Pixelated Therapy: Patient and Provider Experiences and Expectations within a Digitally-Conducted Therapeutic Encounter

• In Event: Emergent Technologies in Biomedicine and Healthcare: Boundaries, Tensions, and Possibilities - II

Abstract

Consumer-grade communication technologies, such as cellphones and video conferencing software, have become important tools in our healthcare landscape. These technologies may offer increased access to clinical care, new self-tracking capabilities, and social support. Increasingly, these technologies are also being used in mental healthcare, particularly trauma-informed care. While research has examined the impacts of telemedicine and hypothesized its future importance, there is little qualitative explorations into the conflicts and successes between providers and patients within this digital space. The emergence of these technologies in therapeutic digital spaces present new challenges, making this an important analytical site for STS scholars. Providers and patients have differing digital expectations as they both seek to “emplace” themselves based on their local context. Providers may have the goal of building a stable therapeutic relationship, while patients may only seek the necessary services. This study draws on two years of ethnographic observations in a small mental health program providing care predominantly via telecommunication technologies, and thirteen interviews with providers specializing in trauma-informed care as well as interviews with patients. During this time, both providers and patients frequently reflected on confronting their differing expectations in a digital space. Findings from this study show how different experiences emerge in digitally constructed therapeutic spaces and how these can have real impacts on the care provided and relationships formed. In doing so, this analysis provides an important element to further explorations into health technologies as important spaces which produce more than the care they are intended to provide.

Author

• Jeff Nicklas, University of California, San Francisco