Werbart Andrzej, Byléhn Linda, Jansson Tuva Maja, Philips Björn
Department of Psychology, Stockholm University, Stockholm, Sweden.
Front Psychol. 2022 Mar 24;13:835214. doi: 10.3389/fpsyg.2022.835214. eCollection 2022.
Telepsychotherapy is an increasingly common way of conducting psychotherapy. Previous research has shown that patients usually have positive experiences of online therapy, however, with large individual differences. The aim of this study was to explore patients' experiences of transition from in-person psychotherapy sessions to telepsychotherapy during the COVID-19 pandemic, as well as variation in the experiences with regard to the patients' personality orientation. Seven psychotherapy patients in Sweden were interviewed and the transcripts were analyzed using thematic analysis. Additionally, the participants were asked to rate their dissatisfaction/satisfaction with the transition, how hindering/helpful the transition was, and how unsafe/safe they felt after the transition in comparison to before. Personality orientation on relatedness or self-definition was assessed applying a self-assessment instrument (Prototype Matching of Anaclitic-Introjective Personality Configuration; PMAI). The participants experienced telepsychotherapy as qualitatively different from in-person psychotherapy. They reported several essential losses: the rituals surrounding therapy sessions were lost, including the transitional time and space between their every-day life and the therapy sessions, less therapeutic work was done, the therapists could lose their therapeutic stance, the sense of rapport was impaired, and the patients felt less open and emotionally available. On the other hand, some patients could feel freer online. As six of the participants had an anaclitic personality orientation, the present study could especially contribute to the understanding of how patients with strong affiliative needs and fear of abandonment experience the transition to meeting their therapists communication technology. The participants' self-ratings showed that they were only marginally dissatisfied with the transition and experienced the transition as slightly hindering, whereas they felt rather safe after the transition, indicating low concordance between qualitative and quantitative evaluations. New studies are needed to explore the introjective patients' experiences of the transition. An essential topic is also to collect evidence and to test how the impaired sense of rapport when using communication technology can be remedied by adequate, patient-tailored interventions, a topic that has to be included in psychotherapy education and training.
远程心理治疗是进行心理治疗越来越常见的方式。先前的研究表明，患者通常对在线治疗有积极的体验，然而，个体差异很大。本研究的目的是探讨在新冠疫情期间患者从面对面心理治疗转向远程心理治疗的体验，以及患者人格取向方面体验的差异。对瑞典的7名心理治疗患者进行了访谈，并使用主题分析法对访谈记录进行了分析。此外，要求参与者对他们对这种转变的不满/满意程度、这种转变有多大阻碍/帮助，以及与转变前相比，转变后他们感觉有多不安全/安全进行评分。使用一种自我评估工具（依恋-内投人格构型原型匹配；PMAI）评估在关系或自我定义方面的人格取向。参与者体验到远程心理治疗在性质上与面对面心理治疗不同。他们报告了一些重要的损失：围绕治疗 session 的仪式感丧失了，包括他们日常生活与治疗 session 之间的过渡时间和空间，进行的治疗工作减少了，治疗师可能会失去他们的治疗立场，融洽关系感受损，患者感觉不那么开放且情感上难以触及。另一方面，一些患者在网上可能会感觉更自由。由于6名参与者具有依恋型人格取向，本研究尤其有助于理解有强烈归属需求和害怕被抛弃的患者在转向通过通信技术与治疗师会面时的体验。参与者的自我评分表明，他们对这种转变只是略有不满，并且体验到这种转变略有阻碍，而他们在转变后感觉相当安全，这表明定性和定量评估之间的一致性较低。需要新的研究来探索内投型患者对这种转变的体验。一个重要的话题也是收集证据并测试如何通过适当的、针对患者的干预措施来弥补使用通信技术时受损的融洽关系感，这是心理治疗教育和培训中必须涵盖的一个话题。
