Construing a therapeutic relationship online: An analysis of videoconference sessions

Objective: The aim of this study is to investigate the elements that charac-terize the formation of a therapeutic relationship when the sessions are con-ducted through videoconference. Method: Conversation analysis was used to analyse the first three counsel-ling sessions with five clients, for a total of 15 sessions. Results: The phenomena detected in the conversational sequences dealt with the following issues: starting up (early definition of the problem, motivation to use a communication technology, and therapeutic rules), technological rup-tures (interruptions and multimedia repair), environment, privacy, and going beyond videoconferencing, such as inter-session contact and moving from vid-eoconferencing to face-to-face meetings. The analysis of relational asymmetries also highlighted the relational dominance of the therapist. A series of these phenomena could be ascribed to the online modality; other ones are common in face-to-face sessions. The frequent request to integrate online sessions with face-to-face sessions might indicate that online psychotherapy is seen as a com-plement to face-to-face psychotherapy more than as a substitute for it. Conclusions: The potential of online psychotherapy is still underestimated and further studies should be conducted on the specificities of the computer-mediated communication within the therapeutic relationship.