Cataldo Francesco, Mendoza Antonette, Chang Shanton, Buchanan George, Van Dam Nicholas T
School of Computing and Information Systems, Faculty of Engineering and Information Technology, University of Melbourne, Melbourne, Australia.
School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.
JMIR Form Res. 2023 Mar 16;7:e40542. doi: 10.2196/40542.
The COVID-19 pandemic caused a surge in the use of telehealth platforms. Psychologists have shifted from face-to-face sessions to videoconference sessions. Therefore, essential information that is easily obtainable via in-person sessions may be missing. Consequently, therapeutic work could be compromised.
This study aimed to explore the videoconference psychotherapy (VCP) experiences of psychologists around the world. Furthermore, we aimed to identify technological features that may enhance psychologists' therapeutic work through augmented VCP.
In total, 17 psychologists across the world (n=7, 41% from Australia; n=1, 6% from England; n=5, 29% from Italy; n=1, 6% from Mexico; n=1, 6% from Spain; and n=2, 12% from the United States) were interviewed. We used thematic analysis to examine the data collected from a sample of 17 psychologists. We applied the Chaos Theory to interpret the system dynamics and collected details about the challenges posed by VCP. For collecting further information about the technology and processes involved, we relied on the Input-Process-Output (IPO) model.
The analysis resulted in the generation of 9 themes (input themes: psychologists' attitude, trust-reinforcing features, reducing cognitive load, enhancing emotional communication, and engaging features between psychologists and patients; process themes: building and reinforcing trust, decreasing cognitive load, enhancing emotional communication, and increasing psychologist-patient engagement) and 19 subthemes. 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 and out functionality) could enhance the presence and dynamic nature of the therapeutic relationship.
Psychologists expressed a desire for enhanced control of VCP sessions. Psychologists reported a decreased sense of control within the therapeutic relationship owing to the influence of the VCP system. Great control of the VCP system could better approximate the critical elements of in-person psychotherapy (eg, 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 and 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 as a technical medium. By adopting the IPO model in the VCP environment (VCP-IPO model), the relationship experience may help psychologists have more control in their VCP sessions.
新冠疫情导致远程医疗平台的使用激增。心理学家已从面对面诊疗转向视频会议诊疗。因此，通过面对面诊疗易于获取的重要信息可能会缺失。进而，治疗工作可能会受到影响。
本研究旨在探索全球心理学家的视频会议心理治疗（VCP）体验。此外，我们旨在确定可通过增强型VCP来提升心理学家治疗工作的技术特性。
共采访了来自世界各地的17位心理学家（n = 7，41%来自澳大利亚；n = 1，6%来自英国；n = 5，29%来自意大利；n = 1，6%来自墨西哥；n = 1，6%来自西班牙；n = 2，12%来自美国）。我们采用主题分析法来检查从17位心理学家样本中收集的数据。我们应用混沌理论来解释系统动态，并收集有关VCP带来的挑战的详细信息。为收集有关所涉及技术和流程的更多信息，我们依赖输入-过程-输出（IPO）模型。
分析产生了9个主题（输入主题：心理学家的态度、增强信任的特性、减轻认知负荷、加强情感交流以及心理学家与患者之间的互动特性；过程主题：建立和加强信任、减轻认知负荷、加强情感交流以及增加心理学家与患者的互动）和19个子主题。心理学家找到了应对VCP局限性的新策略，但也报告了需要更多技术控制以促进治疗过程。所建议的技术（眼神交流功能、紧急呼叫功能、屏幕控制功能、与其他应用程序和软件的交互式界面以及缩放功能）可增强治疗关系的在场感和动态性。
心理学家表示希望增强对VCP诊疗的控制。心理学家报告称，由于VCP系统的影响，治疗关系中的控制感有所下降。对VCP系统的良好控制可更好地近似面对面心理治疗的关键要素（例如，观察肢体语言）。为便于改善控制，心理学家希望技术具备如改善眼神交流、更好的屏幕控制、紧急呼叫功能、缩放能力以及与其他应用程序通信的交互式界面等特性。这些结果有助于将计算机普遍视为VCP过程的实际组成部分。因此，计算机在交流中发挥着关键作用，而不仅仅是作为一种技术媒介。通过在VCP环境中采用IPO模型（VCP-IPO模型），这种关系体验可能有助于心理学家在其VCP诊疗中拥有更多控制权。
