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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV0453

Where trust is fragile: communication and the therapeutic alliance in technology-mediated care in conflict and crisis contexts

WHEN TRUST IS FRAGILE: COMMUNICATION AND THE THERAPEUTIC ALLIANCE IN TECHNOLOGY-MEDIATED CARE IN CONFLICT AND CRISIS CONTEXTS

Technology can expand access to care, but it cannot extend trust; trust is a dynamic process established, negotiated, and sustained within a relationship.

The aim of this study is to examine how communication processes shape the formation, maintenance, and potential rupture of the therapeutic alliance in technology-mediated psychiatric care delivered under conditions of trauma, uncertainty, and sociopolitical vulnerability. The study is an interdisciplinary conceptual analysis integrating perspectives from clinical psychology (therapeutic alliance, trust, trauma, self-disclosure, relational safety), digital mental health (technology-mediated care, digital access, privacy, data security, surveillance concerns), and sociocultural psychiatry (cultural norms, social context, power, marginalization, conflict-related vulnerability); no quantitative data or sample is presented. The poster addresses the erosion of trust under four headings: trauma, uncertainty, surveillance and data insecurity, and sociopolitical vulnerability. Communication is conceptualized not merely as a channel for transmitting information, but as a relational process through which trust is formed, negotiated, and potentially disrupted; openness, responsiveness, continuity, and confidentiality facilitate trust, while uncertainty, mistrust, surveillance, and contextual insecurity constrain it. The framework termed the digital care paradox emphasizes that technological access is not synonymous with relational safety: access is a prerequisite for care, but not a guarantee of trust. The proposed practice principles for digital psychiatry are an ethical foundation (relational integrity, patient autonomy, and the preservation of trust), cultural sensitivity, and communication-centeredness, with particular relevance to conflict-affected and low-resource settings. The concluding message is that, in conflict and crisis contexts, relational safety is not a by-product of access, but a prerequisite for effective care.

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