The scarce literature on this subject is divided between those who maintain that the screen establishes a relational distance between the patient and the therapist (disengagement theory) and those who

The gap

Consensus across the literature

Supporting evidence — 3 representative gaps

• Between Presence and Distance: Patients’ Experiences of Therapist Connection in Internet Administrated Psychodynamic Therapy for Somatic Symptom Disorder (2026) · doi

  The study demonstrates that therapeutic presence is not con- fined to physical co-presence. In I-EAET, therapist contact can provide containment and validation, and absence may evoke experiences of distance and longing. Working with- out a therapist may foster autonomy and reflective function- ing but also increase vulnerability to emotional overload. Future research should compare guided, partially guided, and self-guided internet-based psychodynamic treatments and examine individual difference factors that moderate patients’ capacity to benefit from varying levels of thera- pist presence. Integrating qualitative and process-oriented measures may further elucidate how emotional processing unfolds in written therapeutic formats.

  Keywords: presence guided therapeutic therapist emotional demonstrates fined physical eaet contact provide containment validation absence evoke
• Online Psychotherapy: Transference and Countertransference Issues (2021) · doi

  I conclude by noting limitations of this study based as it was on the immediate reaction of myself and my colleagues to the transition from providing clinic‐based to online psychotherapy, not on interviews with patients about their experience of this transition nor on any measure of the relative effectiveness of online compared with clinic‐based psychotherapy.

  Keywords: based transition clinic online psychotherapy conclude noting limitations immediate reaction myself colleagues providing interviews patients
• Absent Bodies: Psychotherapeutic Challenges during COVID-19 (2022) · doi

  The scarce literature on this subject is divided between those who maintain that the screen establishes a relational distance between the patient and the therapist (disengagement theory) and those who instead consider it an element that stimulates and facilitates communication (stimulation theory).

  Keywords: theory scarce literature subject divided maintain screen establishes relational distance patient therapist disengagement instead consider