Abstract

Online therapy has increasingly been utilised during the COVID-19 pandemic by many, including working populations. However, few qualitative studies have explored how online therapy is experienced in practice and discussed its implications for those working clients. Semi-structured interviews attended by nine integrative psychotherapists practising in California, the United States, were conducted. Thematic analysis of the transcripts identified three themes: (i) ‘Positive experiences of online therapy’, (ii) ‘Challenges experienced by therapists and clients in online therapy’, and (iii) ‘Preparation and training for online therapy’. Online therapy was assessed as being helpful, particularly in terms of mitigating against previous geographical and temporal barriers to uptake. However, due to technological disruptions and potential blurring of professional boundaries, online therapy may detract from the emotional salience of therapy, negatively impacting the therapeutic relationship and containment. Considering these positive experiences, participants expected that the demand for online therapy would continue to increase. Particularly in the occupational context, online therapy can offer interventions without fostering shame regarding mental health. The findings provide preliminary qualitative evidence that online therapy can be a useful adjunct to traditional forms of face-to-face therapy. However, therapists require more explicit training in implementing online therapy. Results are discussed in particular regarding the utility of this therapy for working clients.

Highlights

  • [1] Both developments underscore the rising interest in online therapy in the counselling and psychotherapy professions. They have paved the way for formal recognition of ‘telepsychology’, known internationally as online therapy, etherapy, e-counselling, computerised cognitive behavioural therapy and electronic cognitive behavioural therapy [2]

  • This paper aims to (a) appraise the perception towards online therapy from the therapist perspective (Aim 1) and offer suggestions for future therapeutic practice (Aim 2) through qualitative investigation, (b) discuss how working clients can benefit from online therapy (Aim 3)

  • The demographic information of the nine participating therapists/counsellors is as follows: seven females and two males, age M = 44.5, SD = 9.8 years, a high level of experience in both providing and receiving therapy (M = 14.2, SD = 6.6 years), and complex theoretical and clinical differences given the variety of therapeutic modalities practised by each participant

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Summary

Introduction

Within the UK, the British Association for Counselling and Psychotherapy (BACP) recently published good practice guidance for therapeutic working online [1] Both developments underscore the rising interest in online therapy in the counselling and psychotherapy professions. They have paved the way for formal recognition of ‘telepsychology’, known internationally as online therapy, etherapy, e-counselling, computerised cognitive behavioural therapy (cCBT) and electronic cognitive behavioural therapy (eCBT) [2]. We acknowledge that this term can include other online and integrative therapeutic support types, including asynchronous (email) and synchronous (instant messaging) communication, alongside live video therapy.

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