JMIR Publications

ABSTRACT

Background:

During the COVID-19 pandemic, people are being encouraged to maintain social distance. Technology is helping people to reschedule meetings as remote videoconferencing sessions rather than “face-to-face" interactions. Psychologists are in high demand, due to an increase in stress as a result of COVID and videoconferencing provides an opportunity for mental health clinicians to treat current and new referrals. However, shifting treatment from face-to-face to videoconferencing is not simple: both psychologists and clients miss the in-person information cues including body language.

Objective:

A new theoretical framework is proposed to guide the design of future studies examining the impact of the computer as a mediator of psychologist-client relationships, and the influence of videoconferencing on the relationship process.

Methods:

We conducted a literature review including studies focused on communication and key concepts of the therapeutic relationship and alliance.

Results:

Studies have reported that clients are generally satisfied with videoconference therapy in terms of the relationship with their therapists and the establishment of the “therapeutic alliance”. Conversely, studies indicate that psychologists continue to highlight difficulties in establishing the same quality of therapeutic relationship and therapeutic alliance. The contrasting experiences might underline the differences on the type of emotional and cognitive work required of both actors in any therapy session; furthermore, the computer seems to take part to their interaction not only as a vehicle to transmit messages but also as an active part of the communication. A new model of interaction and relationship is proposed, taking into account the presence of the computer, along with further hypotheses.

Conclusions:

It is important to consider the computer as having an active role in the client-psychologist relationship; thus, the computer is a third party to the communication that either assists with or interferes in the interaction between psychologists and clients.