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