Online therapies and the person-centered approach

This special issue came about in reponse to the coronavirus pandemic and the rapid shift (in April and May 2020) of psychotherapy, counseling, and other psychological therapies from face-to-face in person to face-to-face online. We were both interested in the impact of this, both as practitioners and as educators and academics. We were also interested in the interplay of online therapy and person-centered psychology, for instance, in how person-centered theory might help us understand different ‘reality’ (Rogers, 1978), as well as how person-centered practice and practitioners might be challenged by the mediation of the therapeutic relationship through and by online communication and platforms.

Keith was engaged with some colleagues in researching and writing about experiences of online therapy (Embleton Tudor et al., 2021; Ioane et al., 2021; Tudor et al., 2021), as well as the article that appears in this issue. In May 2020, Keith wrote to David, enquiring as to whether there were any plans for a special issue of PCEP on this subject; David said that there were none, but asked if Keith would be interested in proposing one; the rest, as they say, is history!

We are aware that, during the past 18 months, while this issue has been in planning and production, there has been an enormous amount of research conducted on and published about the experience and effects of online therapy. This has included a number of special issues of journals on the topic, though, as far as we are aware, only two in the field of psychotherapy, i.e. Group Dynamics (Parks, 2020), and the Journal for Psychotherapy Integration (Callaghan, 2020); and one in a journal that encompasses both psychotherapy and counseling, i.e. the Psychotherapy & Counseling Journal of Australia (Tudor & Price-Robertson, 2021).

The process of putting/pulling together this special issue has not been easy, and, not surprisingly, has reflected the many challenges faced by so many people in what is often referred to as the ‘new normal’: articles were promised but not submitted; other articles were submitted but very delayed; and many colleagues were less available to act as reviewers.We two also felt stretched and stressed: David was out of action for a while after contracting the COVID-19 virus; and, despite our best intentions, the special issue bumped into PCE2021, the conference of the World Association, for which Keith was the chair of the organizing committee. This and other other commitments and responsibilities meant that we did not always have the time we would have liked to have devoted to the issue; nvertheless, and with the support of the editorial team of the journal, we persevered. In the end, we are delighted to report that we had an embarrassment of riches and so, in addition to the the four articles and book review article in this issue, we also have a further three articles on this topic, which will be published in a special section of a future generic issue of the journal.

The first article in this special issue is by Brian Rodgers, Keith Tudor and Anton Ashcroft. The article provides the first detailed theoretical consideration for person-centered therapists as to how Rogers’ (1957, 1959) hypothesis of the six necessary and sufficient conditions is able to accommodate the implications of online psychotherapy. Each condition is considered in the context of working online and both the opportunities and challenges of working online are unpacked. The authors provide (David says) an excellent insight into the potential for online person-centered therapy and one that comes at a very important time for the profession and our person-centered and experiential (PCE) discipline. As the pandemic continues and the variants of COVID-19 multiply, the new normal is online therapy; and more and more therapists are offering and will need to offer this form of therapy. For those of us who identify as PCE therapists and who are committed to developing PCE therapies, this paper provides the theoretical basis for a contemporary, person-centered relational therapy, and offers a stimulus for further research.

The second article in the issue, by Kendell Banack, concerns emotion-focused therapy (EFT). As the author herself acknowledges, EFT emphasizes the present, attuned, therapeutic relationship as an – if not, the – essential component of therapy. In this context, she reports on her experience of delivering EFT as a tele-therapy, virtually, and in a way that is still deeply connected with clients and that fosters experiencing – with certain adaptations. These are: setting the stage; intentionally creating space for transitions; adjusting enactments; and bringing special focus to therapeutic presence. We think that this article itself ‘sets the stage’ for online EFT, and, we hope, will foster further work and research in this tribe or strand of the person-centered nation.

The third article, by Kate Dunn and John Wilson, invites us to take a step back to consider online therapy as a form of therapy ‘at a distance’ which has a number of historical antecedents (including letter writing and telephone counseling/therapy). The authors summarize this history and note certain advantages to this form of therapy, notably its inclusiveness. The article acknowledges the influence of different theoretical/therapeutic orientations on assessment, contracting, therapeutic relating (which they link to attachment theory), and experiencing presence in online space(s). The authors also usefully discuss how these ideas can be implemented in practice and offer a model of additional assessment for hybrid or blended approaches that includes asking clients about their experience of communication and connection during the pandemic – which implicitly references Rogers’ first condition of contact – and, finally, offer some thoughts about self-assessment for the therapist.

The fourth article, ‘Between the tiles … ’, by Krista Susman, takes as its central image the ‘tiles’ or small windows that represent the person on screen, and discusses the ‘inbetween’. The author discusses the nature of video-platforms, which were originally set up to serve business purposes, not the purposes of personal growth and therapy, and argues that we – therapists – need to ‘appropriate’ these platforms in order to support ‘collaborative, relational and co-creative spaces, including the person-centered approach’. (p. 327) By means of the deft use of appropriate and powerful metaphors, the article offers a further step back to consider some of the broader implications of technology and therapy. These include: poor connection (‘You’re on mute’), encounter, disembodiment, bonding, channels (of communication), intimacy, transition, blur, the third, and the mirror. This is a rich, stimulating and challenging article which begins – and ends – with a plea to therapists to maintain and, indeed, expand our agency within the digital sphere, ‘whilst remaining aware of the larger socio-political challenges of the digital age, adamantly advocating for the irreplaceability of meeting in body’. (p. 327)

As we planned, adapted, and replanned this issue, and as we read more and became aware of more of the literature, we realized that we wanted to find a way of representing this wider field, so we asked Terry Hanley to provide a review of a number of publications on online therapy. He did so, kindly, promptly, and admirably. This review article that concludes this special issue is a substantial and informative contribution, and we are both most grateful to Terry for answering the call.

Finally, we hope that you, the reader, find this issue interesting and supportive of your practice and thinking. Stay safe and stay well.