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从精神动力学角度看视频会议心理治疗。一项定性分析。

Videoconferencing psychotherapy from a psychodynamic point of view. A qualitative analysis.

作者信息

Laczkovics Clarissa, Blüml Victor, Kapusta Nestor, Hoffmann-Lamplmair Doris, Casini Erica, Bazan Maria, Torres Miguel Angel Gonzalez, Lendvay Judit, Normandin Lina, Nowacki Henryk, Snigur Vladimir, Doering Stephan, Yeomans Frank, Clarkin John, Preti Emanuele

机构信息

Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria.

Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria.

出版信息

Front Psychiatry. 2023 Sep 15;14:1235478. doi: 10.3389/fpsyt.2023.1235478. eCollection 2023.

Abstract

There is a growing interest in delivering videoconferencing psychotherapy (VCP) due to the enormous impact of the COVID-19 pandemic on our lives since the beginning of severe restrictions worldwide in March 2020. Scientific literature has provided interesting results about the transition to remote sessions and its implications, considering different psychotherapy orientations. Less is known about whether and how VCP affects psychodynamic psychotherapeutic approaches and reports on remote work with severe and complex mental health problems such as severe personality disorders are still scarce. The aim of the study was to examine the experiences of psychodynamic psychotherapists, mainly delivering Transference-Focused Psychotherapy (TFP), with the transition and delivery of VCP during the first wave of the COVID-19 pandemic. Four hundred seventy-nine licensed psychotherapists completed an online survey during the peak of the pandemic. Survey data were analyzed using qualitative analysis. Results are presented and discussed concerning advantages and disadvantages regarding the access to psychotherapy, the specificity of the online video setting, bodily aspects, the quality of the therapeutic relationship, the therapeutic process including technical aspects and therapist's experience. Furthermore, we analyzed and discussed the statements concerning transference and countertransference reactions differentiating between high-level borderline and neurotic patients and low-level borderline patients. Our results support the importance to identify patients who potentially benefit from VCP. Further research including more prospective randomized controlled trials are needed to investigate the therapeutic implications of the findings.

摘要

自2020年3月全球开始实施严格限制措施以来,由于新冠疫情对我们生活产生的巨大影响,视频会议心理治疗(VCP)越来越受到关注。科学文献针对不同心理治疗取向,给出了关于向远程治疗过渡及其影响的有趣研究结果。对于VCP是否以及如何影响精神动力心理治疗方法,人们了解较少,而且关于针对严重和复杂心理健康问题(如严重人格障碍)开展远程治疗的报告仍然很少。本研究旨在考察主要提供移情焦点治疗(TFP)的精神动力心理治疗师在新冠疫情第一波期间进行VCP过渡和治疗的经历。479名有执照的心理治疗师在疫情高峰期完成了一项在线调查。调查数据采用定性分析方法进行分析。呈现并讨论了关于心理治疗可及性、在线视频设置的特殊性、身体方面、治疗关系质量、包括技术方面和治疗师经验在内的治疗过程等方面的优缺点。此外,我们分析并讨论了关于移情和反移情反应的陈述,区分了高水平边缘型和神经症患者以及低水平边缘型患者。我们的研究结果支持识别可能从VCP中受益的患者的重要性。需要开展更多前瞻性随机对照试验等进一步研究,以调查这些发现的治疗意义。

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