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

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.

KEYWORDS:

• Telepsychotherapy
• eye contact
• gaze angle
• camera framing
• zoom
• psychological distance

Acknowledgments

This project was funded by a research grant from Natural Sciences and Engineering Research Council of Canada (Award number: RGPIN 341631-2013).

F.G. is the recipient of a graduate scholarship from the Social Sciences and Humanities Research Council (SSHRC) of Canada and from the Fonds de recherche du Québec – Nature et technologies (FRQNT). The authors would also like to thank Geneviève Belleville, Stéphane Bouchard, Marc-Antoine Linteau, Laetitia Reduron, and Vincent Poiré for their help and their comments on the project.

Disclosure statement

No potential conflict of interest was reported by the authors.

Prior dissemination

These results were not presented elsewhere prior to the submission.

Additional information

Funding

This work was supported by the Natural Sciences and Engineering Research Council of Canada [RGPIN 341631-2013].

Notes on contributors

F. Grondin

F. Grondin is a graduate student in psychology at Université Laval in Quebec City, Canada. In the context of his thesis, he investigates whether empathy is expressed and perceived in the same way when conducting teletherapy through videoconferencing compared to traditional, in-person modalities. Additionally, he is interested in how interacting in cyberspace by means of restricted communication channels impacts how we perceive and reach out to each other. Ultimately, his research aims to identify how empathy can be fostered when therapists and clients do not share the same physical space. [email protected]

A. M. Lomanowska

Dr. Anna Lomanowska is a researcher in psychology and neuroscience. She is the director of the Digital Well-Being Lab and former Assistant Professor of Psychology at the University of Toronto Mississauga and Laval University, Canada. Her research focuses on understanding how digital technologies can be used to foster positive social engagement and interpersonal well-being. Currently acting as Director of Research Partnerships at the Digital Wellness Collective, Anna applies research-informed insights on the influence of technology on human behavior and well-being to a broader audience through knowledge translation and education. [email protected]

V. Békés

Dr. V. Békés is an Assistant Professor of Clinical Psychology at Ferkauf Graduate School of Psychology, Yeshiva University, New York. Her research focuses on trauma and PTSD and the psychotherapy process in various settings, including online interventions. She is especially interested in the role of therapeutic relationship in symptom improvement.She studied clinical psychology at ELTE University in Budapest, and received her clinical psychologist training, as well as her PhD at University of Pécs, Hungary. After her postdoctoral fellowships at McGill University and Université du Québec à Montréal, she continued working at McGill University as Research Associate at the Psychiatry Department, Faculty of Medicine prior to joining the faculty of Ferkauf Graduate School of Psychology. Dr. Békés has gained clinical experience at the psychiatric wards of the Jewish General Hospital in Montreal and Kutvolgyi Hospital in Budapest, and in her private practice. [email protected]

P. L. Jackson

P. L. Jackson, Ph.D., is a professor at the School of Psychology at Université Laval, researcher at CIRRIS and CERVO research centers and member of the College of New Scholars, Artists and Scientists of the Royal Society of Canada. He is co-lead of research at the International Observatory on the Societal Impacts of AI and Digital Technology (OBVIA). Professor Jackson is head of the Cognitive and Social Neuroscience Lab dedicated to the study of human empathy rom a multidisciplinary perspective and using the latest technology in brain imaging, non-invasive brain stimulation and virtual reality. [email protected]