Therapeutic Alliance in Tele-Counseling: The Experiences of Patients with Obsessive-Compulsive Disorder and Counselors

The purpose of this study was to answer the question of what were the experiences of counselors and patients with obsessive-compulsive disorder in tele-counseling and to analyze the experiences related to establishing and maintaining therapeutic alliance in tele-counseling. Thematic analysis was used to answer the research questions. The main data collection method was a semi-structured interview and the interview guide was designed using literature as well as expert opinions. From the analysis of interviews with 12 clients with obsessive-compulsive disorder and 7 obsessive-compulsive therapists with experience in tele-counseling, three main themes have been obtained including the formation of the therapeutic alliance, barriers to the therapeutic alliance and factors involved in the enhancement of therapeutic alliance. The results showed that creating and maintaining a therapeutic alliance in tele-counseling is possible. Although there may be obstacles, if the counselor can identify the existing barriers and adapt the counseling techniques and skills to the conditions of cyberspace, creating and marinating a therapeutic alliance will be possible. Due to the increasing opportunities to have tele-counseling, increasing client demands, as well as the possibility of recurrence of conditions such as the COVID-19 pandemic that forced the use of tele-counseling, it seems that more attention should be paid to identifying barriers and sources of therapeutic alliance in tele-counseling, and more studies are needed in this area.