Cited by 503Psychotherapy Techniques and ApplicationsDigital Mental Health InterventionsTelemedicine and Telehealth Implementation

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Working Alliance in Online Therapy as Compared to Face-to-Face Therapy: Preliminary Results

Cook, Jonathan E., Doyle, Carol·2002·CyberPsychology & Behavior

DOI 10.1089/109493102753770480

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Abstract

Online therapy, defined as the provision of mental health services through the Internet, is a growing field that has sparked an abundance of interest and controversy. A primary concern in the practice of online therapy is whether a working alliance, considered a central component of successful therapy, can develop when participants are geographically separated. Working alliance scores were compared between a small, primarily female sample of online therapy consumers and a representative sample of traditional face-to-face therapy clients. Results revealed significantly higher means on the goal subscale and composite score of the Working Alliance Inventory in the online sample, suggesting that a working alliance can be adequately established in therapy delivered online. No significant differences in the level of working alliance were found within the online therapy sample with respect to modality of communication, client presenting problem, or therapist. Themes from comments suggest the importance for participants of the disinhibiting effects of the medium.

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Authors: Cook, J. E., & Doyle, C.
Affiliations: Portland State University (US)
Lewis & Clark College (US)
ORCID: Cook, Jonathan E.
Venue: CyberPsychology & Behavior
Publisher: SAGE Publications
Published: 2002-04
Volume: 5
Issue: 2
Pages: 95-105
ISSN: 1094-9313 (ISSN-L)
1557-8364
DOI: 10.1089/109493102753770480
OpenAlex: W2102823714
Cited by: 503
References: 40
Citations by year: 2026: 6 · 2025: 20 · 2024: 18 · 2023: 36 · 2022: 32 · 2021: 53 · 2020: 36 · 2019: 23 · 2018: 18 · 2017: 21 · 2016: 31 · 2015: 26 · 2014: 26 · 2013: 21 · 2012: 28
FWCI: 7.50
Type: journal article
Language: en
Open access: closed
Licence: www.liebertpub.com/nv/resources-tools/text-and-data-mining-policy/121/ (tdm)
Locations: CyberPsychology & Behavior (publishedVersion)
PubMed (publishedVersion)
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, online therapy, face-to-face therapy, Working Alliance Inventory, goal setting, therapist characteristics
MeSH terms: Adult, Aged, Aged, 80 and over, Mental Disorders, Female, Humans, Male, Mental Health Services, Middle Aged, Psychotherapy, Surveys and Questionnaires, Work, Internet

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Working Alliance in Online Therapy as Compared to Face-to-Face Therapy: Preliminary Results

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