Online psychotherapy - brought by COVID - Will it remain?

Thanks to the closures imposed by COVID-19, it is no longer impossible that psychological consultations take place via Skype or Zoom, for example, rather than in the therapist's office. Although many studies show that psychology work in the online space can be effective in solving most problems, a new study has now looked at the quality of the relationship between therapist and client.

Gábor Aranyi, a lecturer at the Institute of Psychology and Education at ELTE PPK Szombathely, and his Austrian colleagues conducted a comprehensive study at the Outpatient Clinic for Adults of Sigmund Freud University in Vienna to find out how changes in the therapeutic environment affected the quality of the rapport between psychologist and client. In their survey, more than 120 client-therapist pairs answered a series of open and closed interview questions and completed a questionnaire assessing the therapeutic relationship in three situations: before switching to the web-based interface, during online therapy and after the end of the lockdowns returning to face-to-face consultation.

Since the results showed no significant difference between face-to-face sessions and online consultations, but there was a significant improvement between the first and last measurement, the researchers concluded that:

 the relationship between the therapist and the client was not affected by the change of environment,

and the absence of personal attendance had no negative impact on this trust based relationship which is the basis of all successful therapy.

In addition to the questionnaire survey, clients and therapists were also asked to share their experiences of web-based therapy using guided questions. Feedback indicated that many clients felt safer in the online environment and many reported that they were able to get more engaged in the therapeutic process in this way. In addition, many respondents mentioned the advantages of not having to travel and that booking an appointment is easier and more flexible. On the other hand, technical problems (internet connection, camera set-up) were mentioned as a disadvantage, and some respondents emphasised the importance of the distraction-free environment of an empty room.

In the light of the results, the researchers believe that the online format offers significant advantages in terms of both convenience and emotional safety, with no negative impact on the therapist-client relationship, and that it is therefore worth recommending tele-therapy as a complement to face-to-face consultations for their patients in the future.

The study by Gábor Aranyi, Christiane Eichenberg, Paul Rach and Lisa Winter has been published in the journal Internet Interventions.