Online psychotherapy setting and its reflections on therapeutic relationship during COVID-19 pandemic

The purpose of this study was to explore how psychotherapy setting is affected by the mandatory conversion from face-to-face psychotherapy setting to online platforms due to COVID-19 pandemic restrictions, mainly with respect to the relationship between subjective perceptions and/or experiences regarding COVID-19 and therapeutic alliance for both psychotherapists and patients. A sample of 94 Turkish participants which consisted of 62 psychotherapy patients and 32 mental health professionals filled out the questionnaire whilst semi-structured interviews were done with nine psychotherapists and seven psychotherapy patients. The data collection process lasted from February 2022 to May 2022. As survey questions present quantitative correlations, semi-structured interviews were done to provide a deeper understanding of the outcomes of this shift. Findings show that while COVID-19 history of patients was not related to their alliance scores, psychotherapists who have first-degree relatives tested for COVID-19 positive show significantly lower Working Alliance Invertory (WAI) scores. Both patients and psychotherapists addressed the advantages and disadvantages of OPT in accordance with their COVID-19 perceptions. While the loss of a shared room and embodied psychotherapy setting is a main consideration of both parts, the length of the ongoing psychotherapy process significantly correlated with WAI scores for patients. Patients who considered there are no advantages of OPT showed significantly lower WAI-Bond scores whereas for psychotherapists, the number of disadvantages of OPT was significantly correlated with lower WAI-Bond scores. Limitations and implications for further research were discussed.