Teleconsultation in mental health

The developing online frameworks for mental health teleconsultation create particular conditions of interaction that are contributing to the transformation of psychotherapeutic practices and the therapeutic relationship. The physical and symbolic framework of this relationship is disrupted, the conditions of mutual observability and audibility are not as good as in face-to-face contact and, in various ways, practitioners experience a sense of distance in their relationship with the patient. Because of its greater openness, but also due to the small technical dysfunctions that arise during sessions, the new psychotherapeutic framework makes interactions more fragile, in the sense that they can be more easily disrupted or interrupted than during face-to-face consultations in the protected space of the consulting room. Efforts to sustain attention must also be developed in order to capture the different informational signals emanating from the patient, which are more sparse in teleconsultations. Finally, clinical intuition manifests itself differently and practitioners doubt the quality of their judgment and diagnostic hypotheses more than they otherwise would, which causes them to ask more questions and to leave less room for silence and its interpretation. However, the very fact that clinical intuitions continue to arise during teleconsultations contributes to the establishment of an empathetic relationship, and thus to the accomplishment of remote psychotherapeutic work.