Teletherapy
With the long-awaited vaccine finally here, and the end of the pandemic in sight, it is time to start thinking about which things should go back to how they were pre-covid, and which should not. The switch to remote/virtual/online everything forced us to reconsider whether there are really some activities that can only be done in person. As it turns out, the number is a lot smaller than we previously thought. And while the quality of the experience might not be the same, the convenience of doing things from the comfort of your home will probably ensure that some of the covid-induced switches persist in the post-pandemic world.
Is psychotherapy one of those things? The convenience of online therapy would strongly suggest that. For those of us that had to commute to their appointment, the switch to teletherapy (via FaceTime/Skype/Zoom) eliminated the hassle and the waste of time previously spent getting to and from the sessions. The online aspect of the meeting somehow also created the impression of the therapist as being more available, sort of like an app that we engage with once per week, but is still here, at our fingertips.
On the other hand, it would be wrong to say that nothing was lost in the switch from in-person to online therapy. A study by Kashyap and colleagues’ (2020) reported some touching (and funny) reactions of clients’ to what they perceived to be a diminishment of the client-therapist relationship, brought about by the transition from in-person to virtual. There is also the inconvenience of finding a private space to talk to your therapist, while other members of the household are present. And if you are not able to find that space at home, do you take your therapist with you to a coffee shop (and also let a bunch of strangers become inadvertent witnesses to your most private thoughts and feelings)?
The (un)spoken rules of therapy also tend to get lost in the transition to online. Things that were considered inappropriate during an in-person session - eating, drinking, cooking dinner, checking email - are now being tested for limits by some clients, creating opportunities for therapists to practice boundary-setting and resolving some pretty strong countertransferial responses.
Is the issue in the fact that the transition to online therapy fundamentally changes the therapeutic relationship? In her article on “What have we lost?” in the switch to teletherapy, Rosemary Rizq says that the nature of virtual communication is to give the illusion of closeness and presence, as opposed to the “semblance of distance” that exists when we communicate in person, and which, per Rizq, is necessary for creating sensitivity to otherness. Sounds like there is something there, but is it enough to get us back to the therapists’ office and commuting? What about those of us that only ever tried (tele)therapy during the pandemic, and have no way of comparing it to the in-person version?
Hopefully, we will know in the (very) near future.
