因應COVID-19從實體諮商轉換為視訊晤談的經驗探究：當事人的視角

The Transition from Face-to-Face Counseling to Videoconferencing Following the Onset of the COVID-19 Pandemic in Taiwan: The Client's Perspective

COVID-19疫情嚴重威脅人們的身心健康，也加速通訊諮商的發展。原進行實體諮商的當事人，面對突發疫情須轉為視訊晤談，這轉換過程的經驗、對諮商關係的知覺，是本研究探究焦點。本研究以發現式研究取向，針對九位大學生當事人，透過半結構式深度訪談蒐集資料，並採紮根理論研究的資料分析方法。研究結果發現，當事人在轉換過程的經驗有四個主題，一是對視訊晤談的預想，正面期待與擔憂參半；二是視訊晤談過程實際困境，包含溝通品質不佳影響投入、虛擬空間療癒氛圍難以營造、情緒表達與覺察受限等，此一主題也是敘說最豐富的；三是有助持續視訊晤談的因素，包含當事人務實的考量、視訊困境的應對與調適；四是視訊晤談的正向經驗，包含省時便利、降低社交接觸的負擔。當事人對於轉換過程諮商關係的知覺有兩個主題，一是轉換對諮商關係的影響，包含情感連結的減損、諮商關係更親近；二是有助諮商關係維繫的因素，包含原有實體諮商基礎的加持、心理師即時的支持與回應。本研究認為在視訊晤談前準備度不足，是導致當事人衝擊經驗的主因之一，而當事人與心理師因應視訊形式的雙向調整有助於當事人調適視訊困境，此外，當事人在轉換過程普遍經歷情感連結的弱化，然原有實體諮商關係的基礎有助於調節轉換過程的不適。最後，依研究結果，提供相關實務與未來研究之建議。

 

The global COVID-19 pandemic was a serious threat to the physical and mental health of individuals. Due to social distancing measures, psychological counseling sessions that were previously held face-to-face had to be conducted through videoconferencing. In Taiwan, the two COVID-19 outbreaks in early 2020 and May 2021 necessitated the imposition of social restrictions. This study focuses on the experiences and views of college student clients who initially received counseling for mental health issues through face-to-face sessions but had to transition to online video counseling due to the epidemic.

In this study, a qualitative research method with discovery orientation was adopted. The recruitment of study participants was carried out in two phases. The first phase targeted two universities in central Taiwan, while the second phase was expanded to include universities in northern and southern Taiwan. Both recruitments were promoted online on the school pages of several universities. Over 20 college students signed up in the two stages. After screening by the researchers through telephone and email, only 9 college students (female = 6), all sophomores or juniors, met the study criteria. Data collection was conducted through semi-structured, in-depth interviews conducted through videoconferencing due to social distancing constraints. Open coding, axial coding, and selective coding based on grounded theory research were used for data analysis.

The analysis extracted four themes in the participants’ experiences of transition to videoconferencing. The first theme is the anticipation of the videoconference, which includes three sub-themes: feeling a sense of similarity to previous experiences of online social communication or distance learning, having positive expectations due to novelty and convenience, and worrying about the possible limitations of the videoconference or interfering distractions. The second theme addresses the challenges of videoconferences, encompassing three sub-themes: the adverse effects of poor dialogue quality on engagement, difficulties in establishing a comforting atmosphere in virtual spaces, and limitations on emotional expression and awareness. The participants discussed this theme frequently in the interviews. The third theme is related to the elements that enable the success of continuous videoconference interviews, including two sub-themes: pragmatic considerations of the client and coping with and adjusting to videoconferencing difficulties. Fourth, the positive experience of videoconferencing includes two sub-themes: time-saving and convenience, which reduce the burden of social contact. Two themes were identified in the participants’ perception of the counseling relationship during the transition process. One aspect to consider is the impact of transition on the counseling relationship, which includes two sub-themes: loss of emotional connection and a strengthened counseling relationship. The second theme pertains to the factors that contribute to maintaining the consultation relationship, encompassing two sub-themes: the support of an existing face-to-face counseling relationship and the immediate support and response from the counseling psychologist.

This study suggests that the absence of proper informed consent by psychological counseling professionals before the videoconference is one of the main factors affecting the client’s experience. The quality of the videoconference session is significantly influenced by communication equipment and the environment. In addition, participants typically spoke of a weakening of the emotional connection in the counseling relationship during the transition process. The original face-to-face counseling relationship foundation helped to alleviate the discomfort of the transition process. Finally, based on the study results, recommendations for practice related to telecounseling and suggestions for future research directions are provided.