Let’s face it: video conferencing psychotherapy requires the extensive use of ostensive cues

Shimrit Fisher, Timur Guralnik, Peter Fonagy, Sigal Zilcha-Mano

Research output: Contribution to journalArticlepeer-review


The COVID-19 crisis has required many therapists to switch to video conferencing psychotherapy (VCP). Knowledge about the importance of epistemic trust and its determinants has been accumulating over the last few years, with important implications for psychotherapy and specific significance for the transition to VCP. The present paper provides a brief background on the concept of epistemic trust, research on the determinants of its development and the integrative framework it provides for some traditional concepts in psychotherapy, such as the therapeutic alliance. In particular, research on ostensive cuing, which requires significant modification in a remote delivery context, has important implications in the transition to VCP. We will advance some suggestions while illustrating the ideas with clinical case studies. This knowledge may be of value to psychotherapists, who are required to make substantial changes in the nature of the encounter with their patients, and may help them identify benefits and hindrances that might arise from this transition, as well as pointing out techniques that may encourage effective adaptation to the change.

Original languageEnglish
Number of pages17
JournalCounselling Psychology Quarterly
Issue number3-4
StatePublished - 2020

Bibliographical note

Publisher Copyright:
© 2020, © 2020 Informa UK Limited, trading as Taylor & Francis Group.


  • Covid-19
  • Epistemic trust
  • ostensive cues
  • video conferencing psychotherapy

ASJC Scopus subject areas

  • Clinical Psychology
  • Applied Psychology
  • Psychiatry and Mental health


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