Grappling with our therapeutic relationship and professional self-doubt during COVID-19: will we use video therapy again?

ABSTRACT

The social restrictions during the COVID-19 crisis led to many therapists providing therapy remotely, despite some therapists’ concerns regarding its efficacy, technical challenges and their ability to build a strong therapeutic relationship online. This survey study reports on the experiences of 141 therapists who transitioned to providing video therapy during the pandemic. Aspects of the therapeutic relationship (e.g. working alliance, real relationship), experienced anxiety and professional self-doubt, attitudes towards and intention of video therapy use in the future were assessed. Although therapists reported some anxiety and self-doubt, most felt that online sessions had a sufficient working alliance and a strong real relationship. Therapists with more online therapy experience, lower levels of self-doubt and anxiety, and those who experienced a strong online real relationship during the pandemic, or thought their patients viewed it positively, tended to be more accepting of video therapy. Therapists were largely undecided as to whether they planned to use video therapy in the future; however, those with prior video therapy experience were more likely to endorse future utilization. Training is needed, especially for therapists with less online therapy experience, in order to foster a better experience and to support effective use of online therapy in the future.

KEYWORDS:

• Video therapy
• alliance
• real relationship
• professional self-doubt
• UTAUT
• COVID-19

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Katie Aafjes-van Doorn

Dr. Katie Aafjes-van Doorn is an Assistant Professor of Clinical Psychology at the Clinical Psychology Program of the Ferkauf Graduate School of Psychology, Yeshiva University, New York. She received a MSc in Clinical Psychology from the Vrije Universiteit in Amsterdam, The Netherlands, as well as a MSc in Psychological Research and a doctorate in Clinical Psychology from University of Oxford, United Kingdom. Over the years, she has worked clinically in different settings within the National Health Service, and most recently at a psychoanalytic community clinic in San Francisco. Dr. Aafjes-van Doorn completed a one-year postdoctoral research fellowship at the Derner Institute for Psychological Services, Adelphi University. Her research focuses on psychotherapy process in different modalities, therapist training and the use of technology by therapists and researchers. She is currently associate editor of the journal Clinical Psychology: Science & Practice.

Vera Békés

Vera Békés, PhD is an Assistant Professor of Clinical Psychology at Ferkuaf 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 is co-director of the Psychodynamic Track at Ferkauf Adult Clinical Doctoral Program, and teaches courses on psychodynamic psychotherapy, qualitative methods and multicultural issues. She is also a fellow at the American Psychoanalytic Association this year.

Tracy A. Prout

Tracy A. Prout, Ph.D. is Associate Professor of Psychology at the Ferkauf Graduate School of Psychology at Yeshiva University. She teaches psychodynamic psychotherapy in the School-Clinical Child Combined Doctoral Program, supervises advanced graduate students in the psychodynamic psychotherapy practicum, and leads the psychodynamic psychotherapy lab at Ferkauf. She earned a certificate in psychodynamic psychotherapy from the Institute for Psychoanalytic Education at NYU Medical Center. She serves as co-chair of the Fellowship Committee of the American Psychoanalytic Association and the Research Committee of Division 39.