Quality of the therapeutic relationship and nonverbal interaction in videoconferencing psychotherapy Systematic review

Background Due to the coronavirus disease 2019 (COVID-19) pandemic the importance of videoconferencing psychotherapy (VCP) has considerably increased. Although the effectiveness of VCP is well documented by numerous therapy outcome studies, reservations from clinicians' perspectives are still common. They relate in particular to the limited possibilities for the formation of a relationship and the absence of a physical co-presence in the video setting. Objective This article provides an overview of the empirical findings on the quality of the therapeutic relationship as well as on the nature of nonverbal interaction in VCP. Methods The MEDLINE, APA PsycArticles, APA PsycInfo, and PSYNDEX databases were searched for controlled studies that examined the therapeutic relationship in VCP compared to face-to-face therapy. Another literature search was conducted for studies of nonverbal interaction in VCP. Results The results show that the quality of the therapeutic relationship in VCP is comparable to that in face-to-face therapy. The interaction in VCP has so far only been described in qualitative studies. In interviews patients and therapists report an increase in verbal and nonverbal activity in VCP. For therapeutic work, changes with respect to being silent and understanding of body language are highlighted. Conclusion To the best of our knowledge no studies exist that explain why a comparatively successful relationship structure can be established, despite the changes and limitations associated with the mediation of interaction in VCP.