JMIR Publications

ABSTRACT

Background:

The current situation around the novel coronavirus disease (COVID-19) and the measures necessary to fight it are a challenge for psychotherapists, who usually treat face-to-face in personal contact. This situation accelerates the use of remote psychotherapy, i.e. psychotherapy provided via telephone or internet. However, some reservations against remote psychotherapy have been shown in psychotherapists. As psychotherapists are the individuals who determine the frequency of use of remote psychotherapy, the potential of enabling mental health care during COVID-19 in line with the protective measures to fight COVID-19 can be realized only if psychotherapists are willing to utilize remote psychotherapy.

Objective:

The aim of this study was to investigate experiences with remote psychotherapy in the first weeks of the COVID-19 lockdown in Austria (between March 24th and April 1st, 2020)

Methods:

Austrian psychotherapists were invited to take part in an online survey. The therapeutic orientation (behavioral, humanistic, psychodynamic, systemic), the rating regarding comparability of remote psychotherapy (internet, telephone) with face-to-face psychotherapy in personal contact, as well as a potential discrepancy between actual experiences and previous expectations with remote psychotherapy were assessed. Data of 1,162 psychotherapists practicing before as well as in the COVID-19 lockdown were analyzed.

Results:

Psychotherapy conducted via telephone or internet was reported not to be totally comparable to psychotherapy in personal contact (P < .001). Lowest comparability for psychotherapy via telephone was reported by behavioral psychotherapists, while the highest ratings were reported by psychodynamic and humanistic therapists (P = .001). Irrespective of therapeutic orientation, a more positive experience with remote therapy (internet as well as telephone) compared to previous expectations was observed (P < .001). However, psychodynamic therapists reported a more positive actual experiences for psychotherapy via telephone than expected previously, compared to behavioral and systemic therapists (P = .001). For therapy conducted via internet the therapeutic orientation neither affected the rating regarding comparability to psychotherapy in personal contact, nor the rating regarding the discrepancy in experiences with expectations. Psychotherapy via internet was rated to be more comparable to psychotherapy in personal contact than psychotherapy via telephone (P < .001). The more positive actual experiences than previous expectations with remote psychotherapy were more pronounced for psychotherapy via internet as compared to psychotherapy via telephone (P < .001); however, this discrepancy of expectations vs. experiences between psychotherapy via telephone and internet did not reach significance in psychodynamic therapists.

Conclusions:

Psychotherapists experienced remote psychotherapy (i.e., psychotherapy via internet) better than expected, but not totally comparable to face-to-face psychotherapy in personal contact. Especially behavioral therapists were found to rate psychotherapy via telephone less favorable than therapist with other theoretical backgrounds.