An exploration of digital therapy: the therapeutic alliance online and psychologists’ experiences and reflections on offering online therapy

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dc.availability.bitstreamcontrolled
dc.contributor.advisorLinehan, Conoren
dc.contributor.advisorFoley, Sarahen
dc.contributor.authorGeary, Christina
dc.contributor.funderHealth Service Executiveen
dc.date.accessioned2022-10-03T14:50:55Z
dc.date.available2022-10-03T14:50:55Z
dc.date.issued2022-05-13
dc.date.submitted2022-05-13
dc.description.abstractSystematic Review: Remotely delivered therapy for mental health disorders is increasingly adopted in health services worldwide. However, evidence of how the implementation of remote therapy affects the therapeutic relationship is disjointed. To synthesise international evidence exploring the sociotechnical features that may play a role in determining a strong therapeutic relationship in remotely delivered therapy for mental health disorders. A qualitative systematic review. A systematic review was conducted up until May 2022, including qualitative studies from EBSCO CINAHL, Medline - PubMed, Embase, PsychInfo and SCOPUS, which explored the therapeutic relationship and alliance of remotely delivered therapies. Twenty-three studies were included. The data were categorised into four themes: 1. Therapists’ enthusiasm for remote therapy facilitates service user buy-in, 2. It is possible to establish a therapeutic relationship in remotely delivered therapy 3. Remote therapy should be implemented as an adjunct to face-to-face therapy, and 4. Technical issues have the potential to disrupt the creation of a safe and trusting atmosphere in remote therapy. Sociotechnical components play a role in determining a strong therapeutic alliance in remotely delivered therapy, such as the characteristics of the therapist and the centrality of technology. Augmenting rather than replacing face-to-face, can assist in identifying areas for the improvement of remote therapy. Empirical Research: Digital technologies can transform healthcare services and may contribute to health system goals of accessibility, quality and equality of healthcare. However, this requires careful consideration of both the technical requirements needed to make online therapy work and sensitivity towards the relational factors required to build a therapeutic alliance. The current study uses Psychologists’ experiences during the Covid-19 pandemic and the associated move to online therapy as a critical incident to reflect on the future of digitisation. The socio-technical systems (STS) theory has been adopted as a lens that allows us to interrogate participants' social, technical, interpersonal and organisation experiences of the digitilisation of mental health services. Participants (N=10) were psychologists from Health Service Executive (HSE) Mental Health and Primary Care Services in Ireland who had provided therapeutic intervention online during the Covid-19 pandemic (F= 6, M=4) (age 25- 44). An inductive reflexive thematic analysis generated four themes: 1. Optimizing outreach and engagement through digital therapy; 2. Digital therapeutic disruptions; 3. Understanding what makes online therapy feel like a suboptimal offering; 4. Identifying the enablers to offering effective online therapy. Some psychologists indicated that engaging the online platform could convey a degree of protection and anonymity due to physical distance that was sometimes beneficial to establishing a more intimate connection.en
dc.description.statusNot peer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationGeary, C. 2022. An exploration of digital therapy: the therapeutic alliance online and psychologists’ experiences and reflections on offering online therapy. DClinPsych Thesis, University College Cork.en
dc.identifier.endpage165en
dc.identifier.urihttps://hdl.handle.net/10468/13726
dc.language.isoenen
dc.publisherUniversity College Corken
dc.rights© 2022, Christina Geary.en
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.subjectTherapeutic relationshipen
dc.subjectTherapeutic allianceen
dc.subjectMental healthen
dc.subjecteMental healthen
dc.subjectTechnologyen
dc.subjectRemote therapyen
dc.subjectSystematic reviewen
dc.subjectThematic synthesisen
dc.subjectQualitative researchen
dc.subjectThe socio-technical systems (STS) theoryen
dc.subjectDigitilisationen
dc.subjectMental health servicesen
dc.subjectHealth Service Executiveen
dc.titleAn exploration of digital therapy: the therapeutic alliance online and psychologists’ experiences and reflections on offering online therapyen
dc.title.alternativeStudy 1: The therapeutic alliance in remotely delivered therapy for mental health systematic review and inductive thematic analysisen
dc.title.alternativeStudy 2: Irish Psychologist's experience of offering therapy online: a qualitative studyen
dc.typeDoctoral thesisen
dc.type.qualificationlevelPractitioner Doctorateen
dc.type.qualificationnameDClinPsych - Doctor of Clinical Psychologyen
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