Patients’ Long-Term Experiences of Transitions to or from Telepsychotherapy

What is it about?

The patients experienced that the remote sessions provided availability at the expense of efficiency. The therapists’ interventions were more difficult to receive and lost some of their impact. Interventions including a whiteboard or textual material could not be done as usual, and the therapist’s distance hindered focus on trauma. The therapeutic process went more slowly, and the treatments were experienced as less efficient. Several routines and rituals surrounding the therapy sessions were lost. Conversations were less serious, and therapy sessions seemed to lose direction, which made therapy more supportive rather than a tool for change. The reflections and working through that were an essential ingredient in in-person sessions did not take place remotely, and the non-verbal communication was lost. The patients had difficulties in maintaining their concentration and the therapy focus, which made them tired and frustrated. Both the emotional relationship and the working alliance were negatively influenced. The emotional presence was experienced as weakened, but some of the patients could find expressing their feelings easier in the absence of bodily co-presence. According to the patients, in-person presence contributed to their security and trust, whereas they felt that the therapists seemed different when working remotely: more easygoing and familiar, but also more solution-focused, supportive and unprofessional, less understanding and less therapeutic. Despite their persisting, mainly negative longitudinal experiences, the patients also stressed that telepsychotherapy gave them an opportunity to take therapy with them into their everyday lives when they were in their own homes during the sessions. They appreciated the possibility to continue their treatment despite the pandemic.

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