“I miss not being able to offer my couples a box of tissues…”: Couples' and therapists' perspectives on the therapeutic alliance with the transition to online couple therapy

Alon Aviram*, Yochay Nadan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

The purpose of this study is to advance theory concerning the experiences of couples and therapists involved in online couple therapy and the meanings they assign to them, with a particular focus on the therapeutic alliance. Using constructivist grounded theory methodology, in-depth semi-structured online interviews were conducted with 36 individuals, including 18 couples who had participated in online couple therapy via videoconference. Additionally, 15 couple and family therapists were interviewed in four online focus groups. Our analysis indicates three dimensions that impact the formation of the therapeutic alliance in online couple therapy: (1) emotional closeness, as a conduit for establishing physical or emotional space; (2) limited care, due to the therapist's difficulty providing comfort and security; and (3) body language, as reflected in the lack of physical presence and the close inspection of the face, at two opposite ends of a continuum. We discuss our findings through the lens of the closeness-distance dynamic, which posits that therapists' ability to regulate themselves depends on their clients' emotional needs. We conclude with implications for clinical practice.

Original languageEnglish
Pages (from-to)163-175
Number of pages13
JournalFamily Process
Volume63
Issue number1
DOIs
StatePublished - Mar 2024

Bibliographical note

Publisher Copyright:
© 2023 The Authors. Family Process published by Wiley Periodicals LLC on behalf of Family Process Institute.

Keywords

  • couple therapy
  • online therapy
  • telepsychology
  • teletherapy
  • therapeutic alliance

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