Back to the future: when children and adolescents return to office sessions following episodes of teletherapy

Abstract

Analysts and psychotherapists are beginning to have more thorough and probing discussions about how the COVID‐19 pandemic has affected their work. Shifting to online teletherapy has been necessary due to the public health measures put in place to curtail the spread of the virus. Much of the existing literature addresses how using online platforms for teletherapy works for adults. This paper instead looks at its effects on working with children and adolescents. A contrast between Winnicott’s notion of holding and Bion’s concept of container‐contained is reviewed through a summary of a paper by Ogden. This author finds that holding might be more applicable to online work during a pandemic when the collective relationship to time and its usual parameters is severely upended. Containing could be more arduous and challenging online due to the lack of embodied presence to communicate and detect tiny nonverbal cues. A short questionnaire affirms that child analysts and psychotherapists have struggled with dimensions of online work that are particular to the developmental levels of their patients. Further, teletherapy may often not be a good fit for someone with learning differences.

Tele-psychotherapy during the COVID-19 pandemic: a mini-review

“…It appears that psychodynamic therapists or psychoanalysts have had a more positive opinion regarding the effectiveness of online sessions since the pandemic began, psychotherapists and psychoanalysts based in China being more positive than those based in the US (26). First-person accounts of psychoanalysts were published (27)(28)(29), and clinicians started to use the term "teleanalysis, " comparing the impact of physical distance on psychoanalytic treatment to that of the couch (30, 31). In psychodynamic therapy, whether online or in person, the most important aspects of treatment effectiveness are the same: the therapist's empathy, warmth, wisdom, and skillfulness and patient's motivation, insightfulness, and level of functioning (32).…”