Therapists' Perspectives on Changes in the Therapeutic Relationship after Switching from in-Person to Online Video Therapy Due to Corona: A Qualitative Analysis

Abstract

The aim of this study was to investigate the extent to which the therapeutic relationship changed as a result of the COVID-19-related switch from face-to-face to video therapy. Twenty-one psychotherapists, who had changed the setting of therapy from face-to-face to video therapy were interviewed. The interviews were then transcribed, coded and superordinate themes were created in the context of a qualitative analysis. More than half of the therapists reported that the therapeutic relationship with their patients remained stable. In addition, the majority of therapists described uncertainties in dealing with and responding to non-verbal signals, as well as maintaining an appropriate distance to their patients. Overall, both an improvement and a deterioration of the therapeutic relationship was reported. The stability of the therapeutic relationship was mainly attributed to the therapists' previous face-to-face contact with their patients. The uncertainties expressed could be interpreted as risk factors for the therapeutic relationship. Although the sample represented only a small portion of working therapists, the findings from this study represent an important milestone in understanding how psychotherapy has changed as a result of the COVID-19 pandemic. The therapeutic relationship remained stable despite the change from face-to-face to video therapy.