Expectations and Experiences of Couples Receiving Therapy Through Videoconferencing: A Qualitative Study

Abstract

Videoconferencing is an emerging medium through which psychological therapy, including relationship interventions for couples, can be delivered. Understanding clients' expectations and experiences of receiving therapy through this medium is important for optimizing future delivery. This study used a qualitative methodology to explore the expectations and experiences of couples throughout the process of the Couple CARE program, which was delivered through videoconferencing. Fifteen couples participated in semi-structured interviews during the first and last sessions of the intervention. The interviews were conducted using the iChat program, with the therapist conducting the first interview and an external interviewer conducting the second. Thematic analysis was used to identify themes from the interview transcripts. Five themes were identified from the pre-therapy interviews, reflecting couples' initial impressions and expectations: new experience, comparison, practical aspects, connection and dynamics, and distance and space. Couples' experiences were explored in the eight themes from the post-therapy interviews: technicalities, the idea of "distance," satisfaction and comfort, confidentiality, comparisons, new experience, expectations change, and working alliance. Overall, the present study found that couples experienced a positive shift in expectations. Despite some initial concerns regarding the therapist's ability to empathize over a screen and the potential for the technology to break down, many clients noted that videoconferencing allowed them to become fully immersed in the therapeutic process. In fact, many couples felt that videoconferencing created an element of 'distance' from the therapist that allowed them to feel a greater sense of control and comfort. Couples consistently described being able to effectively connect with the therapist, and that the video actually enhanced the therapeutic alliance, due to a greater perceived focus on therapy processes. Overall, despite some initial concerns, the majority of couples found the videoconferencing experience to be beneficial and positive.

“It’s splendid once you grow into it:” Client experiences of relational teletherapy in the era of COVID‐19

“…Indeed, these benefits parallel many of the experiences shared by our participants in the themes of safe therapeutic space and convenience . Specifically, convenience and comfort of engaging in relational teletherapy from one's home environment or “safety zone” (Kysely et al, 2020), reduced waiting room anxiety, and time‐saving benefits were expressed throughout both themes for the current study. Although one of the main teletherapy training barriers discussed in the MFT literature involves time consumption and financial cost for graduate programs (Cravens Pickens et al, 2019), the juxtaposition is that these economic and time‐saving benefits are what clients often cited as advantageous to their participation in relational teletherapy.…”

“…Findings from this study also suggest that family‐based telehealth interventions are uniquely suited to meet the treatment demands of adolescents without adequate treatment options (Anderson et al, 2017). Furthermore, the experiences of couples receiving teletherapy were explored and reported that couples experienced a positive shift in expectations and specifically noted that teletherapy allowed them to become fully immersed in the therapeutic process (Kysely et al, 2020).…”

Exploring the Efficacy of Telehealth for Family Therapy Through Systematic, Meta-analytic, and Qualitative Evidence

“…Uniquely, our qualitative results suggest some advantage of TH delivery in family therapy over face-to-face, as reported in previous research with individual or couples therapy (Richardson et al 2015 ). Key factors for perceived efficacy from the client and therapist perspectives include ease of talking in telehealth, where turn taking is clearer, and ease of revealing vulnerability for some clients, invoked by a sense of distance in TH that may be conducive to disclosure (Kysely et al 2020 ). Accessibility is also key.…”

Synchronous digital couple and family psychotherapy: a meta‐narrative review

“…Kysely et al . (2020) reported findings from 15 couples who had completed a six‐week structured synchronous videoconference‐delivered intervention. Using a version of thematic analysis, they reported that couples had experienced a positive shift in expectations, with many couples’ initial reservations overtaken by their ability to become fully immersed in the therapeutic process.…”