Let’s face it: video conferencing psychotherapy requires the extensive use of ostensive cues

ABSTRACT

The COVID-19 crisis has required many therapists to switch to video conferencing psychotherapy (VCP). Knowledge about the importance of epistemic trust and its determinants has been accumulating over the last few years, with important implications for psychotherapy and specific significance for the transition to VCP. The present paper provides a brief background on the concept of epistemic trust, research on the determinants of its development and the integrative framework it provides for some traditional concepts in psychotherapy, such as the therapeutic alliance. In particular, research on ostensive cuing, which requires significant modification in a remote delivery context, has important implications in the transition to VCP. We will advance some suggestions while illustrating the ideas with clinical case studies. This knowledge may be of value to psychotherapists, who are required to make substantial changes in the nature of the encounter with their patients, and may help them identify benefits and hindrances that might arise from this transition, as well as pointing out techniques that may encourage effective adaptation to the change.

KEYWORDS:

• Epistemic trust
• video conferencing psychotherapy
• Covid-19
• ostensive cues

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Israeli Science Foundation [186/15].

Notes on contributors

Shimrit Fisher

Shimrit Fisher is a Ph.d student and a licensed clinical psychologist. Shimrit`s research focuses on mentalization, attachment and epistemic trust. She worked for several years as a psychologist in the forensic ward of the Sha'ar Menashe Mental Health Center and currently has a private clinic for the treatment of children, adolescents and adults. She is a psychodynamic therapist and has received specialized training in Mentalization-based therapy from the Anna Freud Center in London. For the past few years, she has been a junior lecturer of psychodiagnostics, statistics and research methods and clinical field experience courses.

Timur Guralnik

Timur Guralnik is a B.A. Psychology student in Haifa University. Timur is part of the Case Manager team, whose responsibility is working with the patients and gathering data through questionaires. Outside of the university, Timur works at an organization that provides services to people on the autistic spectrum.

Peter Fonagy

Peter Fonagy, PhD, FMedSci, FBA, FAcSS, OBE, is Professor of Contemporary Psychoanalysis and Developmental Science and Head of the Division of Psychology and Language Sciences at UCL; Chief Executive of the Anna Freud National Centre for Children and Families, London; Consultant to the Child and Family Program at the Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine, Houston; and holds visiting professorships at Yale and Harvard Medical Schools. His clinical and research interests centre on issues of early attachment relationships, social cognition, borderline personality disorder and violence. A major focus of his contribution has been an innovative research-based psychodynamic therapeutic approach, mentalization-based treatment, which was developed in collaboration with a number of clinical sites in the UK and USA. He has published over 550 scientific papers and 250 chapters, and has authored or co-authored 19 books.

Sigal Zilcha-Mano

Dr. Sigal Zilcha-Mano is an Associate Professor of Clinical Psychology and heads the Psychotherapy Research Lab in the Department of Psychology, University of Haifa. She is Associate Editor of the Journal of Counseling Psychology, and on the editorial board of Journal of Consulting and Clinical Psychology, Journal of Clinical Psychology, Psychotherapy, and Psychotherapy Research. She is a licensed clinical psychologist.Dr. Zilcha-Mano is the recipient of several career awards, including the International Society for Psychotherapy Research Outstanding Early Career Achievement Award, the American Psychological Foundation’s 2019 Division 29 Early Career Award, the International Society for the Exploration of Psychotherapy Integration New Researcher Award, and the Dusty and Ettie Miller Fellowship for Outstanding Young Scholars. She has received many research grants to support her work, including three research and equipment grants from the Israel Science Foundation, the U.S.-Israel Binational Science Foundation Grant (BSF), the JOY Ventures: Innovative Nero Wellness Grant, the MIT-Israel Zuckerman Award, the Society of Psychotherapy Research Grant, the Norine Johnson Psychotherapy Research Early Career Grant, Society for the Advancement of Psychotherapy, APA, and the Charles J. Gelso Grant, Society for the Advancement of Psychotherapy, APA. Dr. Zilcha-Mano has published over 85 peer reviewed papers in the past 6 years focusing on psychotherapy research and precision medicine in leading journals in these fields.