A methodology to improve eye contact in telepsychotherapy via videoconferencing with considerations for psychological distance

Abstract

ABSTRACT Telepsychotherapy by videoconference (VC) is an effective way to treat clients over the Internet, yet therapists often report concerns that VC could affect the therapeutic relationship by hindering the perception of nonverbal behaviors such as eye contact. To date, no simple procedure describes the technical adjustments needed to compensate for the unnatural angle between the eye gaze of the participants and the webcam that is pervasive to most commercial VC systems. This article describes the steps towards a practical and inexpensive VC setup that enables eye contact between therapists and clients. Moreover, this setup allows users to choose between two camera framing conditions: a zoomed-out, head-to-waist framing or a zoomed-in, head-to-chest framing. These two setups were tested by four therapist-client dyads in simulated telepsychotherapy sessions. Participants indicated that they preferred the framing condition congruent with their desire to be “closer” or “farther” from their partner, highlighting how their perception of psychological distance was related to the degree of camera zooming in VC. The article provides recommendations for different adaptations that therapists and clients can implement to maximize their experience of telepsychotherapy by VC.