Danışanların Çevrimiçi Psikolojik Danışma Deneyimleri: Memnuniyet ve Terapötik İşbirliği

Öz

Çevrimiçi psikolojik danışmanlık uygulamaları gittikçe yaygınlaşmaktadır. Ancak Türkiye’de danışanların bu konudaki deneyimlerini derinlemesine ele alan çalışmalar oldukça sınırlıdır. Bu fenomenolojik çalışmanın amacı, çevrimiçi danışmanlık alan danışanların memnuniyet ve terapötik işbirliği konusundaki deneyimlerini anlamaktır. Bu amaçla çevrimiçi psikolojik danışma almış altı danışan ile yarı yapılandırılmış görüşmeler yapılmıştır. Danışanların memnuniyetlerini ve terapötik işbirliği deneyimlerini ortaya koymak için tematik analiz uygulanmıştır. Sonuçlar, çevrimiçi danışmanlıktan memnuniyet için üç temanın ortaya çıktığını göstermiştir; semptomlarda iyileşmeler, çevrimiçi psikolojik danışmanın esnekliği ve çevrimiçi danışma hakkında olumsuz görüşler. Terapötik işbirliğinin tematik analizi ise amaçlar, görevler ve bağ temalarını ortaya çıkarmıştır. Sonuç olarak katılımcılar çevrimiçi oturumlardan yüksek memnuniyet bildirmişlerdir ve psikolojik danışmanları ile hedef belirleme, sorunlara çözüm arama ve bağ kurma konusunda terapötik işbirliği kurabilmişlerdir. Genel olarak katılımcıların çoğu, durumlarında iyileşme ve psikolojik danışmanlarıyla İnternet üzerinden önemli ilişkiler kurma açısından çevrimiçi psikolojik danışmaya yönelik olumlu deneyimler bildirmiştir. 

Anahtar Kelimeler

• Çevrimiçi psikolojik danışma
• Yüz yüze psikolojik danışma
• Danışan memnuniyeti
• Terapötik işbirliği.

Client’s Experiences of Online Counseling: Satisfaction and Therapeutic Alliance

Öz

Online counseling has been increasingly becoming widespread. Nevertheless, the number of studies investigating counselees' online counseling experience in-depth is scarce, especially in Turkey, despite the proliferation of the service. Therefore, this phenomenological study aims to understand the experiences of participants who received online counseling regarding satisfaction and therapeutic alliance. For this purpose, semi-structured interviews were conducted with six participants. Thematic analysis was applied to explore their satisfaction with online counseling and therapeutic alliance. The results showed that three themes emerged for satisfaction with online counseling; improvements in the symptoms, the flexibility of the online counseling, and limitations of online counseling. Thematic analysis of therapeutic alliance revealed the themes; goals, tasks, and bond. As a result, the participants reported high satisfaction with the online sessions, and they were able to establish a therapeutic alliance with their counselor in setting goals, seeking solutions to problems, and bonding. Overall, most of the participants reported positive experiences with online counseling in terms of improvement in their situation and establishing significant relationships with their counselor over the Internet.

Anahtar Kelimeler

• Online counseling Face-to-face counseling
• Clients’ satisfaction
• Therapeutic alliance.

Kaynakça

1. Alleman, J. R. (2002). Online counseling: The Internet and mental health treatment. Psychotherapy: Theory, Research, Practice, Training, 39(2), 199-209. http://psycnet.apa.org/doi/10.1037/0033-3204.39.2.199
2. Andersson, G., Paxling, B., Wiwe, M., Vernmark, K., Felix, C. B., Lundborg, L., Furmark, T., Cuijpers, P., & Carlbring, P. (2012). Therapeutic alliance in guided Internet-relivered cognitive behavioural treatment of depression. Generalized Anxiety Disorder and Social Anxiety Disorder. Behaviour Research and Therapy, 50, 544-550. https://doi.org/10.1016/j.brat.2012.05.003
3. Austen, S., & McGrath, M. (2006). Attitudes to the use of videoconferencing in general and specialist psychiatric services. Journal of Telemedicine and Telecare, 12(3), 146–150. https://doi.org/10.1258/135763306776738594
4. Backhaus, A., Agha, Z., Maglione, M. L., Repp, A., Ross, B., Zuest, D.,Rice-Thorp, N.M, Lohr, J., Thorp, S.R. (2012). Videoconferencing psychotherapy: A systematic review. Psychological Services, 9(2), 111-131. https://doi.org/10.1037/a0027924
5. Ballegooijen W.V., Cuijpers, P., Straten V. A., Karyotaki, E., Andersson, G., Smit, J. H., & Riper, H. (2014). Adherence to Internet-based and face-to-face cognitive behavioral therapy for depression: A meta-Analysis. Plos One, 9(7), e100674. https://doi.org/10.1371/journal.pone.0100674
6. Barak, A., & Grohol, J. M. (2011). Current and future trends in Internet-supported mental health interventions. Journal of Technology in Human Services, 29(3), 155-196. https://doi.org/10.1080/15228835.2011.616939
7. Barak, A., Hen, L., Boniel-Nissim, M., & Shapira, N. (2008). A comprehensive review and a meta-analysis of the effectiveness of internet-based psychotherapeutic interventions. Journal of Technology in Human Services, 26(2), 109-159. https://doi.org/10.1080/15228830802094429
8. Barak, A., Klein, B., & Proudfoot, J. G. (2009). Defining Internet-supported therapeutic interventions. Annals of Behavioural Medicine, 38(1), 4-17. https://doi.org/10.1007/s12160-009-9130-7

9. Berger, T. (2016). The therapeutic alliance in Internet interventions: A narrative review and suggestions for future research. Psychotherapy Research, 27(5), 511-524. https://doi.org/10.1080/10503307.2015.1119908
10. Berry, R. M., Ashby, J. S., Gnilka, P. B., & Matheny, K. B. (2011). A comparison of face-to-face and distance coaching practices: Coaches' perceptions of the role of the working alliance in problem resolution. Consulting Psychology Journal: Practice and Research, 63(4), 243–253. http://psycnet.apa.org/doi/10.1037/a0026735
11. Bloom, J. (1998). The ethical practice of web counselling. British Journal of Guidance and Counselling, 23(1), 53-59.
12. Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research & Practice, 16(3), 252-260. http://psycnet.apa.org/doi/10.1037/h0085885
13. Bozkurt, İ. (2013). The new trend in psychological support practices: Online therapies. International Journal of Human Sciences, 10(2), 130-146.
14. Brown, C. (2012). The working alliance in online counselling for crisis intervention and youth [Unpublished master’s thesis]. University of Alberta.
15. Bucci, S., Seymour‐Hyde, A., Harris, A., & Berry, K. (2016). Client and therapist attachment styles and working alliance. Clinical Psychology & Psychotherapy, 23(2), 155-165. https://doi.org/10.1002/cpp.1944
16. Buyruk Genç, A., Amanvermez, Y., Zeren, Şerife G., & Erus, S. M. (2019). Early separations: Dropout from online and face-to-face counseling. Pegem Journal of Education and Instruction, 9(4), 1001-1030. https://doi.org/10.14527/pegegog.2019.032
17. Chen, N., Zhou, M., Dong, X., Qu, J., Gong, F., Han, Y., Qui, Y., Wang, J., Liu, Y., Wei, Y., Xia, J., & Yu, T. (2020). Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study. The Lancet, 395(10223), 507-513. https://doi.org/10.106/S0140-6736(20)30211-7
18. Chester, A., & Glass, C. A. (2006). Online counselling: A descriptive analysis of therapy services on the Internet. British Journal of Guidance & Counselling, 34(2), 145-160. https://doi.org/10.1080/03069880600583170
19. Cohen, G. E., & Kerr, B. A. (1999). Computer-mediated counselling: an empirical study of a new mental health treatment. Computers in Human Services, 15(4), 13-26. http://psycnet.apa.org/doi/10.1300/J407v15n04_02
20. Cook, J. E., & Doyle, C. (2002). Working alliance in online therapy as compared to face-to-face therapy: Preliminary results. Cyberpsychology & Behavior, 5(2), 95-105. https://doi.org/10.1089/109493102753770480
21. Corey, G. (2008). Psikolojik danışma psikoterapi kuram ve uygulamaları. (T. Ergene, Çev.). Ankara: Mentis Yayıncılık. (Orijinal Çalışma 2005 yılında yayınlanmıştır).
22. Creswell, J. W. (2015). Beş Nitel Araştırma Yaklaşımı (Ed. M. Bütün & S. B. Demir). Nitel Araştırma Yöntemleri Beş Yaklaşıma Göre Nitel Araştırma ve Araştırma Deseni. Ankara: Siyasal Kitabevi (Original Edition 2013).
23. Emmel, N. (2013). Sampling and choosing cases in qualitative research: A realist approach, Sage Publication
24. Erus, S. (2020). Çevrimiçi Psikolojik Danışmada Terapötik İşbirliği. Ş. G. Zeren (Ed.). Psikolojik Danışmada Yeni Açılımlar ve Çevrimiçi Psikolojik danışma Uygulayıcıları için El kitabı (ss. 118-133). Pegem Akademi, Ankara.
25. Erus, S. M., & Zeren, Ş. G. (2020). Danışan ve psikolojik danışmanın penceresinden terapötik Iişbirliği: Çevrimiçi, yüz yüze ve plasebo gruplarının karşılaştırılması. Jass Studies-The Journal of Academic Social Science Studies, 13(81), 139-152. http://dx.doi.org/10.29228/JASSS.40292
26. Gülüm, İ. V., Uluç, S., & Soygüt, G. (2016). Terapötik İttifak Ölçeği- kısa formun psikometrik özelliklerinin incelenmesi. Türk Psikiyatri Dergisi, 29(1), 47-53. https://doi.org/10.5080/u18260
27. Haberstroh, S., Parr, G., Bradley, L., Morgan‐Fleming, B., & Gee, R. (2008). Facilitating online counseling: Perspectives from counselors in training. Journal of Counseling & Development, 86(4), 460-470. https://doi.org/10.1002/j.1556-6678.2008.tb00534.x
28. Holmes, C. M. (2011). An examination of the similarities and differences in mental health status, working alliance, and social presence between face-to- face and online counseling [Unpublished doctoral dissertation]. The College of William and Mary.
29. Holroyd, C. (2001). Phenomenological research method, design and procedure: A phenomenological investigation of the phenomenon of being-in-community as experienced by two individuals who have participated in a community building workshop. Indo-Pacific Journal of Phenomenology, 1(1), 2-10. http://dx.doi.org/10.1080/20797222.2001.11433859
30. Horvath, A. O., Del Re, A. C., Flückiger, C., & Symonds, D. (2011). Alliance in individual therapy. Psychotherapy, 48(1), 9-16. https://psycnet.apa.org/doi/10.1093/acprof:oso/9780199737208.003.0002
31. Joinson, A. N., & Paine, C. B. (2007). Self-disclosure, privacy and the Internet. The Oxford handbook of Internet psychology, 2374252. Retrieved January 22, 2013, from http://www.york.ac.uk/res/e-society/projects/15/PRISD_report2.pdf
32. Joyce, N. (2012). An empirical examination of the influence of personality, gender role conflict, and self-stigma on attitudes and intentions to seek online counselling in college students [Unpublished doctoral dissertation]. The University of Akron.
33. Khan, S., Shapka, J. D., & Domene, J. F. (2021). Counsellors’ experiences of online therapy. British Journal of Guidance & Counselling 50(1). 43-65. https://doi.org/10.1080/03069885.2021.1885009
34. Kilroe, C. (2010). A need assessment of potential online counseling service clients [Unpublished doctoral dissertation]. University of Calgary.
35. Koçyiğit, M., & Pamukçu, B. (2018). Üniversite öğrencilerinin psikolojik danışmadan beklentileri: Cinsiyet, psikolojik yardım alma deneyimi, psikolojik yardım almaya ilişkin tutum ve kişilik özelliklerinin rolü. Abant İzzet Baysal Üniversitesi Eğitim Fakültesi Dergisi, 18(4), 2148-2171. https://doi.org/10.17240/aibuefd.2018.18.41844-504881
36. Kubler, J. R. (2020). Therapists’ perception of client outcomes and therapeutic alliance in online Counselling. Australian Counseling Research Journal, 14(1), 16-24.
37. Leibert, T., & Archer, J. (2006). An exploratory study of client perceptions of Internet counseling and the therapeutic alliance. Journal of Mental Health Counseling, 28(1), 69-83. https://doi.org/10.17744/mehc.28.1.f0h37djrw89nv6vb.
38. Levinson, D., & Ifrah, A. (2010). The robustness of the gender effect on help-seeking for mental health needs in three subcultures in Israel. Social Psychiatry Epidemiology 45(3), 337-344. https://doi.org/10.1007/s00127-009-0079-4
39. Marton, F. (1986). Phenomenography—a research approach to investigating different understandings of reality. Journal of Thought, 21(3), 28-49.
40. Mallen, M. J., Day, S. X., & Green, M. A. (2003). Online versus face-to-face conversation: An examination of relational and discourse variables. Psychotherapy: Theory, Research, Practice, Training, 40(1-2), 155-163. https://doi.org/10.1037/0033-3204.40.1-2.155
41. Murphy, L., Parnass, P., Mitchell, L., Hallett, R., Cayley P., & Seagram, S. (2009). Client satisfaction and outcome comparisons of online and face-to-face counselling methods. British Journal of Social Work, 39(4), 627-640. https://doi.org/10.1093/bjsw/bcp041
42. Nath, S. B., Alexander, L. B., & Solomon, P. L. (2012). Case managers’ perspectives on the therapeutic alliance: A qualitative study. Social psychiatry and psychiatric epidemiology, 47(11), 1815-1826. https://doi.org/10.1007/s00127-012-0483-z
43. Odacı H., & Kınık Ö. (2018). Üniversite öğrencilerinin psikolojik yardım alma tutumlarının bazı demografik değişkenler, öz denetim ve benlik saygısı ile ilişkisi. Yükseköğretim ve Bilim Dergisi, 8(3), 619-625. https://doi.org/10.5961/jhes.2018.302
44. Pihlaja, S., Stenberg, J. H., Joutsenniemi, K., Mehik, H., Ritola, V., & Joffe, G. (2018). Therapeutic alliance in guided internet therapy programs for depression and anxiety disorders–a systematic review. Internet Interventions, 11, 1-10. https://doi.org/10.1016/j.invent.2017.11.005
45. Richards, D., & Viganò, N. (2012). Online counseling. Encyclopedia of Cyber Behavior, 3(1), 699-713. https://doi.org/10.4018/978-1-4666-0315-8.ch059
46. Richards, D., & Viganò, N. (2013). Online counseling: A narrative and critical review of the literature. Journal of Clinical Psychology, 69(9), 994-1011. https://doi.org/10.1002/jclp.21974
47. Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting and Clinical Psychology, 60(6), 827-832. https://doi.org/10.1037/0022-006X.60.6.827
48. Safran, J. D., & Muran, J. C. (2000). Resolving therapeutic alliance ruptures: Diversity and integration. Journal of Clinical Psychology, 56(2), 233-243. https://doi.org/10.1002/(SICI)1097-4679(200002)56:2<233: AID-JCLP9>3.0.CO;2-3
49. Sharf, R. (2014). Psikoterapi ve psikolojik danışma kuramları (N. Voltan-Acar, Çev.). Nobel Akademi. (Orijinal çalışma basım tarihi 2011).
50. Shaw, H. E., & Shaw, S. F. (2006). Critical ethical issues in online counseling: Assessing current practices with an ethical intent checklist. Journal of Counseling & Development, 84(1), 41-53. https://doi.org/10.1002/j.1556-6678.2006.tb00378.x
51. Simpson, S. (2001). The provision of a telepsychology service to Shetland: Client and therapist satisfaction and the ability to develop a therapeutic alliance. Journal of Telemedicine and Telecare, 7(1), 34-36. https://doi.org/10.1177%2F1357633X010070S114
52. Simpson, S., & Reid, C. L. (2014). Therapeutic alli- ance in videoconferencing psychotherapy: A review. The Australian Journal of Rural Health, 22, 280–299. http://dx.doi.org/10.1111/ajr.12149
53. Simpson, S., Richardson, L., Pietrabissa, G., Castelnuovo, G., & Reid, C. (2021). Videotherapy and therapeutic alliance in the age of COVID‐19. Clinical Psychology & Psychotherapy, 28(2), 409-421. https://doi.org/10.1002/cpp.2521
54. Soygüt, G. (2004). Bir düzeltici bağlanma ilişkisi olarak psikoterapi: Psikoterapi süreçlerinde bağlanma ve terapötik ittifak. Türk Psikoloji Yazıları, 7(13), 63-77.
55. Soygüt, G., & Işıklı, S. (2008). Terapötik ittifakın değerlendirilmesi: Terapötik İttifak Ölçeği'nin güvenilirlik ve geçerlik çalışması. Türk Psikiyatri Dergisi, 19(4), 398-408.
56. Soygüt, G., & Uluç, S. (2009). Psychometric properties of the Turkish Working Alliance Inventory- Observer Form. Türk Psikiyatri Dergisi, 20(4), 367-375.
57. Sucala, M., Schnur, J. B., Constantino, M. J., Miller, S. J., Brackman, E. H., & Montgomery, G. H. (2012). The therapeutic relationship in e-therapy for mental health: a systematic review. Journal of Medical Internet Research, 14(4), e110. https://doi.org/10.2196/jmir.2084
58. Summers, R. F., & Barber, J. P. (2003). Therapeutic alliance as a measurable psychotherapy skill. Academic Psychiatry, 27(3), 160-165. https://doi.org/10.1176/appi.ap.27.3.160
59. Tanrıkulu, İ. (2009). Counselors-in-training students’ attitudes towards online counseling. Procedia Social and Behavioral Sciences, 1, 785-788. https://doi.org/10.1016/j.sbspro.2009.01.140
60. Uslu, B., & Welch, A. (2018). The influence of universities’ organizational features on professorial intellectual leadership. Studies in Higher Education, 43(3), 571-585. https://doi.org/10.1080/03075079.2016.1185774
61. Wagner, B., Horn, A. B., & Maercker, A. (2014). Internet-based versus face-to-face cognitive-behavioral intervention for depression: A randomized controlled non-inferiority trial. Journal of Affective Disorders, 152, 113-121. https://doi.org/10.1016/j.jad.2013.06.032
62. Wendt, D., & Shafer, K. (2016). Gender and attitudes about mental health help seeking: Results from national data. Health & Social Work, 41(1), e20-e28. https://doi.org/10.1093/hsw/hlv089
63. Westerman, M. A., & Muran, J. C. (2017). Investigating an approach to the alliance based on interpersonal defense theory. Psychotherapy Research, 27(5), 620-641. https://doi.org/10.1080/10503307.2016.1152407
64. Wind, T.R, Rijkeboer, M., Andersson, G., & Riper, H. (2020). The COVID-19 pandemic: The ‘black swan’ for mental health care and a turning point for e-health. Internet Interventions,20(1), 1-6. https://doi.org/10.1016/j.invent.2020.100317
65. Wu, J. T., Leung, K., & Leung, G. M. (2020). Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: A modelling study. The Lancet, 395(10225), 689-697. https://doi.org/10.1016/S0140-6736(20)30260-9
66. Yıldırım, A., & Şimşek, H. (2013). Sosyal bilimlerde nitel araştırma yöntemleri (6. bs.). Seçkin Yayıncılık.
67. Zhang, J., Wu, W., Zhao, X., & Zhang, W. (2020). Recommended psychological crisis intervention response to the 2019 novel coronavirus pneumonia outbreak in China: A model of West China Hospital. Precision Clinical Medicine, 3(1), 3-8. https://doi.org/10.1093/pcmedi/pbaa006
68. Zeren, Ş. G. (2014). Information and communication technology in education of psychological counselors in training. International Online Journal of Educational Sciences, 6(2), 494-509. http://dx.doi.org/10.15345/iojes.2014.02.019
69. Zeren, Ş. G. (2015). Face-to-face and online counseling: Client problems and satisfaction Yüz yüze ve çevrimiçi psikolojik danışma: Danışanların sorunları ve memnuniyetleri. Education & Science, 40(182), 127-141. http://dx.doi.org/10.15390/EB.2015.4696
70. Zeren, Ş. G. (2017). Therapeutic alliance in face-to-face and online counseling: Opinions of counselor candidates. Journal of Human Sciences, 14(3), 2278-2307. https://doi.org/10.14687/jhs.v14i3.4203
71. Zeren, Ş. G. (2020). Psikolojik danışmada yeni açılımlar ve çevrimiçi psikolojik danışmaya giriş . Ş. G. Zeren (Ed.), Psikolojik danışmada yeni açılımlar ve çevrimiçi psikolojik danışma uygulayıcıları için el kitabı içinde(ss. 2-27). Pegem Akademi.
72. Zeren, Ş. G., Erus, S. M., Amanvermez, Y., Buyruk Genç, A., Yılmaz, M. B., & Duy, B. (2020). An experimental study of online counseling in Turkey: Clients’ subjective well-being. European Journal of Educational Research, 9(2), 825-834. https://doi.org/10.12973/eu-jer.9.2.825
73. Zilcha-Mano, S., Dinger, U., McCarthy, K. S., & Barber, J. P. (2014). Does alliance predict symptoms throughout treatment, or is it the other way around? Journal of Consulting and Clinical Psychology, 82(6), 931-935. http://dx.doi.org/10.1037/a0035141
74. Zilcha-Mano, S., & Errázuriz, P. (2015). One size does not fit all: Examining heterogeneity and identifying moderators of the alliance–outcome association. Journal of Counseling Psychology, 62(4), 579-591. http://dx.doi.org/10.1037/cou0000103
75. Zilcha-Mano, S., Muran, J. C., Hungr, C., Eubanks, C. F., Safran, J. D., & Winston, A. (2016). The relationship between alliance and outcome: Analysis of a two-person perspective on alliance and session outcome. Journal of Consulting and Clinical Psychology, 84(6), 484-496. http://psycnet.apa.org/doi/10.1037/ccp0000058
76. Ægisdóttir, S., & Gerstein, L. H. (2009). Beliefs About Psychological Services (BAPS): Development and psychometric properties. Counselling Psychology Quarterly, 22(2), 197-219. https://doi.org/10.1080/09515070903157347
77. Ægisdóttir, S., & Einarsdóttir, S. (2012). Cross-cultural adaptation of the Beliefs About Psychological Services Scale (I-BAPS) for Iceland. International Perspectives in Psychology: Research, Practice, Consultation, 1, 236-251. https://doi.org/10.1037/a0030854