JMIR Publications

ABSTRACT

Background:

The SARS-CoV-2 pandemic caused a surge in the usage of Telehealth Platforms. Psychologists have shifted from face-to-face to Videoconference sessions. As a result, essential information easily obtainable via in-person sessions may be missing. Consequently, the therapeutic work could be compromised.

Objective:

This research aimed to explore the Videoconference Psychotherapy (VCP) experiences of psychologists around the world. Furthermore, we aimed to identify technological features that might enhance psychologists’ therapeutic work through augmented VCP.

Methods:

Psychologists across the world (7 from Australia, 1 from England, 5 from Italy, 1 from Mexico, 1 from Spain and 2 from US) were interviewed. We used thematic analysis to examine the data collected from a sample of seventeen (17) psychologists. We applied Chaos theory to interpret the system dynamics and collected details on the challenges posed by VCP. For defining further information on the technology and the processes involved, we relied on the Input-Process-Output model.

Results:

The analysis resulted in the generation of nine (9) themes (Input themes: psychologists’ attitude, trusting reinforcing features, reducing cognitive load, enhancing emotional communication, engaging features between psychologists and patients; Process themes: building and reinforcing trust, decreasing cognitive load, enhancing emotional communication, increased psychologist-patient engagement) and nineteen (19) sub-themes. Psychologists found new strategies to deal with VCP limitations but also reported the need for more technical control to facilitate therapeutic processes. The suggested technologies (eye contact functionality, emergency call functionality, screen control functionality, interactive interface with other apps and software, and zooming in/out functionality) could enhance presence and the dynamic nature of the therapeutic relationship.

Conclusions:

Therapists expressed a desire for enhanced control of videoconferencing psychotherapy sessions. Therapists reported a decreased sense of control within the therapeutic relationship due to the influence of the VCP system. Greater control of the VCP system could better approximate critical elements of in-person psychotherapy (e.g., observation of body language). To facilitate improved control, psychologists would like technology to implement features such as improved eye contact, better screen control, emergency call functionality, ability to zoom in/out, and an interactive interface to communicate with other apps. These results contribute to the general perception of the computer as an actual part of the VCP process. Thus, the computer plays a key role in the communication, rather than remaining a technical medium. By adopting the IPO model in the VCP environment (VCP-IPO model), the relationship experience might help therapists have more control in their VCP sessions.