Comparing Psychoanalytic Process in Consulting Room and Teleconference: A Naturally Occurring Controlled Experiment

Area of Science:

• Psychoanalysis
• Psychotherapy Research
• Digital Health

Background:

• COVID-19 pandemic necessitated a shift from in-person to videoconference psychoanalysis.
• This transition provided a unique opportunity for empirical study comparing treatment modalities.
• The study explored the impact of environmental changes on the psychoanalytic process.

Purpose of the Study:

• To investigate whether the quality of the psychoanalytic process (QAP) differs between in-person consulting room (CR) and videoconference (VC) settings.
• To examine the association between patients' defensive functioning (adaptive style) and their ability to maintain the analytic process during the transition from CR to VC.
• To establish the feasibility of empirical research on naturally occurring clinical psychoanalysis.

Main Methods:

• Forty psychoanalysts from accredited programs contributed data from 50 cases.
• Quality of Psychoanalytic Process (QAP) was scored on a 0-100 scale for both CR and VC.
• Patients' defense mechanisms were assessed using the Defensive Functioning Scale (DFS).

Main Results:

• No significant difference in QAP was found for the overall group between CR and VC.
• A significant degradation in QAP from CR to VC was observed specifically in the "Minor Image Distorting" defense group.
• This "Minor Image Distorting" group was the sole subgroup exhibiting a statistically significant decline in QAP.

Conclusions:

• While not all statistical differences may be clinically significant, individual adaptive differences in telepsychoanalysis merit further investigation.
• Empirical research on phenomena within clinical psychoanalysis is feasible.
• The study supports the potential for effective psychoanalytic treatment via videoconference, with specific considerations for certain defense mechanisms.