Exploring the Question: “Does Empathy Work in the Same Way in Online and In-Person Therapeutic Settings?”

Abstract

Providing remote psychotherapy using technology is a growing practice, especially since the outbreak of the COVID-19 pandemic. Even if in numerous studies video conferencing psychotherapy (VCP) was found to be clinically effective, some doubts continue to exist about how the psychotherapeutic alliance works in the online setting, and the characteristics of the empathic process are still poorly understood. This is an exploratory study aimed at analyzing the degree of empathy between the psychotherapist and client pair, and the degree of support perceived by the client who shall be referred to as the patient interchangeably in this study, comparing the sessions in person with those online, during the current pandemic, in order to discriminate the impact of empathy in the digital setting. The sample analyzed was composed of 23 patients with different severity of pathology engaged in online and in-person therapeutic sessions with five psychotherapists of different theoretical leanings. The scores of the support and empathy scale, obtained by both members of the psychotherapeutic couple in the two settings, were analyzed and compared. The test used belongs to an Italian adaptation of the Empathic Understanding (EU) of the Relationship Inventory. What emerged from comparing the scores was interesting: Unlike the psychotherapists, the patients perceived their therapists as significantly more empathic and supportive in the remote setting. These are rather important data, because the literature documents that client empathic perception measures represent a more accurate measure of the empathic relationship and, in general, can predict a good treatment outcome. Although these results need further investigation, they represent an important contribution in filling the scientific gap in the understanding of digital empathy. Also, this study provides new insights for future research on the characteristics and impact empathy has on the practice of remote psychotherapy.

Computational Methods in Psychotherapy: A Scoping Review

“…I group. Of the four papers that used only computational experimental approaches, with the use of digital tools or machine learning, three explored the characteristics of online psychotherapy, evaluating both patient and therapist perspectives [45][46][47], and in all three the feasibility of providing regular psychological assistance with the necessary adaptations to the patient's circumstances using an IT device was highlighted. In contrast, the fourth paper focused on attempting to personalise the treatment of depression by developing specific computational models that use electronic health record (EHR) data to predict the diagnosis and severity of depression and response to treatment [48].…”

“…In addition, evidence that comes from neurorehabilitation that uses biofeedback can give important suggestions about how can use biofeedback in the research about the phenomenology of the psychotherapeutic meeting [61]. In fact, some research, which is studying, for example, the characteristics of empathy in both distance and presence-based psychotherapy, has considered it a desirable frontier to be able to measure the psychophysiological variables of the patient and therapist in order to verify their attunement [47]. Other studies, starting from the concept that the observation of movement in human beings (such as gestures and actions performed in the relational context) allows us to detect the most significant and evident expression of the complexity of a relationship, have also offered interesting insights by exploring the motor aspects of certain dyads [63].…”

Association Between Clinician-Level Factors and Patient Outcomes in Virtual and In-Person Outpatient Treatment for Substance Use Disorders: Multilevel Analysis

“…Initial research suggests that clinician characteristics may interact differently between settings. While therapists might not identify differences when evaluating their own ability to demonstrate empathy and support across in-person versus virtual sessions, patients have described therapists as significantly more supportive and empathetic in remote settings as compared to in-person meetings [23]. To date, there has been limited evaluation of the association between clinician-level characteristics with the use of virtual and in-person treatment platforms and key patient outcomes in SUD-specific treatment programming.…”

It turned into something else: patients’ long-term experiences of transitions to or from telepsychotherapy during the COVID-19 pandemic

“…Even less research has been done on the experience of changing to telepsychotherapy and then back again to in-persontherapy, which will probably be more common after the pandemic, when patients and therapists are used to the remote format and need it from time to time. However, there are some studies indicating that both patients and therapists may experience an advantage with hybrid settings, i.e., that sessions within the same therapy can be either remote or in-person (Sperandeo et al, 2021;Leuchtenberg et al, 2022).…”