A qualitative exploration of psychologists' experiences of teletherapy within the Irish Public Mental Health System

Abstract

Objective The current qualitative study aimed to investigate psychologists' experiences of teletherapy throughout the COVID‐19 pandemic, with a particular focus on teletherapy's impact on therapeutic relationships. Method Fifteen participants, consisting of clinical and counselling psychologists employed by the Health Service Executive (HSE) in Ireland, participated in semi‐structured interviews conducted via telephone. Results Constructionist thematic analysis yielded three prominent themes: (i) psychologists experienced a lack of control over therapeutic boundaries with their clients, such as the setting and time in which sessions take place. Teletherapy also encroaches on psychologists' personal boundaries from having aspects of their home lives becoming associated with clients' trauma; (ii) psychologists have to work much harder to make the connection with clients due to the substantial loss of information, including non‐verbal cues, transmitted across teletherapeutic platforms; and (iii) psychologists themselves feel uncontained from being insufficiently supported by the HSE, which impacts on their ability to contain high‐risk clients via teletherapy. Conclusions Various aspects of the therapeutic relationship, including therapeutic boundaries between psychologists and their clients, and psychologists' ability to make the connection and foster containment with their clients, were impacted by teletherapy. Psychologists need to feel heard, supported and appreciated to ensure optimal delivery of teletherapy in future.

Video chat therapist assistance in an adaptive digital intervention for anxiety and depression: Reflections from participants and therapists.

“…High satisfaction rates may also be explained by the growing familiarity and level of comfort with video communication technologies in the general population, which increased due to COVID-19 social movement restrictions. As previous studies (Aafjies-van Doorn et al, 2021;Reilly et al, 2022) have identified perceptions held toward video chat as a lesser quality service than in person, further research could also investigate the factors contributing to participant and therapist views that infer video chat to be an acceptable substitute rather than equal modality to in-person service.…”

Therapist training in video chat technology for use in an adaptive digital mental health intervention: Challenges, facilitators and implications for training models

“…Specifically, the beliefs were that: Internet-based therapies do not have a strong evidence base; they are less effective than in-person therapy; there is a decreased ability to develop a strong therapeutic alliance digitally; dMH interventions are not suitable for severe mental health problems; and Internet-based therapies will fail to meet clients' expectations of therapy. Thew (2020) Gerton et al, 2022;Poletti et al, 2021;Reilly et al, 2022). With experience, therapists come to view video chat telehealth as effective and comparable to face-to-face services.…”

“…The research conducted to date suggests that therapist perceptions of video chat use within dMH interventions tend to become more positive with experience and are predictive of future adoption into practice (Aafjies‐van Doorn et al, 2021; Connolly et al, 2019; Gerton et al, 2022; Poletti et al, 2021; Reilly et al, 2022). With experience, therapists come to view video chat telehealth as effective and comparable to face‐to‐face services.…”

Receiving teletherapy in Ireland: The experiences of service users in the public mental health system

“…The present study was a qualitative exploration of service users' experiences of teletherapy in a public setting during the COVID‐19 pandemic in Ireland, providing a rich insight into these experiences to inform its future applications. It is one part of a larger study exploring experiences of teletherapy, with Reilly et al (2022) exploring therapists' experiences. Note that the terms “service user” and “client,” and “psychologist” and “therapist,” will be used interchangeably throughout this report, to reflect the terminology used by participants and authors of referenced works.…”