1,303
Views
5
CrossRef citations to date
0
Altmetric
EMPIRICAL PAPERS

Therapists' perception of the working alliance, real relationship and therapeutic presence in in-person therapy versus tele-therapy

ORCID Icon, ORCID Icon, & ORCID Icon
Pages 574-588 | Received 07 Sep 2022, Accepted 14 Mar 2023, Published online: 03 Apr 2023

References

  • Aafjes-van Doorn, K. (2022). The complexity of teletherapy: Not better or worse, but different. Clinical Psychology: Science and Practice, Advance Online Publication, https://doi.org/10.1037/cps0000073
  • Aafjes-van Doorn, K., Békés, V., & Luo, X. (2021). COVID-19 related traumatic distress in psychotherapy patients during the pandemic: The role of attachment, working alliance, and therapeutic agency. Brain Sciences, 11(10), 1288. https://doi.org/10.3390/brainsci11101288
  • Aafjes-van Doorn, K., Békés, V., & Prout, T. A. (2020). Grappling with our therapeutic relationship and professional self-doubt during COVID-19: Will we use video therapy again? Counselling Psychology Quarterly, 1–12. https://doi.org/10.1080/09515070.2020.1773404
  • Aafjes-van Doorn, K., Békés, V., Prout, T. A., & Hoffman, L. (2020). Psychotherapists’ vicarious traumatization during the COVID-19 pandemic. Psychological Trauma: Theory, Research, Practice, and Policy, 12(S1), S148–S150. https://doi.org/10.1037/tra0000868
  • Alvandi̇, E. O. (2019). Cybertherapogy: A conceptual architecting of presence for counselling via technology. International Journal of Psychology and Educational Studies, 6(1), 30–45. https://doi.org/10.17220/ijpes.2019.01.004
  • Békés, V., Aafjes-van Doorn, K., Luo, X., Prout, T. A., & Hoffman, L. (2021). Psychotherapists’ challenges with online therapy during COVID-19: Concerns about connectedness predict therapists’ negative view of online therapy and its perceived efficacy over time. Frontiers in Psychology, 12, 3036. https://doi.org/10.3389/fpsyg.2021.705699.
  • Békés, V., Aafjes-van Doorn, K., Prout, T. A., & Hoffman, L. (2020). Stretching the analytic frame: Analytic therapists’ experiences with remote therapy during COVID-19. Journal of the American Psychoanalytic Association, 68(3), 437–446. https://doi.org/10.1177/0003065120939298
  • Békés, V., Aafjes-van Doorn, K., Roberts, K., Prout, T., & Hoffman, L. (2023). Adjusting to a new reality: Consensual qualitative research on therapists’ experiences with telepsychotherapy. Journal of Clinical Psychology. https://doi.org/10.1002/jclp.23477
  • Berger, T. (2017). The therapeutic alliance in internet interventions: A narrative review and suggestions for future research. Psychotherapy Research, 27(5), 511–524. https://doi.org/10.1080/10503307.2015.1119908
  • Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research & Practice, 16(3), 252–260. https://doi.org/10.1037/h0085885
  • Borenstein, L. (2022). Imagination and play in teletherapy with children. American Journal of Play, 14(1), 13–32. https://files.eric.ed.gov/fulltext/EJ1357954.pdf
  • Boswell, J. F., Sharpless, B. A., Greenberg, L. S., Heatherington, L., Huppert, J. D., Barber, J. P., … & Castonguay, L. G. (2010). Schools of psychotherapy and the beginnings of a scientific approach. In The Oxford handbook of clinical psychology (pp. 98–127). Oxford.
  • Bouchard, S., Dumoulin, S., Michaud, M., & Gougeon, V. (2011). Telepresence experienced in videoconference varies according to emotions involved in videoconference sessions. Studies in Health Technology and Informatics, 167, 128–132. https://www.researchgate.net/profile/Brenda-Wiederhold/publication/316495448_Annual_Review_of_CyberTherapy_and_Telemedicine_Evidence-Based_Clinical_Applications_of_Information_Technology/links/590a531aaca272f6580b6f6c/Annual-Review-of-CyberTherapy-and-Telemedicine-Evidence-Based-Clinical-Applications-of-Information-Technology.pdf#page=116
  • Boydell, K. M., Hodgins, M., Pignatiello, A., Teshima, J., Edwards, H., & Willis, D. (2014). Using technology to deliver mental health services to children and youth: A scoping review. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 23(2), 87–99. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4032077/pdf/ccap_23_p0087.pdf
  • Burgoyne, N., & Cohn, A. S. (2020). Lessons from the transition to relational teletherapy during COVID-19. Family Process, 59(3), 974–988. https://doi.org/10.1111/famp.12589
  • Cataldo, F., Chang, S., Mendoza, A., & Buchanan, G. (2021). A perspective on client-psychologist relationships in videoconferencing psychotherapy: Literature review. JMIR Mental Health, 8(2), e19004. https://doi.org/10.2196/19004
  • Fisher, H., Rafaeli, E., Bar-Kalifa, E., Barber, J. P., Solomonov, N., Peri, T., & Atzil-Slonim, D. (2020). Therapists’ interventions as a predictor of clients’ emotional experience, self-understanding, and treatment outcomes. Journal of Counseling Psychology, 67(1), 66–78. https://doi.org/10.1037/cou0000377
  • Flückiger, C., Del Re, A. C., Wampold, B. E., & Horvath, A. O. (2018). The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 55(4), 316–340. https://doi.org/10.1037/pst0000172
  • Geller, S. (2021). Cultivating online therapeutic presence: Strengthening therapeutic relationships in teletherapy sessions. Counselling Psychology Quarterly, 34(3–4), 687–703. https://doi.org/10.1080/09515070.2020.1787348
  • Geller, S. M. (2017). A practical guide to cultivating therapeutic presence (pp. xiii, 263). American Psychological Association. https://doi.org/10.1037/0000025-000
  • Geller, S. M. (2019). Therapeutic presence: The foundation for effective emotion-focused therapy. In Clinical handbook of emotion-focused therapy (pp. 129–145). American Psychological Association. https://doi.org/10.1037/0000112-006
  • Geller, S. M., & Greenberg, L. S. (2002). Therapeutic presence: Therapists’ experience of presence in the psychotherapy encounter. Person-Centered & Experiential Psychotherapies, 1(1–2), 71–86. https://doi.org/10.1080/14779757.2002.9688279
  • Geller, S. M., & Greenberg, L. S. (2012). Therapeutic presence: A mindful approach to effective therapy (pp. vi, 304). American Psychological Association. https://doi.org/10.1037/13485-000
  • Geller, S. M., Greenberg, L. S., & Watson, J. C. (2010). Therapist and client perceptions of therapeutic presence: The development of a measure. Psychotherapy Research, 20(5), 599–610. https://doi.org/10.1080/10503307.2010.495957
  • Geller, S. M., & Porges, S. W. (2014). Therapeutic presence: Neurophysiological mechanisms mediating feeling safe in therapeutic relationships. Journal of Psychotherapy Integration, 24(3), 178–192. https://doi.org/10.1037/a0037511
  • Gelso, C. (2014). A tripartite model of the therapeutic relationship: Theory, research, and practice. Psychotherapy Research, 24(2), 117–131. https://doi.org/10.1080/10503307.2013.845920
  • Gelso, C. J. (2002). Real relationship: The “something more” of psychotherapy. Journal of Contemporary Psychotherapy, 32(1), 35–40. https://doi.org/10.1023/A:1015531228504
  • Gelso, C. J., Kelley, F. A., Fuertes, J. N., Marmarosh, C., Holmes, S. E., Costa, C., & Hancock, G. R. (2005). Measuring the real relationship in psychotherapy: Initial validation of the therapist form. Journal of Counseling Psychology, 52(4), 640–649. https://doi.org/10.1037/0022-0167.52.4.640
  • Gelso, C. J., Kivlighan, D. M., Jr., & Markin, R. D. (2018). The real relationship and its role in psychotherapy outcome: A meta-analysis. Psychotherapy, 55(4), 434–444. https://doi.org/10.1037/pst0000183
  • Haddouk, L., Bouchard, S., Brivio, E., Galimberti, C., & Trognon, A. (2018). Assessing presence in videconference telepsychotherapies: A complementary qualitative study on breaks in telepresence and intersubjectivity co-construction processes. Annual Review of CyberTherapy and Telemedicine, 16, 118–123. https://www.interactivemediainstitute.com/wordpress/wp-content/uploads/2019/04/ARCTT-16.pdf#page=138
  • Hatcher, R. L., & Gillaspy, J. A. (2006). Development and validation of a revised short version of the working alliance inventory. Psychotherapy Research, 16(1), 12–25. https://doi.org/10.1080/10503300500352500
  • Hayes, J., & Vinca, J. (2011). Therapist presence and its relationship to empathy, session, depth, and symptom reduction. Society for Psychotherapy Research.
  • Hayes, J. A., & Vinca, M. (2017). Therapist presence, absence, and extraordinary presence. In How and why are some therapists better than others?: Understanding therapist effects (pp. 85–99). American Psychological Association. https://doi.org/10.1037/0000034-006
  • Heiden-Rootes, K., Ferber, M., Meyer, D., Zubatsky, M., & Wittenborn, A. (2021). Relational teletherapy experiences of couple and family therapy trainees: “Reading the room,” exhaustion, and the comforts of home. Journal of Marital and Family Therapy, 47(2), 342–358. https://doi.org/10.1111/jmft.12486
  • Hilty, D. M., Randhawa, K., Maheu, M. M., McKean, A. J. S., & Pantera, R. (2019). Therapeutic relationship of telepsychiatry and telebehavioral health: Ideas from research on telepresence, virtual reality and augmented reality. Psychology and Cognitive Sciences – Open Journal, 5(1), 14–29. https://doi.org/10.17140/PCSOJ-5-145
  • Holmes, C., & Foster, V. (2012). A preliminary comparison study of online and face-to-face counseling: Client perceptions of three factors. Journal of Technology in Human Services, 30(1), 14–31. https://doi.org/10.1080/15228835.2012.662848
  • Kwok, E. Y. L., Pozniak, K., Cunningham, B. J., & Rosenbaum, P. (2022). Factors influencing the success of telepractice during the COVID-19 pandemic and preferences for post-pandemic services: An interview study with clinicians and parents. International Journal of Language & Communication Disorders, https://doi.org/10.1111/1460-6984.12760
  • Lin, T., Stone, S. J., Heckman, T. G., & Anderson, T. (2021). Zoom-in to zone-out: Therapists report less therapeutic skill in telepsychology versus face-to-face therapy during the COVID-19 pandemic. Psychotherapy, 58(4), 449–459. https://doi.org/10.1037/pst0000398
  • McCoyd, J. L. M., Curran, L., Candelario, E., & Findley, P. (2022). “There is just a different energy”: Changes in the therapeutic relationship with the telehealth transition. Clinical Social Work Journal, 50(3), 325–336. https://doi.org/10.1007/s10615-022-00844-0
  • Mearns, D., & Cooper, M. (2017). Working at relational depth in counselling and psychotherapy. SAGE.
  • Messina, I., & Loffler-Stastka, H. (2021). Psychotherapists’ perception of their clinical skills and in-session feelings in live therapy versus online therapy during the COVID-19 pandemic: A pilot study. Research in Psychotherapy: Psychopathology, Process and Outcome, 24(1), 514. https://doi.org/10.4081/ripppo.2021.514
  • Morland, L. A., Mackintosh, M.-A., Rosen, C. S., Willis, E., Resick, P., Chard, K., & Frueh, B. C. (2015). Telemedicine versus in-person delivery of cognitive processing therapy for women with posttraumatic stress disorder: A randomized noninferiority trial. Depression and Anxiety, 32(11), 811–820. https://doi.org/10.1002/da.22397
  • Norwood, C., Moghaddam, N. G., Malins, S., & Sabin-Farrell, R. (2018). Working alliance and outcome effectiveness in videoconferencing psychotherapy: A systematic review and noninferiority meta-analysis. Clinical Psychology & Psychotherapy, 25(6), 797–808. https://doi.org/10.1002/cpp.2315
  • Pierce, B. S., Perrin, P. B., Tyler, C. M., McKee, G. B., & Watson, J. D. (2021). The COVID-19 telepsychology revolution: A national study of pandemic-based changes in U.S. mental health care delivery. American Psychologist, 76(1), 14–25. https://doi.org/10.1037/amp0000722
  • Prasad, K., McLoughlin, C., Stillman, M., Poplau, S., Goelz, E., Taylor, S., Nankivil, N., Brown, R., Linzer, M., Cappelucci, K., Barbouche, M., & Sinsky, C. A. (2021). Prevalence and correlates of stress and burnout among U.S. healthcare workers during the COVID-19 pandemic: A national cross-sectional survey study. EClinicalMedicine, 35, 100879. https://doi.org/10.1016/j.eclinm.2021.100879
  • Probst, T., Haid, B., Schimböck, W., Reisinger, A., Gasser, M., Eichberger-Heckmann, H., Stippl, P., Jesser, A., Humer, E., Korecka, N., & Pieh, C. (2021). Therapeutic interventions in in-person and remote psychotherapy: Survey with psychotherapists and patients experiencing in-person and remote psychotherapy during COVID-19. Clinical Psychology & Psychotherapy, 28(4), 988–1000. https://doi.org/10.1002/cpp.2553
  • Rees, C. S., & Stone, S. (2005). Therapeutic alliance in face-to-face versus videoconferenced psychotherapy. Professional Psychology: Research and Practice, 36(6), 649–653. https://doi.org/10.1037/0735-7028.36.6.649
  • Reynolds, D. J., Stiles, W. B., Bailer, A. J., & Hughes, M. R. (2013). Impact of exchanges and client–therapist alliance in online-text psychotherapy. Cyberpsychology, Behavior, and Social Networking, 16(5), 370–377. https://doi.org/10.1089/cyber.2012.0195
  • Richards, P., Simpson, S., Bastiampillai, T., Pietrabissa, G., & Castelnuovo, G. (2018). The impact of technology on therapeutic alliance and engagement in psychotherapy: The therapist’s perspective. Clinical Psychologist, 22(2), 171–181. https://doi.org/10.1111/cp.12102
  • Rotger, J. M., & Cabré, V. (2022). Therapeutic alliance in online and face-to-face psychological treatment: Comparative study. JMIR Mental Health, 9(5), e36775. https://doi.org/10.2196/36775
  • Ruble, A. E., Romanowicz, M., Bhatt-Mackin, S., Topor, D., & Murray, A. (2021). Teaching the fundamentals of remote psychotherapy to psychiatry residents in the COVID-19 pandemic. Academic Psychiatry, 45(5), 629–635. https://doi.org/10.1007/s40596-021-01484-1
  • Sheperis, D., & Smith, A. (2021). Telehealth best practice: A call for standards of care. Journal of Technology in Counselor Education and Supervision, 1(1), https://doi.org/10.22371/tces/0004
  • Shklarski, L., Abrams, A., & Bakst, E. (2021). Will we ever again conduct in-person psychotherapy sessions? Factors associated with the decision to provide in-person therapy in the age of COVID-19. Journal of Contemporary Psychotherapy, 51(3), 265–272. https://doi.org/10.1007/s10879-021-09492-w
  • Simpson, S. G., & Reid, C. L. (2014). Therapeutic alliance in videoconferencing psychotherapy: A review. Australian Journal of Rural Health, 22(6), 280–299. https://doi.org/10.1111/ajr.12149
  • Smith, K., Moller, N., Cooper, M., Gabriel, L., Roddy, J., & Sheehy, R. (2022). Video counselling and psychotherapy: A critical commentary on the evidence base. Counselling and Psychotherapy Research, 22(1), 92–97. https://doi.org/10.1002/capr.12436
  • Solomonov, N., McCarthy, K. S., Gorman, B. S., & Barber, J. P. (2019). The multitheoretical list of therapeutic interventions – 30 items (MULTI-30). Psychotherapy Research, 29(5), 565–580. https://doi.org/10.1080/10503307.2017.1422216
  • Stubbings, D. R., Rees, C. S., Roberts, L. D., & Kane, R. T. (2013). Comparing in-person to videoconference-based cognitive behavioral therapy for mood and anxiety disorders: Randomized controlled trial. Journal of Medical Internet Research, 15(11), e258. https://doi.org/10.2196/jmir.2564
  • Thompson, G. (2018). Brain-empowered collaborators: Polyvagal perspectives on the doctor-patient relationships. In S. Porges & D. Dana (Eds.), Clinical applications of the polyvagal theory: The emergence of polyvagal-informed therapies (pp. 127–148). W.W. Norton & Company.
  • Thompson-de Benoit, A., & Kramer, U. (2021). Work with emotions in remote psychotherapy in the time of Covid-19: A clinical experience. Counselling Psychology Quarterly, 34(3–4), 368–376. https://doi.org/10.1080/09515070.2020.1770696
  • Udwin, S., Kufferath-Lin, T., Prout, T. A., Hoffman, L., & Rice, T. (2021). Little girl, big feelings: Online child psychotherapy during the COVID-19 pandemic. Journal of Infant, Child, and Adolescent Psychotherapy, 20(4), 354–371. https://doi.org/10.1080/15289168.2021.1999158
  • Van Daele, T., Karekla, M., Kassianos, A. P., Compare, A., Haddouk, L., Salgado, J., Ebert, D. D., Trebbi, G., Bernaerts, S., Van Assche, E., & De Witte, N. A. J. (2020). Recommendations for policy and practice of telepsychotherapy and e-mental health in Europe and beyond. Journal of Psychotherapy Integration, 30(2), 160–173. https://doi.org/10.1037/int0000218
  • Watts, S., Marchand, A., Bouchard, S., Gosselin, P., Langlois, F., Belleville, G., & Dugas, M. J. (2020). Telepsychotherapy for generalized anxiety disorder: Impact on the working alliance. Journal of Psychotherapy Integration, 30(2), 208–225. https://doi.org/10.1037/int0000223
  • Yellowlees, P., & Nafiz, N. (2010). The psychiatrist-patient relationship of the future: Anytime, anywhere? Harvard Review of Psychiatry, 18(2), 96–102. https://doi.org/10.3109/10673221003683952

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.