Relational Processes in Videoconference and In-Person Psychotherapy When Wearing Face Masks: A Cross-Cultural Study

Abstract

Aim

Prompted by concerns about the quality of the therapeutic relationship due to the impact of COVID-19's protective measures on communication, we aimed to understand how therapists and clients from different cultural backgrounds perceive the impact of videoconference (VT) and in-person psychotherapy with face masks (IPTFM) on the relational processes in psychotherapy.

Methods

A sample of 139 therapists and 71 clients participated in an online survey. We conducted an exploratory analysis using descriptive and inferential statistics to examine therapists' and clients' ratings of session quality, therapeutic relationship, communication and expression/perception of emotions in VT and IPTFM.

Results

Therapists and clients generally rated the communication, real relationship and working alliance in IPTFM and VT as good. However, when asked to compare IPTFM and VT with regular in-person therapy, therapists and clients recognised some differences, especially regarding session quality, communication and emotional expression or perception. There were also differences between therapists and clients in terms of working alliance in IPTFM and post-session mood in VT. The way therapists and clients perceived the quality of the relational processes in IPTFM and VT also differed based on some cultural aspects (e.g. age, disability, religion, ethnic identity and gender).

Conclusion

The results of the study emphasise the need for therapists to develop cultural competence by becoming aware of their own personal characteristics and inner processes (e.g. expectations, values and beliefs) and exploring clients' expectations of the therapeutic process based on their cultural identity while tailoring therapeutic approaches to the distinct relational and environmental dynamics of VT and IPTFM.