Empathic interactions in online treatment: experiences of mental healthcare practitioners

Studies on practitioners' perceptions of eMental Health repeatedly report experienced difficulties in establishing empathic interactions with their clients online – a fact that plays an important role in the adoption, or lack thereof, of technology-mediated treatments. Especially now, in times when social distancing and lockdown measures are effectuated globally to combat the COVID-19 pandemic, the need for high-quality online formats of mental health care has become more urgent than ever. To increase our understanding of the process of achieving empathic interactions in technology-mediated communication, the current paper presents an online survey study using open questions on practitioners' experiences of establishing empathy in online therapeutic interactions (n = 363). Responses were analyzed using thematic analysis. From the derived themes, a conceptual model was built showing several properties of online communication that influence empathy and how these properties affect the therapeutic interaction on emotional, conversational and relational levels. Additionally, our findings highlight the behavioral strategies practitioners employ to find workarounds in order to manage these effects and attempt to (re)connect with their clients. Our findings thus provide experience-based insights into the process of building empathy in online treatments – insights that can be used to improve current and future eMental Health technologies, enabling practitioners to reach the desired level of empathic understanding during remote therapeutic interactions.