Families' Experience of Family Therapy by Videoconference During the First Lockdown: A Qualitative Study

Abstract

To ensure continuity of care during the Covid-19 pandemic, family therapy sessions were maintained via videoconferencing. Few studies evaluate the effectiveness of this modality. This exploratory qualitative study gathered the experiences of families who underwent videoconferencing family therapy during the first French lockdown and in-person therapy before and after. This study was conducted in France, within a department of adolescent medicine and psychiatry. Ten semi-structured interviews were conducted with eight families and analyzed using Interpretative Phenomenological Analysis. Results show that the absence of travel constraints in videoconferencing limited engagement during sessions. At home, daily life disrupted immersion, close proximity censored conversations, and therapists' virtual presence was perceived as intrusive or alliance-reinforcing. Patients described the sessions as a hiatus in therapy, citing therapists' exclusion from the family system, the paradox of being in therapy without full participation, and weak integration into the family narrative. However, videoconferencing provided crucial support during the crisis, encouraged initiative-taking, enabled participation of typically absent members, and allowed for experimentation with new formats. Some patients proposed alternating between in-person and remote sessions in the future. These challenges highlight the disruption of the therapeutic system during the abrupt transition. Therapists, shifting from active participants to observers, struggled to maintain a cohesive system. Yet, videoconferencing can redistribute control, fostering family initiative and balancing group and individual identities. This tool could complement traditional family therapy. Further research is needed to identify conditions, populations, and stages of therapy where videoconferencing is most effective.