Supervised tele-mental health training in Ecuador during COVID-19: stress and coping among psychology students

To evaluate perceived stress among senior psychology students delivering supervised tele-mental health services during the COVID-19 emergency in Ecuador, and to identify the coping strategies and contextual perceptions associated with variations in stress levels.

A cross-sectional, observational study was conducted with 308 psychology trainees who completed a 30-h national training program and subsequently provided supervised telecare during the public health emergency. Perceived stress was measured using the 10-item Perceived Stress Scale (PSS-10), coping strategies via the Spanish Brief COPE, and sociodemographic attributes, perceived telecare self-efficacy, and perceived risk of COVID-19 contagion through ad hoc questionnaires. Data analysis comprised descriptive statistics, Spearman correlations, sex-based t-tests with Cohen's d, and robust hierarchical multiple linear regression with 5,000 bootstrap resamples and 95% bias-corrected and accelerated confidence intervals.

Mean perceived stress was 14.6/40, below the midpoint of the PSS-10. Stress was inversely associated with age (rho = -0.231) and perceived telecare self-efficacy (rho = -0.309) and positively associated with perceived COVID-19 contagion risk (rho = 0.195). Eleven coping strategies correlated significantly with stress, with the strongest associations observed for self-blame (rho = 0.587) and behavioral disengagement (rho = 0.409). Men reported greater use of humor, whereas women reported greater behavioral disengagement. The final regression model explained 52.2% of the variance in perceived stress and was positively associated with: self-blame, venting, self-distraction, denial, and perceived COVID-19 contagion risk, whereas religion and acceptance were negatively associated with stress.

Supervised tele-mental health training in crisis contexts should include systematic monitoring of trainee stress, perceived vulnerability, and coping patterns. Educational supervision should strengthen adaptive coping, psychological flexibility, and timely emotional support for trainees involved in emergency telecare, particularly in resource-constrained health systems where students may be mobilized rapidly during severe public health emergencies and future disasters. These findings offer practical guidance for future emergency education training protocols.