New skills for distance regulation: Therapists’ experiences of remote psychotherapy following the COVID-19 pandemic.

Abstract

Social distancing during the COVID-19 pandemic forced many therapists to shift from inperson sessions to the use of communication technology. This shift actualizes the issue of for whom and when remote therapy is suitable and how the therapeutic technique should be adjusted. Our study explored therapists' long-term experiences of remote psychotherapy after this transition. Data were collected about 2 years after World Health Organization's (WHO's) declaration of the COVID-19 pandemic. Semistructured interviews with 10 therapists with different treatment orientations were analyzed, applying the qualitative method of inductive experiential thematic analysis. The therapists said that the use of communication technology implied a new and different in-session interaction, inclusive of changed relational dynamics and the need to adjust their way of working. All therapists experienced possibilities and advantages as well as difficulties and challenges with remote psychotherapy. As time went on, they gained both positive and negative new experiences of the distinctive features of remote therapy and became more comfortable with remote communication. Above all, they acquired new technical and relational skills. Taken together, the therapists' experiences illustrate the need to develop new skills for negotiating setting alternations and distance regulation and to adapt therapeutic interventions when shifting between in-person settings and remote sessions. Public Health Significance StatementShifting between in-person and remote settings has a strong impact on the patient-therapist interplay, forcing therapists to develop new and advanced therapeutic skills. These skills include the therapist's sensitivity to both participants' ways of balancing the needs of togetherness and of autonomy, ongoing negotiation of different aspects of setting alternations, as well as developing a new repertoire of teleinterventions. Psychotherapy training and supervision need to encompass the challenges of teletherapy.