In person online

What trainee psychotherapists discovered about online clinical work

  • Elizabeth Day
  • Kerry Thomas-Anttila
Keywords: clinical, in-person, online therapy, trainee psychotherapist, student, COVID-19, pandemic


During the 2020 lockdown in response to COVID-19, students in the Master of Psychotherapy at the Auckland University of Technology (AUT) were required to rapidly move their clinical work online. We surveyed these students about their experience of working clinically online. We used a mixed-methods approach and analysed qualitative data using grounded theory methods. Students found the move online difficult, with technological challenges, the loss of a professional clinical space, and having to establish and maintain the therapeutic alliance in the unfamiliar online setting. They showed a strong preference for in-person clinical work, along with scepticism about the efficacy of online therapy, though some acknowledged its convenience and others its currency and relevance. Most expressed a need for more specific training in online therapy. Students rated their technological skill level higher than their levels of interest in online communication. This suggests that preferences, rather than technical skill, influenced their hesitancy for working clinically online. While online therapy can impose increased strain on clinicians and directly impact their capacity to manage online clinical work, the literature finds strong and consistent evidence that online therapy has equivalent outcomes to in-person therapy. There is significant emphasis in the literature on the disjunct between the outcomes evidence and therapist expectations. This is modified somewhat by training and experience in online therapy. We recommend that research- active psychotherapists engage actively and collaboratively with the profession, through professional bodies, to encourage research-informed professional development and practice for clinicians; and that further research is conducted into effective strategies for training in online clinical delivery.

Author Biographies

Elizabeth Day

Elizabeth Day, BA (Hons), PhD, left her home town of Melbourne in 2015 to move to Aotearoa New Zealand with her partner, Willa. The move was prompted by an offer from a benefactor for them to establish a yoga and meditation studio, and clinical practice, here; and it enabled them to connect with their New Zealand family. After years of clinical work, and decades of meditation practice — including time as a monk in a buddhist monastery in England — Elizabeth felt the pull to a more integrated, embodied focus for clinical work with a

primary orientation to wairua.
In Melbourne Elizabeth was Academic Head of a Psychotherapy and Counselling

Department for a national college. She transferred to online teaching and research supervision through the re-settlement to Aotearoa New Zealand. After establishing the studio at Kihikihi, she joined the Department of Psychotherapy and Counselling at AUT, where she is a senior lecturer and current Head of the Department. She teaches postgraduate courses, conducts research, and provides research supervision for Masters and Doctoral students.

Elizabeth has published on phenomenology and ethics, gender and sexuality identity, mindfulness, field theory, and COVID-19; and co-edited a book on contemporary counselling and psychotherapy practices in Australia. Her professional service includes Chair of the Research Committee of the Psychotherapy and Counselling Federation of Australia, and Editorial Board member of PACJA. Her therapeutic practice is informed by training in gestalt and psychodynamic psychotherapy, alongside intersubjective and phenomenological research, and intensive mindfulness practice for around 30 years.

Kerry Thomas-Anttila

Kerry Thomas-Anttila, PhD, MPsychotherapy (Hons), MA (Hons), began training as a psychotherapist at AUT in 2001. She has been a member of NZAP since 2007, is an immediate past co-convenor of the Auckland Branch, and is registered with PBANZ. In 2010 she joined the Psychotherapy Department at AUT as a staff member, was the Programme Leader for the Graduate Diploma in Psychosocial Studies (now Graduate Diploma in Psychotherapy Studies) between 2013 and 2017 and, since 2018, has been the Programme Leader for the Master

of Psychotherapy (adult pathway). She completed her PhD in 2017; this research included interviewing practising psychotherapists to explore their experiences of their ongoing learning. Using hermeneutic phenomenology as a methodology, with particular reference to Heideggerian notions, helped to articulate the ways in which psychotherapists’ learning processes and experiences do not fit well within the constraints of positivist paradigms.

Kerry is a senior lecturer and, as well as being in the programme leader role, currently teaches and researches in the department and provides academic supervision for Masters and Doctoral students. She has published on psychotherapists’ lived experience of their ongoing learning, understanding the other in the psychotherapy relationship, online therapy, and on confidentiality and privacy issues relating to clinical work. Kerry lives with husband Olli in Parnell, Auckland, where they each maintain a psychotherapy and supervision practice. Between them they have four adult children and three grandchildren.

How to Cite
Day, E., & Thomas-Anttila, K. (2021). In person online: What trainee psychotherapists discovered about online clinical work. Ata: Journal of Psychotherapy Aotearoa New Zealand, 25(1), 89-105.