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.

Andrea Jesser,Bernd Lunglmayr,Johanna Muckenhuber

doi:10.3389/fpsyg.2021.777102

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.

Highlights

The COVID-19-pandemic brought massive changes in the provision of psychotherapy—and other health care services— all around the world
To avoid or reduce the risk of infection, many therapists switched from face-to-face sessions in personal contact to remote psychotherapy, i.e., psychotherapy delivered by telephone or videoconferencing
A comparison of the distribution of their psychodynamic methods with the distribution of the three investigated psychodynamic methods in the official Austrian list of psychotherapists showed that the distribution was representative (% in the study sample vs. % according to the Austrian list of psychotherapists): Guided Affective Imagery 72.9 vs. 74.1%, Hypnosis 17.7 vs. 18.9%, and Autogenous Relaxation 4.4 vs. 7%

Summary

Introduction

The COVID-19-pandemic brought massive changes in the provision of psychotherapy—and other health care services— all around the world. Like other medical treatments, was among the few exceptions to the complete curfew, remote treatments increased in all four psychotherapeutic orientations eligible in Austria (psychodynamic, humanistic, systemic, behavioral) (Probst et al, 2020). Until this point, psychotherapy by telephone or videoconferencing was not considered lege artis (Austrian Federal Ministry of Health, 2005) and was not covered by health insurance companies. Remote psychotherapy was almost non-existent before COVID-19 (Probst et al, 2021) This situation changed in the course of the lockdown when the government expanded existing regulations (Eichenberg, 2021) and most insurance companies started covering the expenses for remote psychotherapy to the same extent as inperson psychotherapy

Methods

Results

Conclusion