[Video-based treatment in psychodynamic psychotherapy in times of the COVID-19 pandemic].

Background: In the course of the pandemic triggered by the coronavirus disease 2019 (COVID-19), video-based treatment (VBT) has undergone a trend reversal. It must be assumed that the abrupt switch from traditional psychotherapy to the video setting (VS) has an impact on the therapeutic relationship and thus on the therapeutic process. This study examined how the switch from traditional treatment to VBT (and back again) during the COVID-19 pandemic was experienced by patients and therapists with respect to the therapeutic relationship and the therapeutic process.

Methods: Group-specific, semi-structured interviews with therapists ( = 8), therapists in training ( = 6), and patients ( = 9).

Results: The results show that the majority of participants, both therapists as well as patients, experienced the therapeutic situation in VS as more permeable and less predictable. Although the VS contributes to maintenance of the therapeutic situation, the interaction was described as shallow and less oriented. Furthermore, every setting change was associated with a process of habituation. Therefore, the therapeutic work can only be carried out with the highest possible intensity after several sessions within each setting.

Conclusion: The possibility of maintaining the therapeutic relationship using VBT can lead to a strengthening of the therapeutic alliance. Although the VS is associated with uncertainties, shame-ridden topics can be addressed more freely. Anxiety patients, in particular, could engage in a more intense therapeutic process after a universally observed phase of habituation.