Dealing with affect using IPT on line...Liz Robinson and Catherine Edmunds. Covid 19 Challenges in...

Dealing with affect using IPT on line

Liz Robinson and Catherine Edmunds

Covid 19

Challenges in providing medical intervention

Covid 19

Challenges in providing psychotherapy online

Using tools to access/connect with affect

• Send information before/between sessions

• Diaries, stories, images

• Caution - confidentiality

• Pitch to individual, developmental stage

• Share screen as reminder – as tool to focus on clients affect

Dealing with affect

Grief- facilitating mourning

Treasured memories

Grief- facilitating mourning

Everydaymemories

Grief- facilitating mourning

Sharp, hard to hold memories/ feelings

Challenges of remote working

Technology and internet issues • poor sound• unstable Internet• distraction (beeps, people/pets coming in)

Interpersonal issues• being present in room• difficulty reading silences• hard to read affect over screen• eye contact• therapists work harder to stay focused

Engaging the client

• Suitability

• Safe space

• Timing

• Explicit naming of emotions

Discussion with expert IPT Phone therapist and researcher – suggest:

• Ask pt bit more often – check emotions

• Helpful to mentalise

• Venture a guess – they can always correct

• Absorb a lot from client in sessions

Client• Problematic affect is present

• They are living with the emotions

• What are consequences of a therapist asking….?

• What are consequences of a therapist not asking…..?

• How to optimise support for client throughout the process?

Remote sessions - affect work

Therapist concerns

• Therapist working in unchartered territory

• Will client cope, are they ready?

• Therapist anxiety about being able to help, to be present

Purpose of therapy

• Express and process affect

• Gradually reduce distress linked to interpersonal event

The therapist:

• Models tolerating intense/distressing affect

• Supports client to do this in a way that feels safe/manageable

• Provides scaffold for exploration and processing

Therapist

Self care

• No commute to wind down/process

• No regular, routine contact with professional colleagues and time to informally debrief

• Use of supervision

• Optimise self care – physical and emotional