A qualitative exploration of psychologists' experiences of teletherapy within the Irish Public Mental Health System

Objective: The current qualitative study aimed to investigate psychologists' experiences of teletherapy throughout the COVID-19 pandemic, with a particular focus on teletherapy's impact on therapeutic relationships. Method: Fifteen participants, consisting of clinical and counselling psychologists employed by the Health Service Executive (HSE) in Ireland, participated in semistructured interviews conducted via telephone. Results: Constructionist thematic analysis yielded three prominent themes: (i) psychologists experienced a lack of control over therapeutic boundaries with their clients, such as the setting and time in which sessions take place. Teletherapy also encroaches on psychologists' personal boundaries from having aspects of their home lives becoming associated with clients' trauma; (ii) psychologists have to work much harder to make the connection with clients due to the substantial loss of information, including non-verbal cues, transmitted across teletherapeutic platforms; and (iii) psychologists themselves feel uncontained from being insufficiently supported by the HSE, which impacts on their ability to contain high-risk clients via teletherapy. Conclusions: Various aspects of the therapeutic relationship, including therapeutic boundaries between psychologists and their clients, and psychologists' ability to make the connection and foster containment with their clients, were impacted by teletherapy. Psychologists need to feel heard, supported and appreciated to ensure optimal delivery of teletherapy in future.