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In a recent Twitter debate (May 23, 2023), psychoanalyst Jonathan Shedler engaged in a discussion about the evolving landscape of AI-powered ‘therapy’. He underscored the need for a sharp distinction between therapy and the domain of artificial intelligence interventions. Shedler’s main point, which applies beyond AI therapy, centred on the pivotal role of the therapist-patient relationship in psychotherapy:
It must be a relational experience because that’s where unknown parts of self manifest themselves – where they can be experienced, recognized and understood. Remove the relationship and you remove the psychotherapy. (Shedler, 2023)
AI interventions are of course only the newest additions to the vast world of online therapeutic offers. The advent of the internet, in recent decades, has brought us both delights and confusions; the confusions are not surprising: each technological advancement involves challenges, but my sense regarding our worries about the internet is that, most likely, ‘this too shall pass’. Each generation, after all, has had its technology ‘boogie man’, ‘fears that tend to abate as the generations pass and as different trends and technologies come along’ (Foulkes, 2022, p. 145).
For the time being, as psychoanalytic child psychotherapists, we need to continue contemplating how the online world influences our practice, affecting both us and our patients. After reading MacKean et al.’s paper in this issue of the Journal, which discusses an innovative online intervention for depressed adolescents, I was prompted to reflect on questions around the definitions of psychotherapy and psychodynamic approaches, as well as the opportunities and challenges that online interventions in our field present.
I’ll begin by breaking down the paper’s main building blocks, considering it alongside a previous article by Midgley et al. (2021), with which it’s linked. My initial question is whether the intervention presented, in both this paper and the one from 2021, can