Τhe group behind the glass: An interpretative phenomenological analysis of online group psychotherapy in the time of Covid-19 in Greece


Published: Dec 27, 2025
Keywords:
οnline psychotherapy, groups, Covid-19, interpretative phenomenological analysis
Christina Chrysoula Deni
Christina Papachristou
Abstract

The aim of the study was to investigate the experience of group psychotherapists about online group psychotherapy during the Covid-19 lockdown period. The study examined the psychotherapists’ experiences regarding the groups’ online conduction, the challenges and possibilities that emerged, as well as the effect of the online therapeutic setting on group interaction and on therapeutic interventions. Semi-structured individual interviews were conducted with 15 group psychotherapists, from different therapeutic approaches. Interpretive Phenomenological Analysis was applied for data analysis. A major finding concerns the specific character of the online psychotherapy setting, which had to be adjusted and reconceptualized to the physical distance and the technology involvement. Remote participation in the group seemed to weaken the setting against ruptures and to disrupt confidentiality. According to findings, the online setting proved less adequate in establishing relationships and group cohesion. It was found that: a) due to the lack of physical presence in a common shared space, the perception of the group in its whole is limited and b) the absence of a physical space both enables or obstructs self-disclosure and feelings of intimacy, and intensifies aggression. Online group therapy was viewed as less effective and more as a solution out of necessity during the pandemic, with yet a positive subjective therapeutic outcome. The clinicians’ ability to adapt therapeutic practice, according to conditions is important in order to ensure a safe environment for the provision of psychotherapy in times of crisis. Since online psychotherapy requires specific skills and training, the results contribute by making specific suggestions to understanding and adopting effective online group interventions.

Article Details
  • Section
  • SPECIAL SECTION
Downloads
Download data is not yet available.
References
American Psychological Association. (2020). Psychologists embrace telehealth to prevent the spread of COVID-19. https://www.apaservices.org/practice/legal/technology/psychologists-embrace-telehealth
Banbury, A., Nancarrow, S., Dart, J., Gray, L., & Parkinson, L. (2018). Telehealth interventions delivering home-based support group videoconferencing: Systematic review. Journal of Medical Internet Research, 20(2), e25. https://doi.org/10.2196/jmir.8090
Batastini A. B., Paprzycki P., Jones A. C., MacLean N. (2021). Are videoconferenced mental and behavioral health services just as good as in-person? A meta-analysis of a fastgrowing practice. Clinical Psychology Review, 83, 101944. https://doi.org/10.1016/j.cpr.2020.101944.
Ben-David, Y., Ickeson, T., & Kaye-Tzadok, A. (2021). Lost in the matrix: Dialectical tensions in facilitating virtual video groups during COVID-19 pandemic. Internet interventions, 26, 100445. https://doi.org/10.1016/j.ivent.2021.100445
Békés, V., & Aafjes-van Doorn, K. (2020). Psychotherapists’ attitudes toward online therapy during the COVID-19 pandemic. Journal of Psychotherapy Integration, 30(2), 238–247. https://doi.org/10.1037/int0000214
Békés, V., Aafjes-van Doorn, K., Luo, X., Prout, T. A., & Hoffman, L. (2021). Psycho-therapists' challenges with online therapy during COVID-19: Concerns about connectedness predict therapists' negative view of online therapy and its perceived efficacy over time. Frontiers in psychology, 12, 705699. https://doi.org/10.3389/fpsyg.2021.705699
Békés, V., Aafjes-van Doorn, K., Prout, T. A., & Hoffman, L. (2020). Stretching the analytic frame: Analytic therapists' experiences with remote therapy during COVID-19. Journal of the American Psychoanalytic Association, 68(3), 437–446. https://doi.org/10.1177/0003065120939298
Biancalani, G., Franco, C., Guglielmin, M. S., Moretto, L., Orkibi, H., Keisari, S., &Testoni, I. (2021). Tele-psychodrama therapy during the COVID-19 pan-demic: Participants’ experiences. The Arts in Psychotherapy, 75. https://doi.org/10.1016/j.aip.2021.101836
Bouchard, S., Paquin, B., Payeur, R., Allard, M., Rivard, V., Fournier, T., Renaud, P., & Lapierre, J. (2004). Delivering cognitive-behavior therapy for panic disorder with agoraphobia in videoconference. Telemedicine journal and e-health: the official journal of the American Telemedicine Association, 10(1), 13–25. https://doi.org/10.1089/153056204773644535
Brooks, E., Turvey, C., & Augusterfer, E. F. (2013). Provider barriers to telemental health: Obstacles overcome, obstacles remaining. Telemedicine and e-Health, 19(6), 433–437. https://doi.org/10.1089/tmj.2013.0068
Burgoyne, N., & Cohn, A. S. (2020). Lessons from the transition to relational teletherapy during COVID‐19. Family Process, 59(3), 974–988. https://doi.org/10.1111/famp.12589
Connolly, S. L., Miller, C. J., Lindsay, J. A., & Bauer, M. S. (2020). A systematic review of providers’ attitudes toward tele-mental health via videoconferencing. Clinical Psychology: Science and Practice, 27(2), https://doi.org/10.1111/cpsp.12311
Creswell, J.W., (2016). 30 Essential Skills for the Qualitative Researcher. Sage.
Downing, L., Marriott, H., & Lupton, D. (2021). ‘Ninja’ levels of focus”: Therapeutic holding environments and the affective atmospheres of telepsychology during the COVID-19 pandemic. Emotion, Space and Society, 40, 100824. https://doi.org/10.1016/j.emospa.2021.100824
Dubey, S., Biswas, P., Ghosh, R., Chatterjee, S., Dubey, M. J., Chatterjee, S., Lahiri, D., & Lavie, C. J. (2020). Psychosocial impact of COVID-19. Diabetes & metabolic syndrome, 14(5), 779–788. https://doi.org/10.1016/j.dsx.2020.05.035
Ertelt, T. W., Crosby, R. D., Marino, J. M., Mitchell, J. E., Lancaster, K., & Crow, S. J. (2011). Therapeutic factors affecting the cognitive behavioral treatment of bulimia nervosa via telemedicine versus face-to-face delivery. International Journal of Eating Disorders, 44(8), 687–691. https ://doi.org/10.1002/eat.20874
Feijt, M., de Kort, Y., Bongers, I., Bierbooms, J., Westerink, J., & IJsselsteijn, W. (2020). Mental health care goes online: Practitioners' experiences of providing mental health care during the COVID-19 pandemic. Cyberpsychology, Behavior, and Social Networking, 23(12), 860–864. https://doi.org/10.1089/cyber.2020.0370
Gentry, M. T., Lapid, M. I., Clark, M. M., & Rummans, T. A. (2018). Evidence for telehealth group-based treatment: A systematic review. Journal of Telemedicine and Telecare, 25(6), 327–342. https://doi.org/10.1177/1357633X18775855
Gullo, S., Lo Coco, G., Leszcz, M., Marmarosh, C. L., Miles, J. R., Shechtman, Z., Weber, R., & Tasca, G. A. (2022). Therapists’ perceptions of online group therapeutic relationships during the COVID-19 pandemic: A survey-based study. Group Dynamics: Theory, Research, and Practice, 26(2), 103–118. https://doi.org/10.1037/gdn0000189
Harrell, M. C., & Bradley, M. A. (2009). Data collection methods: Semi-structured interviews and focus groups [Technical report TR-718]. RAND Corporation. https://www.rand.org/pubs/technical_reports/TR718.html
Holmes, E. A., O'Connor, R. C., Perry, V. H., Tracey, I., Wessely, S., Arseneault, L., Ballard, C., Christensen, H., Cohen Silver, R., Everall, I., Ford, T., John, A., Kabir, T., King, K., Madan, I., Michie, S., Przybylski, A. K., Shafran, R., Sweeney, A., Worthman, C. M., Bullmore, E. (2020). Multidisciplinary research priorities for the COVID-19 pandemic: Α call for action for mental health science. The lancet. Psychiatry, 7(6), 547–560. https://doi.org/10.1016/S2215-0366(20)30168-1
Hood, P., Turner, C. J., Beggs, B., Owens, L., & Chapman, A. L. (2023). Making lemonade out of lemons: Dialectical behavior therapy via telehealth during a pandemic. Behavior Therapy, 54(5), 876–891. https://doi.org/10.1016/j.beth.2023.03.007
Kokou-Kpolou, C. K., Fernández-Alcántara, M., & Cénat, J. M. (2020). Prolonged grief related to COVID-19 deaths: Do we have to fear a steep rise in traumatic and disenfranchised griefs? Psychological Trauma: Theory, Research, Practice, and Policy, 12(S1), S94-S95. https://doi.org/10.1037/tra0000798
Kotera, Y., Kaluzeviciute, G., Lloyd, C., Edwards, A. M., & Ozaki, A. (2021). Qualitative investigation into therapists' experiences of online therapy: Implications for working clients. International journal of environmental research and public health, 18(19), 10295. https://doi.org/10.3390/ijerph181910295
Larkin, M., & Thompson, A. R. (2012). Interpretative phenomenological analysis in mental health and psychotherapy research. In D. Harper & A. R. Thompson (Eds.), Qualitative research methods in mental health and psychotherapy: A guide for students and Practitioners (pp. 99–116). John Wiley & Sons.
Lemma, A. (2017). The digital age on the couch: Psychoanalytic practice and new media. Routledge.
Lemma, A. (2021, May 15). Psychoanalysis behind the screen: Some personal reflections. Keynote speech at the EFFP one-day online conference, Pandemic in our lives: Impact on our patients. https://hspgp.gr/pandemic-in-our-lives-impact-on-our-patients/
Li, Q., Guan, X., Wu, P., Wang, X., Zhou, L., Tong, Y., Ren, R., Leung, K. S. M., Lau, E. H. Y., Wong, J. Y., Xing, X., Xiang, N., Wu, Y., Li, C., Chen, Q., Li, D., Liu, T., Zhao, J., Liu, M., Tu, W., … Feng, Z. (2020). Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. The New England Journal of Medicine, 382(13), 1199–1207. https://doi.org/10.1056/NEJMoa2001316
Lin, T., Stone, S. J., Heckman, T. G., & Anderson, T. (2021). Zoom-in to zone-out: Therapists report less therapeutic skill in telepsychology versus face-to-face therapy during the COVID-19 pandemic. Psychotherapy, 58(4), 449–459. https://doi.org/10.1037/pst0000398
Lopez, A., Rothberg, B., Reaser, E., Schwenk, S., & Griffin, R. (2020). Therapeutic groups via video teleconferencing and the impact on group cohesion. mHealth, 6, 13. https://doi.org/10.21037/mhealth.2019.11.04
Maier, C. A., Riger, D., & Morgan-Sowada, H. (2021). "It's splendid once you grow into it:" Client experiences of relational teletherapy in the of COVID19. Joural of marital and family therapy, 47(2), 304-319. https://doi.org/10.1111/jmft.12508
Marmarosh, C. L., Forsyth, D. R., Strauss, B., & Burlingame, G. M. (2020). The psychology of the COVID-19 pandemic: A group-level perspective. Group Dynamics Theory, Research and Practice, 24(3), 122–138. https://doi.org/10.1037/gdn0000142
McBeath, A. G., du Plock, S., & Bager-Charleson, S. (2020). The challenges and experiences of psychotherapists working remotely during the coronavirus pandemic. Counselling and psychotherapy research, 20(3), 394–405. https://doi.org/10.1002/capr.12326
McWilliams N. (2004). Psychoanalytic psychotherapy: a practitioner's guide. Guilford Press.
Pietkiewicz, I., & Smith, J. A. (2014). A practical guide to using interpretative phenomenological analysis in qualitative research psychology. Czasopismo Psychologiczne / Psychological Journal, 20(1), 7–14. https://doi.org/10.14691/CPPJ.20.1.7
Robledo Yamamoto, F., Voida, A., & Voida, S. (2021). From therapy to teletherapy: Relocating mental health services online. Proceedings of the ACM on Human-Computer Interaction, 5(CSCW2), 1–30. https://doi.org/10.1145/3479508
Simpson, S. (2009). Psychotherapy via videoconferencing: A review. British Journal of Guidance and Counselling, 37(3), 271–286. https://doi.org/10.1080/03069880902957007
Simpson, S.R., Bell, L., Knox, J., & Mitchell, D. (2005). Therapy via videoconferencing: a route to client empowerment? Clinical Psychology & Psychotherapy, 12, 156-165. https://doi.org/10.1002/cpp.436 100
Simpson, S., Knox, J., Mitchell, D., Ferguson, J., Brebner, J., & Brebner, E. (2003). A multidisciplinary approach to the treatment of eating disorders via videoconferencing in north-east Scotland. Journal of Telemedicine and Telecare, 9, 37–38. https://doi.org/10.1258/135763303322196286
Simpson, S., & Morrow, E. (2010). Using videoconferencing for conducting a therapeutic relationship. In K. Anthony, D. Nagel, & S. Goss (Eds.), The use of technology in mental health: Applications, ethics & practice (pp. 113–127). Charles C Thomas.
Simpson, S. G., & Reid, C. L. (2014). Therapeutic alliance in videoconferencing psychotherapy: A review. Australian Journal of Rural Health, 22, 280–299. https://doi.org/10.1111/ajr.12149
Smith, J. A., & Osborn, M. (2003). Interpretative phenomenological analysis. In J. A. Smith, Qualitative Psychology: A practical guide to research methods. Sage Publications.
Suler, J. (2004). The Online Disinhibition Effect. Cyberpsychology & Behavior, 7(3), 321–326. https://doi.org/10.1089/1094931041291295
Weinberg, H. (2020). Online group psychotherapy: Challenges and possibilities during COVID-19—A practice review. Group Dynamics: Theory, Research, and Practice, 24(3), 201–211. https://doi.org/10.1037/gdn0000140
Weinberg, H., & Rolnick, A. (2019). Theory and practice of online therapy: Internet de-livered interventions for individuals, families, groups and organizations. Wiley. https://doi.org/10.4324/9781315545530
Willig, C. (2015). Qualitative research methods in psychology: An introduction [Ποιοτικές μέθοδοι έρευνας στην ψυχολογία: Μια εισαγωγή] (E. Avgita, Trans.; E. Tseliou, Ed.). Gutenberg. (Original work published 2013).
Zerwas S. C., Watson H. J., Hofmeier S. M., Levine M. D., Hamer R. M., Crosby R. D., Runfola C. D., Peat C. M., Shapiro J. R., Zimmer B., Moessner M., Kordy H., Marcus M. D., Bulik C. M. (2017). CBT4BN: A Randomized Controlled Trial of Online Chat and Face-to- Face Group Therapy for Bulimia Nervosa. Psychotherapy and Psychosomatics, 86(1), 47-53. https://doi.org/10.1159/000449025
Most read articles by the same author(s)