How Does It Feel to Be Online? Psychotherapists’ Self-Perceptions in Telepsychotherapy Sessions During the COVID-19 Pandemic in Italy

Abstract

Aims: The COVID-19 pandemic and consequent extreme restrictions imposed by governments across the world forced psychotherapists to abruptly change their working modality. The first aim of the current study was to assess psychotherapists’ self-perceptions (i.e., affective and cognitive perceptions about their self and their self in relation to clients) when providing telepsychotherapy during the first peak of the COVID-19 pandemic in Italy. The second aim was to explore the associations between psychotherapists’ self-perceptions, characteristics, and clinical practices.Method: An online survey was administered to 281 Italian licensed psychotherapists (Mage=45.15; SD=10.2; 83.6% female) between April 5 and May 10, 2020. The survey comprised ad-hoc questions that were designed to collect sociodemographic details and information related to working practices. Moreover, a semantic differential (SD) scale was developed to assess psychotherapists’ self-perceptions, and a factor analysis was performed from the SD items.Results: The SD scale showed an overall trend of positive psychotherapist self-perception during telepsychotherapy, despite reports of greater fatigue and directive and talkative behavior during sessions. Four SD factors accounted for 45% of the variance: “Affective Availability,” “Attitude Predisposition,” “Well-being,” and “Interventionism.” Scores on the first three factors were indicative of psychotherapists’ Positive vs. Negative self-perception. A comparison of the Positive and Negative attitudinal profiles using the chi-squared test with Yates’s correction and a Monte Carlo simulation found that psychotherapists with a Positive profile reported greater satisfaction with the telematic modality and were more likely to perceive that their clients were able to maintain privacy during sessions.Conclusion: The results suggest that Italian psychotherapists have been able to promptly adapt to the imposed telematic modality during the COVID-19 pandemic. However, they may have attempted to compensate for their physical distance from clients by intervening more during sessions. These findings may support psychotherapists who are currently practicing and inform future practitioners who are considering the use of telematic treatment as a routine component of psychotherapeutic care.

Remote Psychotherapy During the COVID-19 Pandemic. Experiences With the Transition and the Therapeutic Relationship. A Longitudinal Mixed-Methods Study

“…Surprisingly, many answers at t1 but only a few at t2 indicate that psychotherapists suffer from constraints regarding full-sensory perception of their patients during remote psychotherapy sessions. Psychotherapists seem to adapt and enhance their skills in remote psychotherapy over time, as Mancinelli et al (2021) have similarly observed in Italian psychotherapists during the pandemic. With curfews imposed again at test period t3 in Fall 2020, the previously positive attitude changed.…”

“…Even though psychotherapists experienced some professional self-doubt or anxiety and worry about technicalities and therapeutic relationship in the early phase of the pandemic in 2020, they reported a relatively good working alliance and strong real relationship with their patients in a remote setting (Aafjes-van Doorn et al, 2020). Despite reports of more directive and talkative behavior, a study by Mancinelli et al (2021) shows an overall positive self-perception in psychotherapists.…”

Therapists’ experiences of remote working during the COVID-19 pandemic

“…The additional mental demands entailed by the lack of visual information, the removal of expected cues and the need for abstraction also help to explain why participants, and other research studies (Cantone et al, 2021;Mancinelli et al, 2021), found remote therapy even more effortful than face to face therapy.…”

“…Therapists can feel under-skilled due to a lack of specific training and standardized ways of working and have doubts about the efficacy of remote therapy (Bee et al, 2016;Turner et al, 2018;Knott et al, 2020;McBeath et al, 2020). Two key concerns were a lack of confidence in managing risk (Fisher et al, 2020) and feeling particularly fatigued during remote therapy (Cantone et al, 2021;Mancinelli et al, 2021).…”

Care models for mental health in a population of patients affected by COVID-19

“…Clinicians delivering telepsychotherapy have reported concerns about their ability to be authentically and emotionally connected with their clients, as well as their ability to be as effective as they would if providing mental health services in a traditional therapy setting. 22 , 23 However, research has proven the efficacy of this modality, which enables psychotherapists and patients in separate locations to see each other and interact synchronously in real-time. Our study findings are also supported by experimental studies showing that the perceived distance between two interacting individuals modulates the empathic reaction between them, which is a key ingredient in all psychotherapeutic interventions.…”