A Perspective on Client-Psychologist Relationships in Videoconferencing Psychotherapy: Literature Review

Abstract

Background During the COVID-19 pandemic, people have been encouraged to maintain social distance. Technology helps people schedule meetings as remote videoconferencing sessions rather than face-to-face interactions. Psychologists are in high demand because of an increase in stress as a result of COVID-19, and videoconferencing provides an opportunity for mental health clinicians to treat current and new referrals. However, shifting treatment from face-to-face to videoconferencing is not simple: both psychologists and clients miss in-person information cues, including body language. Objective This review proposes a new theoretical framework to guide the design of future studies examining the impact of a computer as a mediator of psychologist-client relationships and the influence of videoconferencing on the relationship process. Methods We conducted a literature review including studies focused on communication and key concepts of the therapeutic relationship and therapeutic alliance. Results Studies have reported that clients are generally satisfied with videoconference therapy in terms of the relationship with their therapists and the establishment of the therapeutic alliance. Conversely, studies indicate that psychologists continue to highlight difficulties in establishing the same quality of therapeutic relationship and therapeutic alliance. The contrasting experiences might underlie the differences in the type of emotional and cognitive work required by both actors in any therapy session; furthermore, the computer seems to take part in their interaction not only as a vehicle to transmit messages but also as an active part of the communication. A new model of interaction and relationship is proposed, taking into account the presence of the computer, along with further hypotheses. Conclusions It is important to consider the computer as having an active role in the client-psychologist relationship; thus, it is a third party to the communication that either assists or interferes with the interaction between psychologists and clients.

The Digital Therapeutic Alliance: Prospects and Considerations

“…In the paper "A Perspective on Client-Psychologist Relationships in Videoconferencing Psychotherapy: Literature Review" [15], the authors emphasize the prescience of this topic during the time of the COVID-19 pandemic. Suddenly, mental health therapy through digital means has become an imperative for many consumers, and so the quality of these therapies in establishing effective treatment has become a more urgent problem to solve.…”

“…Participants in the study identified one of the benefits of blended therapy as strengthening the relationship between the client and the clinician, which is clearly important for DTA. It would be interesting to see this study extended to cover the views of therapists so that it could be compared to the findings of Cataldo et al [15].…”

COVID-19 Related Traumatic Distress in Psychotherapy Patients during the Pandemic: The Role of Attachment, Working Alliance, and Therapeutic Agency

“…Despite therapists' concerns about the ability to develop a strong working alliance in online settings [41,42], research suggests that the working alliance in online psychotherapy is usually strong [43] and comparable to in-person therapies [44,45]. Although there is lack of research regarding the impact of the working alliance on online psychotherapy, the working alliance has been suggested to be crucial for good outcomes in online therapy via videoconferencing [46]. With regards to patients' attachments, individuals with a more secure attachment tend to report a stronger working alliance with their therapist, and more insecurely attached patients report a lower working alliance (for a meta-analysis, see [47]).…”

„In Videobehandlungen trotz Distanz Nähe schaffen“

“…So deuten die Ergebnisse einiger Studien auch darauf hin, dass die therapeuteneingeschätzte Allianz im Rahmen der VB niedriger ist, als dies in Face-to-Face-Therapien der Fall ist (Cataldo et al. 2021 ; Rees und Stone 2005 ). Die Ursachen für diese z. T. widersprüchlichen Erfahrungen von Patienten und Therapeuten näher zu untersuchen, bleibt weiter von Bedeutung.…”