APA Citation
Békés, V., & Doorn, K. (2020). Psychotherapists' Attitudes Toward Online Therapy During the COVID-19 Pandemic. *Journal of Psychotherapy Integration*, 30(2), 238-247.
Summary
This study examined psychotherapists' attitudes and experiences with online therapy during the early COVID-19 pandemic. Researchers surveyed mental health professionals about their readiness, comfort levels, and perceived effectiveness of teletherapy. The study found that while therapists initially had reservations about online treatment, many adapted quickly and found it effective for certain client populations. The research highlighted both opportunities and challenges in delivering trauma-informed care through digital platforms.
Why This Matters for Survivors
For survivors of narcissistic abuse, this research validates that effective therapy can happen online, expanding access to specialized trauma treatment. Many survivors face barriers to in-person therapy due to safety concerns, geographic isolation, or lingering effects of abuse. The study's findings offer hope that quality therapeutic support for healing from narcissistic abuse is available through digital platforms.
What This Research Establishes
Therapists successfully adapted to online delivery of trauma-informed care during the pandemic, with many reporting positive outcomes for clients dealing with complex trauma and abuse histories.
The therapeutic alliance can form effectively through digital platforms when therapists employ specific rapport-building techniques and maintain consistent, empathetic presence across virtual sessions.
Online therapy increased access to specialized treatment for vulnerable populations, including survivors who previously faced barriers to in-person care due to safety concerns or geographic isolation.
Initial therapist skepticism gave way to recognition of online therapy’s unique benefits, particularly for clients who feel safer and more in control when receiving treatment from their own secure environments.
Why This Matters for Survivors
For survivors of narcissistic abuse, the shift to online therapy represents a revolutionary expansion of access to healing. Many survivors have felt trapped by geographic limitations, unable to find local therapists who truly understand narcissistic abuse dynamics. This research validates that quality trauma therapy can happen through a screen, opening doors to specialized treatment regardless of location.
The safety aspect cannot be overstated. Online therapy allows you to receive treatment from your own secure space, without the vulnerability of being seen entering a therapy office. For survivors still entangled with abusive individuals or those dealing with hypervigilance, this privacy can be life-changing.
The research confirms that the therapeutic relationship—so crucial for healing from narcissistic abuse—can absolutely develop through virtual sessions. Your healing journey doesn’t require you to be physically present in an office; it requires connection with a skilled, understanding therapist who can meet you where you are.
Perhaps most importantly, this study emerged during a time when many survivors found themselves isolated with abusers during lockdowns. The validation that effective treatment could continue remotely provided hope during some of the darkest moments of the pandemic for those experiencing abuse.
Clinical Implications
This research provides evidence-based support for trauma therapists to confidently offer online services to narcissistic abuse survivors. The study’s findings suggest that many trauma-specific interventions can be effectively adapted for digital delivery, though therapists need training in online safety protocols and crisis intervention procedures.
Clinicians working with narcissistic abuse survivors should recognize that online therapy may actually feel safer for many clients who have experienced boundary violations and control. The ability to maintain their own environment and have greater control over the session can be therapeutically beneficial for rebuilding agency and autonomy.
The research highlights the importance of adapting rapport-building techniques for virtual environments. Therapists need to be more intentional about creating warmth and presence through screens, using verbal validation and emotional attunement to compensate for reduced nonverbal cues.
Safety planning becomes even more critical in online settings, particularly for survivors who may be accessing therapy while still living with abusive individuals. Therapists must develop sophisticated protocols for ensuring client safety and privacy during virtual sessions.
How This Research Is Used in the Book
Chapter 16 on “Finding Professional Support” draws heavily on this research to reassure survivors that online therapy can be as effective as in-person treatment. The accessibility findings are particularly relevant for survivors in rural areas or those seeking specialized narcissistic abuse treatment.
“The pandemic forced a rapid evolution in how we deliver trauma care, and the results were surprisingly positive. As Békés and Doorn’s research demonstrates, the therapeutic relationships that form online can be just as strong and healing as those that develop in traditional office settings. For survivors of narcissistic abuse, this means that geography, mobility, or safety concerns no longer have to be barriers to accessing specialized treatment. Your healing journey can begin from wherever you feel safe.”
Historical Context
This research was published during a pivotal moment in mental health care history, as the COVID-19 pandemic forced an unprecedented shift to online therapy delivery. The study captured therapists’ real-time experiences during this transition, providing crucial data that shaped the future of teletherapy and informed best practices for remote trauma treatment.
Further Reading
• Humer, E., et al. (2020). Provision of psychotherapy during the COVID-19 pandemic among Czech, German and Slovak psychotherapists. International Journal of Environmental Research and Public Health, 17(13), 4811.
• Pierce, B. S., et al. (2021). The effects of the COVID-19 pandemic on eating disorder risk and symptoms. International Journal of Eating Disorders, 54(7), 1166-1170.
• Weinberg, H. (2021). Online group psychotherapy: Challenges and possibilities during COVID-19—A practice review. Group Dynamics: Theory, Research, and Practice, 25(3), 201-211.
About the Author
Vera Békés is a clinical psychologist and researcher specializing in psychotherapy process research and digital mental health interventions. She has extensive experience studying therapeutic relationships and treatment outcomes in various modalities.
Katie A. Doorn is a clinical psychologist with expertise in psychotherapy integration and evidence-based treatment approaches. Her research focuses on improving access to mental health care and understanding factors that influence therapeutic effectiveness.
Historical Context
Published during the early months of the COVID-19 pandemic, this research captured a critical moment when mental health care rapidly shifted online. The findings became foundational for understanding how trauma therapy could be effectively delivered through digital platforms.
Frequently Asked Questions
Research shows online therapy can be highly effective for trauma recovery, including narcissistic abuse. Many survivors actually prefer the safety and privacy of remote sessions.
Online therapy offers increased safety, privacy, accessibility, and comfort for survivors who may feel triggered by in-person environments or face geographic barriers to specialized care.
Studies indicate that while therapists initially had reservations, many found online therapy surprisingly effective for trauma treatment when proper techniques and rapport-building strategies were used.
The pandemic accelerated adoption of online therapy, making specialized narcissistic abuse recovery treatment more accessible to survivors worldwide while maintaining therapeutic effectiveness.
Challenges include ensuring client safety and privacy, building therapeutic rapport through screens, managing technology issues, and adapting trauma-specific interventions for digital delivery.
Research demonstrates that strong therapeutic relationships can develop through online platforms when therapists use appropriate techniques and maintain consistent, empathetic presence.
Online therapy can be safer for many survivors, allowing them to access treatment from secure locations without risk of being seen entering therapy offices by abusive individuals.
Therapists modify techniques by focusing on safety planning, using digital tools for grounding exercises, ensuring private spaces, and developing crisis intervention protocols for remote sessions.