The challenges mentioned by participants can be generally divided into two categories: challenges related to technology, and challenges related to the psychological and health-related aspects of the pandemic.
Challenges Related to Technology
Some clients resisted the use of virtual platforms, and some don’t use the Internet at all. Ziva, who works with single women from the Haredi community in Jerusalem, stated, “Several of my Haredi women [patients] don’t even have an Internet connection.”
Gil also described the fundamental objections to Internet use and referred to the educational settings:
…Here in Jerusalem, where I work and live, many educational institutions are religious. This led to a new conflict between objections to technology and the Internet, and the need to use the Internet and video for remote learning. Quite a few teachers did not have WhatsApp for the same reasons, and the new dependency on websites, video, and WhatsApp created a considerable crisis. Internally and practically. [For these educators] one of the basic principles is to promote unmediated communications in general, and specifically to distance themselves from social media and the Internet, [yet] these educators were forced to use social media and websites that offer videoconferencing in order to communicate with their students, and at the same time they were forced to deal with their students’ questions about the use [of these tools], and what was no less difficult — with their own internal questions related to this dilemma.
Several patients had trouble working with virtual platforms, especially video-based platforms. Orit reported that “some clients adamantly refused to work with a camera. Under any circumstances.”
Sheerie spoke of one of her clients in the outpatient department whom she contacted on the day of the group’s scheduled session. “She asks me to keep it only on voice call; ‘No video,’ she says”.
Other clients and therapists who lacked a computer used their smartphone to participate in group sessions, despite this tool’s limitations for Zoom and WhatsApp video calls. Gil described the situation:
I and most of the therapists I spoke with conducted their sessions holding their mobile phone in their hand, and over time I discovered that this involves a (rather large) blind spot: our failure to seriously address the technical issues that impact our ability to feeling the other person’s presence, even through their body language, [these things are] affected when you work on video, and certainly when you work on your mobile phone (which you have to hold in your hand throughout the therapy session).
Several participants reported that remote therapy affects the dynamics of the therapy session. This was especially prominent in group work. Several participants reported that discourse in the virtual groups was shallow. Gil attributes this to the fact that group sessions are conducted on smartphones:
