COVID-19 presented rapid challenges to usual practice within mental health services. Despite the suspension of face-to-face psychotherapy, as a group we felt compelled to adapt so that our relationships with patients could continue. This article documents some of the challenges and opportunities faced by our group. We use collaborative writing as a method of inquiry, informed by a phenomenological approach. Each of the six therapists in the group and the supervisor wrote a freestyle personal reflection; when these reflections were viewed together, noticeable themes emerged which bear relevance to future practice. We present here anonymised vignettes (excerpts from therapists’ reflections) under thematic headings, to bring to life the collaboratively written discussions that follow. These include important moments related to the transition from face-to-face practice, and new perspectives on beginnings and endings in therapy. We highlight the power of holding onto hope for those that we work alongside, of advocating for the importance of these relationships, and of the vital role played by regular supervision meetings. The pandemic has prompted us to question our way of working and has shown us new ways to be flexible in the future. We invite others to reflect on whether they relate to our experiences or have different perspectives on the delivery of psychotherapy during such unpredictable times.


psychotherapy, medical education, psychiatry, collaborative writing

Author Bio(s)

Dr. Katherine Hall is an academic psychiatry trainee in Bristol. She is interested in integrating perspectives from wider disciplines into psychiatric practice and research, for example gaining a deeper understanding into the human experience from the Arts and Humanities. Please direct correspondence to k.hall8@nhs.net.

Dr. Alice Pitt has worked in Psychiatry both in New Zealand and the UK and is currently a Registrar in General Adult Psychiatry, working in Medical Psychotherapy. She has a keen interest in bridging the divide between traditional biomedical and psychological models of thinking, through working flexibly and creatively with people in secondary mental health services.

Dr. Emma Pope is a psychiatry trainee at ST4 level in Older Adult Psychiatry. Her particular fields of interest within this work are in medical education.

Dr. Aurielle Goddard is a psychiatry trainee in her 3rd year of core training and is about to begin specialist training in learning disability psychiatry. She works in Bristol.

Dr. Elisabetta Howe is a psychiatry higher trainee specialising in general and older adult psychiatry. She is currently working in an inpatient rehabilitation unit.

Dr. Stephanie Upton is a dual general adult and medical psychotherapy registrar in Bristol. She works as an educational fellow in co-production and works alongside experts by experience to help challenge and improve practice in mental health services.

Dr. Thanos Tsapas works as a consultant psychiatrist in psychotherapy in Bristol. His practice is influenced by ideas from psychoanalysis and Narrative therapy and his interests include justice doing approaches in psychotherapy and the use of films in Medical Education. He volunteers for Medical Justice providing medico-legal reports for asylum seekers in detention centres.


We would like to thank all of the people with whom we work, from whom we are constantly learning. We would also like to thank Katrina Plumb, who has kindly allowed us to quote her words in this paper.

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