Change to the therapeutic frame: Exploring the therapeutic alliance when transitioning from face-to-face therapy to videoconferencing

Anthony Shoullis, Simone Mohi, Elly Quinlan, James Collison, Georgia Braude

Research output: Contribution to journalArticlepeer-review


The use of videoconferencing to deliver therapeutic services to clients has increased in recent times amongst mental health clinicians such as counsellors, psychologists, and psychotherapists. During lockdown periods associated with the COVID pandemic, most Australian mental health clinicians were required to transition their existing therapy clients from face-to-face to telehealth. The aim of the current study was to explore mental health clinicians’ experiences transitioning their existing therapy clients from a face-to-face modality to video conferencing, in order to understand potential implications to the therapeutic alliance. The study had a qualitative design using semi-structured interviews with 16 practicing psychologists. Inductive thematic analysis of the interviews revealed several unique findings. Psychologists reported that the change of frame, from face-to-face to videoconferencing, was helpful or unconstructive to the therapeutic alliance depending on client’s attitudes towards telehealth. Challenges for the therapeutic alliance included a lack of control over the environmental conditions and disruptions caused to the previously arranged tasks and goals of therapy. What helped the therapeutic alliance navigate the change of frame, was innovating news ways of working collaboratively, the prior establishment of a bond in person, and maintaining other aspects of the frame with consistently. The implications of these findings are discussed herein.
Original languageEnglish
Pages (from-to)458-474
Number of pages17
JournalInternational Journal for the Advancement of Counselling
Issue number3
Early online dateJun 2023
Publication statusPublished - Sept 2023


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