TY - JOUR
T1 - Therapeutic alliance in guided internet therapy programs for depression and anxiety disorders
T2 - A systematic review
AU - Pihlaja, Satu
AU - Stenberg, Jan-Henry
AU - Joutsenniemi, Kaisla
AU - Mehik, Heidi
AU - Ritola, Ville
AU - Joffe, Grigori
PY - 2018/3
Y1 - 2018/3
N2 - Objective The role of internet therapy programs for mental disorders is growing. Those programs employing human support yield better outcomes than do those with no such support. Therapeutic alliance may be a critical element in this support. Currently, the significance of therapeutic alliance in guided, internet-delivered cognitive behavioral therapy programs (iCBT) remains unknown. This review aims to determine whether the therapeutic alliance influences outcome of iCBTs and if it does, what plausible factors underlie this association. Method Towards that goal searches were made in PubMed, PsycINFO, SCOPUS, The Cochrane Library and CINAHL in May 2016 and January 2017. Results From the 1658 relevant studies, only six studied the relationship of therapeutic alliance and outcome. All six studies showed a high level of client-therapist alliance; in the three most recent studies, the alliance was directly associated with outcome. No studies reported alliance-adherence associations. Conclusions Alliance research in iCBT for mental disorders is scarce. Therapeutic alliance seems to associate with outcomes. More studies are necessary to define the optimal support to strengthen alliance. iCBT is a feasible environment for alliance research both practically and theoretically. The impact of alliance on adherence to iCBT requires study.
AB - Objective The role of internet therapy programs for mental disorders is growing. Those programs employing human support yield better outcomes than do those with no such support. Therapeutic alliance may be a critical element in this support. Currently, the significance of therapeutic alliance in guided, internet-delivered cognitive behavioral therapy programs (iCBT) remains unknown. This review aims to determine whether the therapeutic alliance influences outcome of iCBTs and if it does, what plausible factors underlie this association. Method Towards that goal searches were made in PubMed, PsycINFO, SCOPUS, The Cochrane Library and CINAHL in May 2016 and January 2017. Results From the 1658 relevant studies, only six studied the relationship of therapeutic alliance and outcome. All six studies showed a high level of client-therapist alliance; in the three most recent studies, the alliance was directly associated with outcome. No studies reported alliance-adherence associations. Conclusions Alliance research in iCBT for mental disorders is scarce. Therapeutic alliance seems to associate with outcomes. More studies are necessary to define the optimal support to strengthen alliance. iCBT is a feasible environment for alliance research both practically and theoretically. The impact of alliance on adherence to iCBT requires study.
KW - Therapeutic relationship, Alliance, Internet-based therapy, CBT, iCBT
KW - 3124 Neurology and psychiatry
U2 - 10.1016/j.invent.2017.11.005
DO - 10.1016/j.invent.2017.11.005
M3 - Review Article
SN - 2214-7829
VL - 11
SP - 1
EP - 10
JO - Internet interventions : The application of information technology in mental and behavioural health
JF - Internet interventions : The application of information technology in mental and behavioural health
ER -