The containing relationship (Bion,1962), the holding environment (Winnicott, 1985), the therapeutic alliance (Malan, 1985) are just three commonly used terms used to describe the vitally important connection between therapist and client(s) which research shows is important in shaping therapeutic outcomes. It is a complex phenomenon and while, ultimately, psychotherapists understand it in psychological terms, its development and form is significantly influenced by material factors-for example, the nature and configuration of consulting rooms, the time boundaries to sessions, and the ways in which we communicate with our clients at all stages of the therapeutic encounter.

The containing relationship (Bion,1962), the holding environment (Winnicott, 1985), the therapeutic alliance (Malan, 1985) are just three commonly used terms used to describe the vitally important connection between therapist and client(s) which research shows is important in shaping therapeutic outcomes. It is a complex phenomenon and while, ultimately, psychotherapists understand it in psychological terms, its development and form is significantly influenced by material factors-for example, the nature and configuration of consulting rooms, the time boundaries to sessions, and the ways in which we communicate with our clients at all stages of the therapeutic encounter.

Christopher Vincent and colleagues were aware that how they related to their clients had been profoundly changed in recent years by new telecommunication technologies. Some of these changes, like the increasing use of emails, the reliance on mobile phones and text messaging had insinuated themselves into their ways of working almost without notice suggesting that they were subject to a form of ‘technology creep’. Other technologies like the use of video software as an alternative or supplement to face to face client contact required more conscious and deliberate choice.

Aware that these developments were continuing at a rapid pace, they thought it would be useful to benchmark how they were experiencing these developments at a particular point in time (2015). They developed and completed a questionnaire for themselves and two other colleagues and the emerging data from these documents formed the basis of a series of video conference discussions the notes from which formed the basis of their report published in the British Journal of Psychotherapy.

Specific technologies considered were websites both organisational and personal, emails, mobile phones, video software contact with clients and the role of bank transfers for the payment of fees. In their deliberations they also considered how these technologies influenced contact with professional colleagues.

Key findings from the study included:-

• That the ease and speed of email and mobile phone communication have resulted in therapists finding it hard to resist responding to clients on demand. In private practice there is not the protection of working hours provided by working in a clinic or agency.
• That professional anonymity is dead as Gabbard (2014, p 16) has written. We all have digital foot prints or ‘tattoos’ (footprints unlike, tattoos, get washed away). This transparency creates advantages for clients accessing the services they need but challenges the therapist reticence associated with established psychoanalytic technique.
• That emails and mobile phone messaging are in some situations utilised as part of the on-going therapeutic dialogue. These new opportunities can be used for both creative and perverse ends. So, for example, emailing and texting can be helpful is sharing experiences that would be too shaming to disclose in a face to face situation. On the other hand, the recording of sessions using a mobile phone can be undertaken without the therapist’s knowledge raising a question about the appropriateness of this behaviour.
• That face to face video software contact was thought of as a second best option to live contact but in this hectic world was justified when individuals or couples could not attend therapy often because work commitments had involved travel away.
• That the payment of client fees by bank transfer meant that it became easier to avoid or sidestep the dynamic issues around paying for therapy as the handing over of cheques is becoming less and less common.
• That there seems a reticence to include the subjects covered in this research in Continuing Professional Development Programmes. Why this should be is not clear. Perhaps change is a threat to ideal images of how therapy should be conducted but maybe change is so continuous that it becomes difficult to capture. The authors of this study recognised that their findings were particular to a point in time and, in this sense, they were writing social history.