"Reading between the lines" : a grounded theory study of text-based synchronous online therapy : how practitioners establish therapeutic relationships online

Simpson, Catherine (2016) "Reading between the lines" : a grounded theory study of text-based synchronous online therapy : how practitioners establish therapeutic relationships online. Doctoral thesis, London Metropolitan University.

Abstract

This qualitative research study explored the therapeutic relationship in online therapy from a counselling psychology perspective. An overview of the different types of online therapy and a brief history of the field were given and the existing literature surrounding online therapy and the therapeutic relationship was critically reviewed. Through this, a need was identified for an understanding of how therapeutic relationships are established in online therapy, with a particular focus on therapy via instant messaging. Semi-structured interviews were conducted asking online therapy practitioners about their experiences of therapeutic relationships. The resulting data were analysed using the grounded theory method and a tentative model of the processes that influence the formation of a therapeutic relationship online was created. An important factor in the model was therapists’ development of skills in online communication, which serve to overcome the lack of a physical presence and non-verbal communication that hinder text-based interactions. Another key influence was the management of the therapeutic frame, which is challenged by the nature of the online setting. Also significant was a client’s rationale for choosing online therapy, which influences their ability to engage in a therapy relationship online. The implications of the findings for counselling psychology professional practice, training and research were discussed.

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