Long-term psychodynamic psychotherapy in a face-to-face versus videoconferencing setting: A single case study

Area of Science:

• Psychology
• Psychiatry
• Clinical Psychology

Background:

• The COVID-19 pandemic necessitated a rapid shift to telehealth for psychotherapists globally.
• Research on the efficacy of video-based psychodynamic psychotherapy remains limited.
• This study addresses the need to understand how long-term psychodynamic psychotherapy functions in both face-to-face and video-based formats.

Observation:

• A single case design analyzed 85 sessions of psychodynamic psychotherapy for major depression, transitioning from in-person to video-based treatment.
• Video recordings were assessed for nonverbal synchrony using motion energy analysis and surrogate synchrony approaches.
• Time series analyses examined changes in symptom severity, therapeutic alliance, and intersession phenomena.

Findings:

• While symptom severity showed a descriptive improvement, it was not statistically significant across the therapy duration.
• Significant differences were observed in the therapeutic relationship, intersession experiences, and nonverbal synchrony between face-to-face and video-based sessions.
• The study highlights distinct interactional dynamics in different therapeutic modalities.

Implications:

• The employed methodology is suitable for rigorously comparing face-to-face and video-based psychodynamic psychotherapy.
• Further research is warranted to understand the nuances of therapeutic relationships and synchrony in telehealth.
• Findings contribute to the evidence base for delivering psychodynamic psychotherapy remotely.