The therapeutic alliance in internet interventions: A narrative review and suggestions for future research

Psychotherapy Research

Volumn 27, Issue 5, 2017, Pages 511-524

  Berger, Thomas ^a  

^a UNIVERSITY OF BERN   (Switzerland)

Author keywords

computer; Internet intervention; Internet based treatment; therapeutic relationship; working alliance

Indexed keywords

HUMAN; INTERNET; PROCEDURES; PROFESSIONAL-PATIENT RELATIONSHIP; PSYCHOTHERAPY;

HUMANS; INTERNET; PROFESSIONAL-PATIENT RELATIONS; PSYCHOTHERAPY;

EID: 84953265247     PISSN: 10503307     EISSN: 14684381     Source Type: Journal    
DOI: 10.1080/10503307.2015.1119908     Document Type: Article

References (79)

1. Alexander, L. B., & Luborsky, L., (1986).The Penn helping alliance scales. In L. S., Greenberg & M. W., Pinsof (Eds.), The psychotherapeutic process:A research handbook (pp. 325–366). New York, NY:Guilford.
2. Andersson, G., (2014). The internet and CBT:A clinical guide. Boca Raton:CRC Press.
3. Andersson, G., Bergström, J., Buhrman, M., Carlbring, P., Holländare, F., Kaldo, V., Nilsson-Ihrfelt, E., Paxling, B., Ström, L., & Waara, J., (2008). Development of a new approach to guided self-help via the Internet. The Swedish experience. Journal of Technology and Human Services, 26, 161–181.
4. Andersson, G., & Cuijpers, P., (2009). Internet-based and other computerized psychological treatments for adult depression:A meta-analysis. Cognitive Behaviour Therapy, 38(4), 196–205.
5. Andersson, G., Cuijpers, P., Carlbring, P., Riper, H., & Hedman, E., (2014). Guided internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders:A systematic review and meta-analysis. World Psychiatry, 13(3), 288–295.
6. Andersson, G., & Hedman, E., (2013). Effectiveness of guided internet-based cognitive behavior therapy in regular clinical settings. Verhaltenstherapie, 23(3), 140–148.
7. Andersson, G., Paxling, B., Roch-Norlund, P., Ostman, G., Norgren, A., Almlov, J., … Silverberg, F., (2012). Internet-based psychodynamic versus cognitive behavioral guided self-help for generalized anxiety disorder:A randomized controlled trial. Psychotherapy and Psychosomatics, 81(6), 344–355.
8. Andersson, G., Paxling, B., Wiwe, M., Vernmark, K., Felix, C. B., Lundborg, L., … Carlbring, P., (2012). Therapeutic alliance in guided internet-delivered cognitive behavioural treatment of depression, generalized anxiety disorder and social anxiety disorder. Behaviour Research & Therapy, 50(9), 544–550.
9. Andrews, G., Cuijpers, P., Craske, M. G., McEvoy, P., & Titov, N., (2010). Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical health care:A meta-analysis. Plos One, 5(10), e13196. doi:10.1371/journal.pone.0013196
10. Baldwin, S. A., Wampold, B. E., & Imel, Z. E., (2007). Untangling the alliance–outcome correlation:Exploring the relative importance of therapist and patient variability in the alliance. Journal of Consulting and Clinical Psychology, 75(6), 842–852.
11. Barak, A., Hen, L., Boniel-Nissim, M., & Shapira, N. a., (2008). A comprehensive review and a meta-analysis of the effectiveness of internet-based psychotherapeutic interventions. Journal of Technology in Human Services, 26(2–4), 109–160.
12. Barak, A., Klein, B., & Proudfoot, J. G., (2009). Defining internet-supported therapeutic interventions. Annals of Behavioral Medicine, 38(1), 4–17.
13. Berger, T., (2015). Internetbasierte Interventionen bei psychischen Störungen (Fortschritte der Psychotherapie, Bd. 58). Göttingen:Hogrefe.
14. Berger, T., & Andersson, G., (2009). Internetbasierte Psychotherapien:Besonderheiten und empirische Evidenz. Psychotherapie, Psychosomatik, Medizinische Psychologie, 59, 159–170.
15. Berger, T., Boettcher, J., & Caspar, F., (2014). Internet-based guided self-help for several anxiety disorders:A randomized controlled trial comparing a tailored with a standardized disorder-specific approach. Psychotherapy, 51(2), 207–219.
16. Berger, T., Caspar, F., Richardson, R., Kneubuehler, B., Sutter, D., & Andersson, G., (2011). Internet-based treatment of social phobia:A randomized controlled trial comparing unguided with two types of guided self-help. Behaviour Research & Therapy, 49(3), 158–169.
17. Berger, T., Haemmerli, K., Gubser, N., Andersson, G., & Caspar, F., (2011). Internet-based treatment of depression:A randomized controlled trial comparing guided with unguided self-help. Cognitive Behaviour Therapy, 40(4), 251–266.
18. Berger, T., Hohl, E., & Caspar, F., (2009). Internet-based treatment for social phobia:A randomized controlled trial. Journal of Clinical Psychology, 65(10), 1021–1035.
19. Bergman Nordgren, L., Carlbring, P., Linna, E., & Andersson, G., (2013). Role of the working alliance on treatment outcome in tailored internet-based cognitive behavioural therapy for anxiety disorders:Randomized controlled pilot trial. JMIR Research Protocols, 2(1), e4. doi:10.2196/resprot.2292.
20. Bischoff, R. J., Hollist, C. S., Smith, C. W., & Flack, P., (2004). Addressing the mental health needs of the rural underserved:Findings from a multiple case study of a behavioral telehealth project. Contemporary Family Therapy:An International Journal, 26(2), 179–198.
21. Bordin, E. S., (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy:Theory, Research & Practice, 16(3), 252–260.
22. Busseri, M. A., & Tyler, J. D., (2003). Interchangeability of the working alliance inventory and working alliance inventory, short form. Psychological Assessment, 15(2), 193–197.
23. Caspar, F., & Berger, T., (2011). Internet-delivered psychological treatments and psychotherapy integration. Psychotherapy Bulletin, 46(4), 6–11.
24. Chester, A., & Glass, C. A., (2006). Online counselling:A descriptive analysis of therapy services on the internet. British Journal of Guidance & Counselling, 34(2), 145–160.
25. Cook, J. E., & Doyle, C., (2002). Working alliance in online therapy as compared to face-to-face therapy:Preliminary results. CyberPsychology & Behavior, 5(2), 95–105.
26. Cuijpers, P., van Straten, A., & Andersson, G., (2008). Internet-administered cognitive behavior therapy for health problems:A systematic review. Journal of Behavioral Medicine, 31(2), 169–177.
27. Day, S. X., & Schneider, P. L., (2002). Psychotherapy using distance technology:A comparison of face-to-face, video, and audio treatment. Journal of Counseling Psychology, 49(4), 499–503.
28. Del Re, A. C., Fluckiger, C., Horvath, A. O., Symonds, D., & Wampold, B. E., (2012). Therapist effects in the therapeutic alliance–outcome relationship:A restricted-maximum likelihood meta-analysis. Clinical Psychology Review, 32(7), 642–649.
29. Donker, T., Bennett, K., Bennett, A., Mackinnon, A., van Straten, A., Cuijpers, P., … Griffiths, K. M., (2013). Internet-delivered interpersonal psychotherapy versus internet-delivered cognitive behavioral therapy for adults with depressive symptoms:Randomized controlled noninferiority trial. Journal of Medical Internet Research, 15(5), e82–161.
30. Ertelt, T. W., Crosby, R. D., Marino, J. M., Mitchell, J. E., Lancaster, K., & Crow, S. J., (2011). Therapeutic factors affecting the cognitive behavioral treatment of bulimia nervosa via telemedicine versus face-to-face delivery. International Journal of Eating Disorders, 44(8), 687–691.
31. Esterling, B. A., L'Abate, L., Murray, E. J., & Pennebaker, J. W., (1999). Empirical foundations for writing in prevention and psychotherapy:Mental and physical health outcomes. Clinical Psychology Review, 19(1), 79–96.
32. Germain, V., Marchand, A., Bouchard, S., Guay, S., & Drouin, M. S., (2010). Assessment of the therapeutic alliance in face-to-face or videoconference treatment for posttraumatic stress disorder. Cyberpsychology Behavior and Social Networking, 13(1), 29–35.
33. Hatcher, R. L., & Gillaspy, J. A., (2006). Development and validation of a revised short version of the working alliance inventory. Psychotherapy Research, 16(1), 12–25.
34. Hedman, E., Furmark, T., Carlbring, P., Ljotsson, B., Ruck, C., Lindefors, N., & Andersson, G., (2011). A 5-year follow-up of internet-based cognitive behavior therapy for social anxiety disorder. Journal of Medical Internet Research, 13(2), e39. doi:10.2196/jmir.1776.
35. Horvath, A. O., Del Re, A. C., Fluckiger, C., & Symonds, D., (2011). Alliance in individual psychotherapy. Psychotherapy, 48(1), 9–16.
36. Horvath, A. O., & Greenberg, L. S., (1989). Development and validation of the working alliance inventory. Journal of Counseling Psychology, 36(2), 223–233.
37. Jasper, K., Weise, C., Conrad, I., Andersson, G., Hiller, W., & Kleinstauber, M., (2014a). Internet-based guided self-help versus group cognitive behavioral therapy for chronic tinnitus:A randomized controlled trial. Psychotherapy and Psychosomatics, 83(4), 234–246.
38. Jasper, K., Weise, C., Conrad, I., Andersson, G., Hiller, W., & Kleinstauber, M., (2014b). The working alliance in a randomized controlled trial comparing internet-based self-help and face-to-face cognitive behavior therapy for chronic tinnitus. Internet Interventions, 1(2), 49–57.
39. Kessler, D., Lewis, G., Kaur, S., Wiles, N., King, M., Weich, S., … Peters, T. J., (2009). Therapist-delivered Internet psychotherapy for depression in primary care:A randomised controlled trial. Lancet, 374(9690), 628–634. doi:10.1016/S0140-6736(09)61257-5
40. Kiropoulos, L. A., Klein, B., Austin, D. W., Gilson, K., Pier, C., Mitchell, J., & Ciechomski, L., (2008). Is internet-based CBT for panic disorder and agoraphobia as effective as face-to-face CBT? Journal of Anxiety Disorders, 22(8), 1273–1284.
41. Klein, B., Austin, D., Pier, C., Kiropoulos, L., Shandley, K., Mitchell, J., … Ciechomski, L., (2009). Internet-based treatment for panic disorder:Does frequency of therapist contact make a difference? Cognitive Behaviour Therapy, 38(2), 100–113.
42. Klein, B., Mitchell, J., Abbott, J., Shandley, K., Austin, D., Gilson, K., … Redman, T., (2010). A therapist-assisted cognitive behavior therapy internet intervention for posttraumatic stress disorder:Pre-, post- and 3-month follow-up results from an open trial. Journal of Anxiety Disorders, 24(6), 635–644.
43. Knaevelsrud, C., Brand, J., Lange, A., Ruwaard, J., & Wagner, B., (2015). Web-based psychotherapy for posttraumatic stress disorder in war-traumatized Arab patients:Randomized controlled trial. Journal of Medical Internet Research, 17(3), e71. doi:10.2196/jmir.3582
44. Knaevelsrud, C., & Maercker, A., (2006). Does the quality of the working alliance predict treatment outcome in online psychotherapy for traumatized patients? Journal of Medical Internet Research, 8(4), e31.
45. Knaevelsrud, C., & Maercker, A., (2007). Internet-based treatment for PTSD reduces distress and facilitates the development of a strong therapeutic alliance:A randomized controlled clinical trial. BMC Psychiatry, 7, 13.
46. Krieger, T., Meyer, B., Sude, K., Urech, A., Maercker, A., & Berger, T., (2014). Evaluating an e-mental health program (“deprexis)” as adjunctive treatment tool in psychotherapy for depression:Design of a pragmatic randomized controlled trial. BMC Psychiatry, 14, 285. doi:10.1186/s12888-014-0285-9.
47. Lange, A., Rietdijk, D., Hudcovicova, M., van de Ven, J. P., Schrieken, B., & Emmelkamp, P. M., (2003). Interapy:A controlled randomized trial of the standardized treatment of posttraumatic stress through the internet. Journal of Consulting and Clinical Psychology, 71(5), 901–909.
48. Lange, A., van de Ven, J. P., Schrieken, B., & Emmelkamp, P. M., (2001). Interapy, treatment of posttraumatic stress through the internet:A controlled trial. Journal of Behavior Therapy and Experimental Psychiatry, 32(2), 73–90.
49. Lindner, P., Olsson, E., Johnsson, A., Dahlin, M., Andersson, G., & Carlbring, P., (2014). The impact of telephone versus e-mail therapist guidance on treatment outcomes, therapeutic alliance and treatment engagement in internet-delivered CBT for depression:A randomised pilot trial. Internet Interventions, 1(4), 182–187.
50. Martin, D. J., Garske, J. P., & Davis, M. K., (2000). Relation of the therapeutic alliance with outcome and other variables:A meta-analytic review. Journal of Consulting and Clinical Psychology, 68(3), 438–450.
51. Meyer, B., Berger, T., Caspar, F., Beevers, C. G., Andersson, G., & Weiss, M., (2009). Effectiveness of a novel integrative online treatment for depression (Deprexis):Randomized controlled trial. Journal of Medical Internet Research, 11(2), e15. doi:10.2196/jmir.1151.
52. Meyer, B., Bierbrodt, J., Schroder, J., Berger, T., Beevers, C., Weiss, M., … Klein, J., (2015). Effects of an internet intervention (Deprexis) on severe depression symptoms:Randomized controlled trial. Internet Interventions, 2(1), 48–59.
53. Mitchell, J. E., Crosby, R. D., Wonderlich, S. A., Crow, S., Lancaster, K., Simonich, H., … Myers, T. C., (2008). A randomized trial comparing the efficacy of cognitive–behavioral therapy for bulimia nervosa delivered via telemedicine versus face-to-face. Behaviour Research & Therapy, 46(5), 581–592.
54. Morgan, R. D., Patrick, A. R., & Magaletta, P. R., (2008). Does the use of telemental health alter the treatment experience? Inmates’ perceptions of telemental health versus face-to-face treatment modalities. Journal of Consulting and Clinical Psychology, 76(1), 158–162.
55. Newman, M. G., Erickson, T., Przeworski, A., & Dzus, E., (2003). Self-help and minimal-contact therapies for anxiety disorders:Is human contact necessary for therapeutic efficacy? Journal of Clinical Psychology, 59(3), 251–274.
56. Newman, M. G., Kenardy, J., Herman, S., & Taylor, C. B., (1997). Comparison of palmtop-computer-assisted brief cognitive–behavioral treatment to cognitive–behavioral treatment for panic disorder. Journal of Consulting and Clinical Psychology, 65(1), 178–183.
57. Paxling, B., Lundgren, S., Norman, A., Almlov, J., Carlbring, P., Cuijpers, P., & Andersson, G., (2013). Therapist behaviours in internet-delivered cognitive behaviour therapy:Analyses of e-mail correspondence in the treatment of generalized anxiety disorder. Behavioural and Cognitive Psychotherapy, 41(3), 280–289.
58. Preschl, B., Maercker, A., & Wagner, B., (2011). The working alliance in a randomized controlled trial comparing online with face-to-face cognitive-behavioral therapy for depression. BMC Psychiatry, 11, 189.
59. Rees, C. S., & Stone, S., (2005). Therapeutic alliance in face-to-face versus videoconferenced psychotherapy. Professional Psychology:Research and Practice, 36(6), 649–653.
60. Reynolds, D. A. J., Jr., Stiles, W. B., & Grohol, J. M., (2006). An investigation of session impact and alliance in internet based psychotherapy:Preliminary results. Counselling & Psychotherapy Research, 6(3), 164–168.
61. Richardson, R., Richards, D. A., & Barkham, M., (2010). Self-help books for people with depression:The role of the therapeutic relationship. Behavioural and Cognitive Psychotherapy, 38(1), 67–81.
62. Rochlen, A. B., Zack, J. S., & Speyer, C., (2004).Online therapy:Review of relevant definitions, debates, and current empirical support. Journal of Clinical Psychology, 60(3), 269–283.
63. Ruwaard, J., Lange, A., Bouwman, M., Broeksteeg, J., & Schrieken, B., (2007). E-mailed standardized cognitive behavioural treatment of work-related stress:A randomized controlled trial. Cognitive Behaviour Therapy, 36(3), 179–192.
64. Ruwaard, J., Lange, A., Schrieken, B., & Emmelkamp, P., (2011). Efficacy and effectiveness of online cognitive behavioral treatment:A decade of interapy research. Studies of Health Technology and Informatics, 167, 9–14.
65. Ruwaard, J., Schrieken, B., Schrijver, M., Broeksteeg, J., Dekker, J., Vermeulen, H., & Lange, A., (2009). Standardized web-based cognitive behavioural therapy of mild to moderate depression:A randomized controlled trial with a long-term follow-up. Cognitive Behaviour Therapy, 38(4), 206–221.
66. Simpson, S. G., & Reid, C. L., (2014).Therapeutic alliance in videoconferencing psychotherapy:A review. Australian Journal of Rural Health, 22(6), 280–299.
67. Spek, V., Cuijpers, P., Nyklicek, I., Riper, H., Keyzer, J., & Pop, V., (2007). Internet-based cognitive-behaviour therapy for symptoms of depression and anxiety:a meta-analysis. Psychological Medicine, 37, 319–328.
68. Strupp, H. H., Hartley, D., & Blackwood, G. L., (1974).Vanderbilt Psychotherapy Process Scale and rater's manual. Unpublished manuscript. Vanderbilt University, Nashville, TN.
69. Sucala, M., Schnur, J. B., Brackman, E. H., Constantino, M. J., & Montgomery, G. H., (2013). Clinicians’ attitudes toward therapeutic alliance in e-therapy. Journal of General Psychology, 140(4), 282–293.
70. Sucala, M., Schnur, J. B., Constantino, M. J., Miller, S. J., Brackman, E. H., & Montgomery, G. H., (2012). The therapeutic relationship in e-therapy for mental health:A systematic review. Journal of Medical Internet Research, 14(4), e110–187.
71. Suler, J., (2004). The online disinhibition effect. CyberPsychology & Behavior, 7, 312–326.
72. Svartvatten, N., Segerlund, M., Dennhag, I., Andersson, G., & Carlbring, P., (2015). A content analysis of client e-mails in guided internet-based cognitive behavior therapy for depression. Internet Interventions, 2(2), 121–127.
73. Titov, N., (2011). Internet-delivered psychotherapy for depression in adults. Current Opinion in Psychiatry, 24, 18–23.
74. Vernmark, K., Lenndin, J., Bjärehed, J., Carlsson, M., Karlsson, J., Oberg, J., … Andersson, G., (2010). Internet administered guided self-help versus individualized e-mail therapy:A randomized trial of two versions of CBT for major depression. Behav Research & Therapy, 48(5), 368–376.
75. Wagner, B., Brand, J., Schulz, W., & Knaevelsrud, C., (2012). Online working alliance predicts treatment outcome for posttraumatic stress symptoms in Arab war-traumatized patients. Depression and Anxiety, 29(7), 646–651.
76. Wagner, B., Horn, A. B., & Maercker, A., (2014). Internet-based versus face-to-face cognitive-behavioral intervention for depression:A randomized controlled non-inferiority trial. Journal of Affective Disorders, 152–154, 113–121.
77. Webb, C., Derubeis, R., Amsterdam, J., Shelton, R., Hollon, S., & Dimidjian, S., (2011). Two aspects of the therapeutic alliance:Differential relations with depressive symptom change. Journal of Consulting and Clinical Psychology, 79(3), 279–283.
78. Wells, M., Mitchell, K. J., Finkelhor, D., & Becker-Blease, K. A., (2007). Online mental health treatment:Concerns and considerations. CyberPsychology & Behavior, 10(3), 453–459.
79. Wilmers, F., Munder, T., Leonhard, F., Herzog, T., Plassmann, R., Barth, J., & Linster, H. W., (2008). Die deutschsprachige Version des Working Alliance Inventory-short revised (WAI-SR). Ein schulenübergreifendes, ökonomisches und empirisch validiertes Instrument zur Erfassung der therapeutischen Allianz. Klinische Diagnostik und Evaluation, 1, 343–358.