How does tele-mental health affect group therapy process? Secondary analysis of a noninferiority trial.
Abstract
OBJECTIVE: Video teleconferencing (VTC) is used for mental health treatment delivery to geographically remote, underserved populations. However, few studies have examined how VTC affects individual or group psychotherapy processes. This study compares process variables such as therapeutic alliance and attrition among participants receiving anger management group therapy either through traditional face-to-face delivery or by VTC. METHOD: The current study represents secondary analyses of a randomized noninferiority trial (Morland et al., in press) in which clinical effectiveness of VTC delivery proved noninferior to in-person delivery. Participants were male veterans (N = 112) with posttraumatic stress disorder (PTSD) and moderate to severe anger problems. The present study examined potential differences in process variables, including therapeutic alliance, satisfaction, treatment credibility, attendance, homework completion, and attrition. RESULTS: No significant differences were found between the two modalities on most process variables. However, individuals in the VTC condition exhibited lower alliance with the group leader than those in the in-person condition. Mean self-leader alliance scores were 4.2 (SD = 0.8) and 4.5 (SD = 0.4), respectively, where 5 represents strongly agree and 4 represents agree with positive statements about the relationship, suggesting that participants in both conditions felt reasonably strong alliance in absolute terms. Individuals who had stronger alliance tended to have better anger outcomes, yet the effect was not strong enough to result in the VTC condition producing inferior aggregate outcomes. CONCLUSION: Our findings suggest that even if group psychotherapy via VTC differs in subtle ways from in-person delivery, VTC is a viable and effective means of delivering psychotherapy.
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One study used VCT to deliver group therapy to military veterans for Post-Traumatic Stress Disorder (PTSD) and anger management, and both treatment modalities (therapist via VCT vs in-person) were effective in reducing anger scores.
“One study used VCT to deliver group therapy to military veterans for Post-Traumatic Stress Disorder (PTSD) and anger management. 5 In both conditions, group members attended the session together in-person. However, there were treatment arms with the therapist attending via VCT versus in-person. Both treatment modalities were effective in reducing anger scores.”
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- Authors
- Greene, C. J., Morland, L. A., Macdonald, A., Frueh, B. C., Grubbs, K. M., & Rosen, C. S.
- Affiliations
- VA Palo Alto Health Care System (US)
- VA Pacific Islands Health Care System (US)
- VA Boston Healthcare System (US)
- University of Hawaii System (US)
- ORCID
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2010
- Volume
- 78
- Issue
- 5
- Pages
- 746-750
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- OpenAlex
- W2028357419
- Cited by
- 116
- References
- 22
- Citations by year
- 2025: 4 · 2024: 6 · 2023: 7 · 2022: 7 · 2021: 7 · 2020: 9 · 2019: 8 · 2018: 7 · 2017: 6 · 2016: 5 · 2015: 19 · 2014: 10 · 2013: 9 · 2012: 9
- FWCI
- 6.66
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- US Department of Veterans Affairs (TEL 03-080-3)
- VA Pacific Islands Healthcare System
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- telemental health, videoconferencing, group therapy, anger management, therapeutic relationship, attrition, post-traumatic stress disorder, veterans, homework completion, treatment credibility, treatment satisfaction
- MeSH terms
- Adult, Aged, Anger, Combat Disorders, Follow-Up Studies, Humans, Male, Middle Aged, Professional-Patient Relations, Psychotherapy, Group, Social Environment, Stress Disorders, Post-Traumatic, Veterans, Remote Consultation, Vietnam Conflict, Videoconferencing
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