Practitioner experiences of online treatment

Abstract

It is increasingly popular to provide psychological assistance online. Existing literature summarises a variety of benefits associated with online treatments including remote access, or access to treatment where situational or environmental barriers may prevent clients from attending traditional face-to-face appointments.

The first part of this thesis is a qualitative systematic review synthesising the best available evidence exploring experiences and attitudes to online therapy and what role they play from the perspectives of practitioners. Relevant databases were searched focusing on qualitative empirical papers that fit the inclusion criteria. Thematic Synthesis was used to bring together findings. Ten studies were included and nine themes emerged from the data highlighting practitioner experiences and their contributions to their attitude toward online therapy. Themes included: Structure and safety of standardised manual approach; The power of the written word; Practical aspects – pros and cons; Communicating online – Fluidity and Structure; Social norms and genuineness; The Therapeutic Alliance; Responsibility; Therapist Skills; Efficacy, effectiveness and general professional issues. A need for more qualitative studies from practitioner perspectives may further research in online treatments.

The second part of this thesis is an empirical paper exploring practitioner experiences of facilitating family-focused online interventions via video conferencing. Important questions are whether therapeutic relationships can be developed via the internet and how therapeutic alliance is affected within family interventions. Semi structured interviews explored nine practitioner’s experiences of facilitating family-focused online interventions. Interpretative Phenomenological Analysis enabled detailed investigation of practitioner’s personal perspectives. Three master themes emerged: The therapeutic relationship: both the same and different; The positives outweigh the negatives; Balancing the patients’ need with the practitioners’. Practitioners highlighted benefits of
access, providing a comfortable therapeutic environment for clients to disclose personal information. Strong relationships were built with clients despite disruptions and restricted visual information. Practitioner self-care, and their ability to minimise their needs against their view of the clients were emerging issues

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