Dr. Aafjes–van Doorn and Dr. Békés. surveyed 2,787 participants to get their demographics, history of adverse childhood experiences, current coping strategies (use of implicit and explicit emotion regulation) and current psychological distress.

They found that “the overall prevalence of clinical levels of anxiety, depression, and post-traumatic stress was higher than the prevalence outside a pandemic.” They also found that these rates were higher than those among health care workers and survivors of a previous coronavirus infection, severe acute respiratory syndrome (SARS).

They conclude that because the COVID-19 pandemic is still unfolding, “it is likely that the virus and its consequences will impact the global population for some time to come.” They note that what they’ve discovered means that health care providers, in addition to whatever other aid they are delivering, will also need to be sensitive to how this distress expresses itself both physically and emotionally, even if the condition that brings the patients into treatment is not related to the pandemic.

They also note that their findings dovetail with other COVID-19 research about pandemic distress and conclude that because “there will undoubtedly be increased demand for mental health services in the coming years, it is essential that primary care and mental healthcare providers be equipped to respond to this dire need.” Providers will need to exercise increased skill in assessing their patients for how they are expressing their worries and what their patients are or are not doing to handle them.

They also suggest that “the increase in telepsychotherapy may afford patients greater access to high-quality mental healthcare that can improve mental health outcomes and support resilience during the COVID-19 pandemic,” a suggestion that fits with their related research on psychotherapists’ adaptation to the new challenges and benefits of therapy by video.

Another study with more than 16,000 participants by Dr. Békés with Dr. John Christopher Perry (McGill University) and Claire J. Starrs (CUNY at Potsdam), is also ongoing. This study is supported by the Markus Foundation and is conducted on an international sample focusing on stress, coping, and health behavior during COVID-19, with a special focus on health care workers and diverse and minority populations.

Ongoing Work

Just as the pandemic continues, these four professors are also maintaining their work monitoring both its short-term and long-term effects, looking at impacts on therapists, patients, and the general community and assessing post-traumatic growth during the ongoing pandemic.