Therapeutic alliance in face-to-face and telephone-administered cognitive behavioral therapy.
Open accessAbstract
OBJECTIVE: Telephone-administered therapies have emerged as an alternative method of delivery for the treatment of depression, yet concerns persist that the use of the telephone may have a deleterious effect on therapeutic alliance. The purpose of this study was to compare therapeutic alliance in clients receiving cognitive behavioral therapy (CBT) for depression by telephone (T-CBT) or face-to-face (FtF-CBT). METHOD: We randomized 325 participants to receive 18 sessions of T-CBT or FtF-CBT. The Working Alliance Inventory (WAI) was administered at Weeks 4 and 14. Depression was measured during treatment and over 1 year posttreatment follow-up using the Hamilton Rating Scale for Depression and Patient Health Questionnaire-9. RESULTS: There were no significant differences in client or therapist WAI between T-CBT or FtF-CBT (Cohen's f² ranged from 0 to .013, all ps > .05). All WAI scores predicted depression end of treatment outcomes (Cohen's f² ranged from .009 to .06, all ps < .02). The relationship between the WAI and depression outcomes did not vary by treatment group (Cohen's f² ranged from 0 to .004, ps > .07). The WAI did not significantly predict depression during posttreatment follow-up (all ps > .12). CONCLUSIONS: Results from this analysis do not support the hypothesis that the use of the telephone to provide CBT reduces therapeutic alliance relative to FtF-CBT.
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Current evidence supports the feasible and efficacious delivery of web-based CBT using nontraditional health professionals such as PTs and OTs, with reduced time commitment and treatment costs, and positive self-reported changes in PTs' attitudes, confidence, and practice.
“Current evidence supports the feasible and efficacious delivery of web-based CBT using nontraditional health professionals such as physiotherapists (PTs) and occupational therapists (OTs) [45], with reduced time commitment and treatment costs, and positive self-reported changes in the PTs’ attitudes, confidence, and practice [46-48].”
From Development and usability testing of a web-based and therapist-assisted coping skills program for managing psychosocial problems in individuals with hand and upper limb injuries: Mixed methods study (2020) · cites this paper as [47]
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Finazzi, E., MacLeod, E., & MacBeth, A. M. (2023) · PLoS ONE · doi:10.1371/journal.pone.0279263 · Cited by 2 · see citing works
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The Use of Technology to Augment Clinical Care in Depression and Anxiety Disorders: An Evidence Map
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Clinical Health Psychologists’ Role in the COVID-19 Response in Veteran and Military Hospitals
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Audio-Based Care for Managing Mental Health and Substance Use Disorders in Adults
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- Authors
- Stiles-Shields, C., Kwasny, M. J., Cai, X., & Mohr, D. C.
- Affiliations
- Northwestern University (US)
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2014
- Volume
- 82
- Issue
- 2
- Pages
- 349-354
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- PMC
- PMC3966946
- OpenAlex
- W2116886816
- Cited by
- 69
- References
- 28
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 8 · 2023: 9 · 2022: 6 · 2021: 6 · 2020: 8 · 2019: 9 · 2018: 4 · 2017: 4 · 2016: 2 · 2015: 5 · 2014: 4
- FWCI
- 5.90
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01 MH059708)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- therapeutic relationship, depression treatment, Working Alliance Inventory, treatment outcome prediction, telehealth delivery
- MeSH terms
- Adult, Depressive Disorder, Female, Humans, Male, Middle Aged, Professional-Patient Relations, Surveys and Questionnaires, Telephone, Cognitive Behavioral Therapy, Treatment Outcome, Remote Consultation
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