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. 2020 Nov 27;22(11):e20246.
doi: 10.2196/20246.

Experiences of Psychotherapists With Remote Psychotherapy During the COVID-19 Pandemic: Cross-sectional Web-Based Survey Study

Elke Humer  1 , Peter Stippl  2 , Christoph Pieh  1 , Rüdiger Pryss  3 , Thomas Probst  1
Affiliations

Experiences of Psychotherapists With Remote Psychotherapy During the COVID-19 Pandemic: Cross-sectional Web-Based Survey Study

Elke Humer et al. J Med Internet Res. .

Abstract

Background: The current situation around the COVID-19 pandemic and the measures necessary to fight it are creating challenges for psychotherapists, who usually treat patients face-to-face with personal contact. The pandemic is accelerating the use of remote psychotherapy (ie, psychotherapy provided via telephone or the internet). However, some psychotherapists have expressed reservations regarding remote psychotherapy. As psychotherapists are the individuals who determine the frequency of use of remote psychotherapy, the potential of enabling mental health care during the COVID-19 pandemic in line with the protective measures to fight COVID-19 can be realized only if psychotherapists are willing to use remote psychotherapy.

Objective: This study aimed to investigate the experiences of psychotherapists with remote psychotherapy in the first weeks of the COVID-19 lockdown in Austria (between March 24 and April 1, 2020).

Methods: Austrian psychotherapists were invited to take part in a web-based survey. The therapeutic orientations of the psychotherapists (behavioral, humanistic, psychodynamic, or systemic), their rating of the comparability of remote psychotherapy (web- or telephone-based) with face-to-face psychotherapy involving personal contact, and potential discrepancies between their actual experiences and previous expectations with remote psychotherapy were assessed. Data from 1162 psychotherapists practicing before and during the COVID-19 lockdown were analyzed.

Results: Psychotherapy conducted via telephone or the internet was reported to not be totally comparable to psychotherapy with personal contact (P<.001). Psychodynamic (P=.001) and humanistic (P=.005) therapists reported a higher comparability of telephone-based psychotherapy to in-person psychotherapy than behavioral therapists. Experiences with remote therapy (both web- and telephone-based) were more positive than previously expected (P<.001). Psychodynamic therapists reported more positive experiences with telephone-based psychotherapy than expected compared to behavioral (P=.03) and systemic (P=.002) therapists. In general, web-based psychotherapy was rated more positively (regarding comparability to psychotherapy with personal contact and experiences vs expectations) than telephone-based psychotherapy (P<.001); however, psychodynamic therapists reported their previous expectations to be equal to their actual experiences for both telephone- and web-based psychotherapy.

Conclusions: Psychotherapists found their experiences with remote psychotherapy (ie, web- or telephone-based psychotherapy) to be better than expected but found that this mode was not totally comparable to face-to-face psychotherapy with personal contact. Especially, behavioral therapists were found to rate telephone-based psychotherapy less favorably than therapists with other theoretical backgrounds.

Keywords: COVID-19; expectations; experiences; internet; psychology; psychotherapists; remote psychotherapy; telehealth; telephone; therapy.

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Conflict of interest statement

Conflicts of Interest: None declared.

References

    1. Grady B, Myers K, Nelson EL, Belz NLL, Bennett L, Carnahan L, Decker VB, Holden D, Perry G, Rosenthal L, Rowe N, Spaulding R, Turvey CL, White R, Voyles D, American Telemedicine Association Telemental Health Standards and Guidelines Working Group Evidence-based practice for telemental health. Telemed J E Health. 2011 Mar;17(2):131–48. doi: 10.1089/tmj.2010.0158. - DOI - PubMed
    1. Connolly SL, Miller CJ, Lindsay JA, Bauer MS. A systematic review of providers’ attitudes toward telemental health via videoconferencing. Clin Psychol Sci Pract. 2020 Jan 06;27(2):e12311. doi: 10.1111/cpsp.12311. - DOI - PMC - PubMed
    1. Fletcher TL, Hogan JB, Keegan F, Davis ML, Wassef M, Day S, Lindsay JA. Recent Advances in Delivering Mental Health Treatment via Video to Home. Curr Psychiatry Rep. 2018 Jul 21;20(8):56. doi: 10.1007/s11920-018-0922-y. - DOI - PubMed
    1. Wright J, Caudill R. Remote Treatment Delivery in Response to the COVID-19 Pandemic. Psychother Psychosom. 2020 Mar 26;89(3):130–132. doi: 10.1159/000507376. https://www.karger.com?DOI=10.1159/000507376 - DOI - PMC - PubMed
    1. Nussbaumer-Streit B, Mayr V, Dobrescu AJ, Chapman A, Persad E, Klerings I, Wagner G, Siebert U, Christof C, Zachariah C, Gartlehner G. Quarantine alone or in combination with other public health measures to control COVID-19: a rapid review. Cochrane Database Syst Rev. 2020 Apr 08;4:CD013574. doi: 10.1002/14651858.CD013574. - DOI - PMC - PubMed