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St. Joseph's Health Centre Toronto

How St. Joseph’s is blending virtual and in-person therapy for mental health patients

Eunice Kim, Dr. Khorasani (on iPad) and occupational therapist Antoinette Krakovsky.

Eunice Kim, Dr. Khorasani (on iPad) and occupational therapist Antoinette Krakovsky. Photo courtesy of Monica Figueiredo.

Before the pandemic, Eunice Kim, an occupational therapist, led a group therapy session on the 7M unit at St. Joseph’s Health Centre called “The Afternoon Tea Group.” It was a space for patients living with mental illness to have tea, chat and get used to group settings. She also led group activities such as colouring or gardening.

Some patients decorated their hospital rooms with the art they made. One patient took the plants she potted in the gardening activity with her after discharge. “It was a point of pride for her,” says Kim. “She used them immediately to decorate her new room, right on the windowsill.”

“It’s meaningful activity,” says Kim. “It gives them an opportunity to make choices for themselves in a safe environment.”

Since June, Kim has been co-facilitating her Afternoon Tea Group virtually. She sets up a room that can hold up to 10 people. Then, she calls in Dr. Khorasani via Zoom. This is how they have been conducting these groups since the pandemic limited physical interaction. Dr. Khorasani is a psychiatrist and whose practice is based on running therapy groups and supporting physicians in health care facilities, including St. Joseph’s.

Dr. Khorasani, who co-facilitated group sessions at St. Joseph’s prior to the pandemic, says the goal of patient groups is connection. “Patients often stay in their room and don’t want to leave because either they are very afraid, shy, guilt-ridden or dealing with what they imagine other people are thinking of them,” he says. The social connection facilitated in these groups decreases anxiety about being in the hospital.”

He used to run the groups in person. When COVID happened, the groups were temporarily suspended as Dr. Khorasani socially distanced himself at home.

Kim says that the unit focused on creating activities for patients to do on their own in their rooms, such as puzzles, crosswords and looking at magazines. However, these activities lacked important social interaction. Then, the unit received a donation of iPads, which allowed them to restart one group by calling in Dr. Khorasani virtually.

Now, Kim carries Dr. Khorasani on the iPad, via Zoom, to patient rooms to check in with them and invite them to come to the group. Then patients gather, in-person, masked and socially distanced, in a room. Dr. Khorasani facilitates the group virtually with Kim’s assistance.

Dr. Khorasani says shifting to group therapy to a virtual environment has given him a new level of compassion for patients, because he has to rely on the patients or Kim to move him around on the iPad.

“I’m not in control and I’m isolated and that’s how they feel,” he says. “It flips the roles somewhat.”

Overall, Kim says that this virtually-facilitated group has been popular with patients, who cycle in and out over the hour-long time slot.

“We’ve been having a very good turnout,” she says. “In an environment where they don’t have much control, like meals come at a certain time and they can’t always predict the doctor’s schedule, it gives them a sense of agency. It’s meaningful activity and connection.”

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