New Avenues to Facilitate Engagement in Psychotherapy: The Use of Videoconferencing and Text-Chat in a Severe Case of Obsessive-compulsive Disorder

Client engagement is a necessary component of psychotherapy, but it can be challenging to foster in clients with severe and complex problems. Telehealth technology influences the clinical dyad in unique ways and offers new opportunities for approaching the challenge of client engagement. In this article, we present a qualitative case study of a client with severe and complex obsessive-compulsive disorder (OCD) who received 40 sessions of cognitive-behavioural-based psychotherapy administered through a mix of videoconference and text-chat. The results suggest that telehealth technology may have facilitated client engagement by helping to reduce interpersonal anxiety, thus allowing the client to continue disclosing and discussing issues that were espoused in shame, guilt, and embarrassment.