Psychodynamic Therapist’s Subjective Experiences With Remote Psychotherapy During the COVID-19-Pandemic—A Qualitative Study With Therapists Practicing Guided Affective Imagery, Hypnosis and Autogenous Relaxation

Abstract

The COVID-19-pandemic brought massive changes in the provision of psychotherapy. To contain the pandemic, many therapists switched from face-to-face sessions in personal contact to remote settings. This study focused on psychodynamic therapists practicing Guided Affective Imagery, Hypnosis and Autogenous Relaxation and their subjective experiences with psychotherapy via telephone and videoconferencing during the first COVID-19 related lockdown period in March 2020 in Austria. An online survey completed by 161 therapists produced both quantitative and qualitative data with the latter being subject to a qualitative content analysis. Our research suggests that telephone and videoconferencing are considered valuable treatment formats to deliver psychodynamic psychotherapy. However, therapists’ experiences with remote psychotherapy are multifaceted and ambiguous. In particular, the findings raise questions concerning the maintenance of the therapeutic alliance, the development of the analytic process, the sensitivity to unconscious communication, and the indication for certain types of patients that still need further investigation. Our research indicates that the long-standing reticence toward remote treatments offers among psychodynamic therapists is becoming more differentiated and partially dissolves as therapists gain experiences in their use. Attitudes are becoming more open. At the same time, the way is being prepared to take a closer look at the specific processes and dynamics of remote psychotherapy and to examine them critically in future studies.

Remote Psychotherapy during the COVID-19 Pandemic: A Mixed-Methods Study on the Changes Experienced by Austrian Psychotherapists

“…Technical problems were also reported in other studies from the same period [ 41 , 42 ]. As also noted by Jesser et al [ 43 ] and Eichenberg et al [ 44 ], therapists tried to compensate for the lack of non-verbal communication by focusing on other channels of perception. The respondents described this as exhausting and tiring, a finding that was also echoed by other authors [ 21 , 39 , 43 ].…”

“…As also noted by Jesser et al [ 43 ] and Eichenberg et al [ 44 ], therapists tried to compensate for the lack of non-verbal communication by focusing on other channels of perception. The respondents described this as exhausting and tiring, a finding that was also echoed by other authors [ 21 , 39 , 43 ]. The lack of a non-verbal level affected the therapeutic process.…”

“…Simpson et al [ 48 ], for example, described the “democratizing effect” of remote therapies, which enable patients to become more active in their own “territory”. Furthermore, Jesser et al [ 43 ] worked out that in a setting at a distance, successes can also be experienced more independently of the therapist.…”

Säuglings‑, Kinder- und Jugendlichen- (SKJ) Psychotherapien während der Covid-19 Pandemie: Ergebnisse einer Studie unter psychodynamischen Psychotherapeut*innen in Österreich

“…Ob Personen, die nicht sichtbar waren, ebenfalls "mit dabei" waren, war auch nicht immer klar. Derartige Beobachtungen sind auch aus anderen Untersuchungen bekannt -selbst in Erwachsenenpsychotherapien haben Patient*innen nicht immer die Möglichkeit, sich für die Psychotherapie einen geschützten Raum in den eigenen vier Wänden zu schaffen (Jesser et al 2022b). Diese Einschränkung muss sehr kritisch gesehen werden.…”

“Bye, click, and gone”—A qualitative study about the experiences of psychotherapists and adolescent patients on remote treatment during the COVID-19 pandemic.

“…Most interestingly, many therapists felt a need to compensate for the lack of physical presence. An Austrian survey on 161 psychodynamic therapists by Jesser et al (2021Jesser et al ( , 2022 revealed that transference and countertransference processes and the intensity of the therapeutic process changed the most. Moreover, the therapists experienced some of their patients to have difficulties in establishing a safe space at home, severe limitations of sensory perception, and an inferior relationship in the context of the remote setting.…”