Therapists’ view of transition to remote psychotherapy

What is it about?

The aim of this study was to explore psychodynamic therapists’ experiences of forced transitions to telepsychotherapy. The qualitative analysis of the therapists’ accounts revealed that the core aspect of their experiences was a deep feeling of several types of loss, even if telepsychotherapy could give some new opportunities. Initially, the therapists struggled with technical and safety aspects at the expense of therapy focus. They felt that the therapy frame became exiled and they experienced that the loss of the therapy room and of access to non-verbal nuances resulted in lost depth in the dialogue and impaired contact with the patients. One year later, many of the difficulties remained, but the therapists had developed better coping strategies and seemed to be back to the therapy focus.

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Why is it important?

Whether the negative experiences of the therapists were part of the learning process of a new therapy format, rather than signs of lasting drawbacks with remote therapy, is a relevant question. All new things take time to learn. Indeed, one year later, safety concerns and the focus on technology were no longer in the foreground in the therapists’ experiences and all of them, in different ways, were back to the therapy focus. Most of them described becoming more flexible and developing new strategies, which had helped them to be more comfortable while working online. They compensated for the limited non-verbal communication and lost nuances by being more pedagogical and matter-of-fact, but also by developing new ways of listening, focusing on cues accessible in the online communication (facial expressions, avoiding screen, etc.), and inviting the patient to look at what was going on in the online exchanges. All therapists made some adjustments to the remote work and all of them felt that they were still conducting psychodynamic psychotherapy.