Work with emotions in remote psychotherapy in the time of Covid-19: a clinical experience

Abstract

Objective: Face-to-face experiential work with emotions is effective, but it remains unclear what the feasibility of teletherapeutic work with emotions is. The current Covid-19 worldwide situation represents an opportunity for psychotherapists to test new ways of working with clients, including from an emotion-focused and emotionally focused perspective. Methods: The present brief report describes a clinical experience based on 6 weeks, so far, of telepsychotherapeutic work focused on emotions via online tools, during the Covid-19 partial confinement in Switzerland. Results: We found a certain feasibility of remote work with emotions in psychotherapy, for individual clients, and for couples. Specific challenges represent relationship and contextual factors (clear communication, using tone of voice, regular check ins, setting up a clear frame, technical aspects of communication, the Self of the therapist), accessing and deepening emotions and managing dysregulated experience and interpersonal escalation. Discussion: Based on this initial clinical experience, we propose that integrative experiential practice partially delivered via a computer screen be studied in controlled settings by psychotherapy research in the future.

Telemental Health Use in the COVID-19 Pandemic: A Scoping Review and Evidence Gap Mapping

“…Recommendations regarding telemental health use Access to care Health service providers and policy makers must both recognize and advocate to reduce health disparities (35,103,126,154) Ensure adequate privacy and confidentiality protections (50,57,70,72,79,92,94,95,159,175,180) Prepare a device inventory (e.g., tablets) to share with marginalized populations (180) Standardize policies on licensing and regulatory issues (50,53,74,85,121,126,159,175,199) Financial impact Ensure patients are aware of billing and insurance policies up front (72,74) Ensure insurance providers expand coverage for telemental health (53) Malpractice insurance for telemental health services (175) Patient experience Prepare for the telemental health experience (53,85,121,126,133,167,180) Telemental health sessions should last for reasonable lengths of time, with a periodic break, if needed (176) Empower patients to participate and be an equal partner in their own care (176) Have one-on-one sessions prior to group sessions, schedule the group sessions at convenient times for all using differing modalities to maximize participation (57,91) Healthcare Develop tools to enhance ...…”

„In Videobehandlungen trotz Distanz Nähe schaffen“

“…Diese Schwierigkeiten, die paralinguistische, körperliche und prosodische Aspekte der Kommunikation betreffen, wurden auch von anderen Autoren beschrieben (Fernández-Álvarez und Fernández-Álvarez 2021 ; DPtV 2020 ). In ihrem Bericht zur Arbeit mit Emotionen in videobasierter VB führten Thompson-de Benoit und Kramer ( 2020 ) aus, dass diese Arbeit aus der Ferne zwar prinzipiell machbar sei, jedoch spezifische Herausforderungen beim Vertiefen von Emotionen und beim Umgang mit dysregulierten emotionalen Erfahrungen entstehen, durch das Fehlen von direktem Blickkontakt, die erschwerte Nutzung des Tonfalls oder die Körperhaltung sowie schwierigere Einschwingungs- und Abstimmungsprozesse. Auch die von der DPtV durchgeführte und veröffentlichte „Blitzumfrage“ zur VB kommt zu dem Ergebnis, dass die nonverbale Interaktion, die Nutzung von Sinneseindrücken, diagnostische und Beziehungsarbeit via Video erschwert sind (DPtV 2020 ).…”

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“…As Markowitz et al (2020) explained, telehealth presented some major technical hurdles like challenges connecting, frozen screens, delayed audio, dropped calls, and more, all adding to therapist attitudes about telehealth and its efficacy. Thompson-de Benoit and Kramer (2020) noted that good connectivity, a good microphone, adequate lighting, a camera at eye level to enhance eye contact, and limiting distractions like notifications and email were critical to successful teletherapy.…”