Pandem-ethics: Post-mortem reflection on healthcare worker ethics during the time of coronavirus disease 2019 pandemonium.

Despite their substantial prevalence and impact on quality of life, mental health conditions remain among the most undertreated health conditions worldwide []. Nevertheless, global spending on mental health remains at around 2% of total health budgets, with significant disparities depending on income levels. These disparities can result in many people not receiving adequate treatment, which causes enormous losses for both national economies and individuals []. Face-to-face psychotherapy (F2FT) has long been the gold standard for mental health treatment, demonstrating consistent effectiveness across therapeutic modalities []. Therapist-patient co-presence enables rich nonverbal communication, enhances disclosure and therapeutic closeness, and supports psychological stability and trust []. Many therapists consider F2FT optimal for alliance building because it provides emotional safety, minimizes distraction, and helps patients perceive their therapists as empathic, sensitive, and understanding []. However, F2FT faces significant accessibility barriers, including spatiotemporal constraints, costs, and stigma []. These limitations have prompted the development of alternative delivery modalities, particularly videoconferencing psychotherapy (VCT). VCT has several advantages, including improved accessibility, spatiotemporal flexibility, and cost reduction [,-]. Despite initial concerns about relationship building, evidence indicates that VCT achieves effects comparable to those of F2FT, with similar alliance formation and perceived empathy [,,-] for patients and therapists []. Furthermore, VCT demonstrated equivalent therapeutic outcomes to those of F2FT across a range of psychiatric disorders [].