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Working Alliance in Online Therapy as Compared to Face-to-Face Therapy: Preliminary Results
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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“Previous studies have provided evidence that a therapeutic alliance may be established successfully in fully internet-delivered therapy, even to degrees comparable to or even higher than in traditional face-to-face treatment (Pihlaja et al., 2018; Hadjistavropoulos et al., 2017; Cook and Doyle, 2002; Sucala et al., 2012; Andersson et al., 2012).”
From Internet-delivered Mindfulness-Based Cognitive Therapy for anxiety and depression in cancer survivors: Predictors of treatment response (2021) · cites this paper as Cook and Doyle, 2002
Citations
Cites
The generalizability of the psychoanalytic concept of the working alliance.
Bordin, E. S. (1979) · Psychotherapy: Theory, Research & Practice · doi:10.1037/h0085885 · Cited by 5,238
GPOWER: A general power analysis program
Erdfelder, E., Faul, F., & Buchner, A. (1996) · Behavior Research Methods, Instruments, & Computers · doi:10.3758/bf03203630 · Cited by 4,864
Development and validation of the working alliance inventory
Horvath, A. O., & Greenberg, L. S. (1989) · Journal of Counseling Psychology · doi:10.1037//0022-0167.36.2.223 · Cited by 3,520
Relation between working alliance and outcome in psychotherapy: A meta-analysis
Horvath, A. O., & Symonds, B. D. (1991) · Journal of Counseling Psychology · doi:10.1037/0022-0167.38.2.139 · Cited by 2,673
Factor structure of the working alliance inventory
Tracey, T. J., & Kokotovic, A. M. (1989) · Psychological Assessment: A Journal of Consulting and Clinical Psychology · doi:10.1037/1040-3590.1.3.207 · Cited by 1,501 · cited 1×
“Both confirmatory 35 and exploratory 36 factor analysis have revealed that the composite score is the most salient measurement of working alliance.”
The heart and soul of change: What works in therapy.
Hubble, M. A. (1999) · American Psychological Association eBooks · doi:10.1037/11132-000 · Cited by 1,403
The role of the therapeutic alliance in psychotherapy.
Horvath, A. O., & Luborsky, L. (1993) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.61.4.561 · Cited by 1,331
Relational Communication in Computer-Mediated Interaction
Walther, J. B., & Burgoon, J. K. (1992) · Human Communication Research · doi:10.1111/j.1468-2958.1992.tb00295.x · Cited by 1,025
World-Wide Web survey research: Benefits, potential problems, and solutions
Schmidt, W. C. (1997) · Behavior Research Methods, Instruments, & Computers · doi:10.3758/bf03204826 · Cited by 620
The relationship between extraversion and neuroticism and the different uses of the Internet
Hamburger, Y. A., & Ben‐Artzi, E. (2000) · Computers in Human Behavior · doi:10.1016/s0747-5632(00)00017-0 · Cited by 609
Research works printed but not linked: 9
- Barak A., 2000, Journal of Virtual Environments. Available: www.brandeis.edu/pubs/jove/html/v5/ v5n1jove.html.
- 10.1037//0022-006X.68.4.650 · DOI · Paper page
- 10.1037//0022-0167.38.2.139 · DOI · Paper page
- 10.1037//1040-3590.3.2.188 · DOI
- Horvath A.O., 1995, In Session-Psychotherapy in Practice, 1, 7
- 10.1037//0022-0167.37.1.16 · DOI
- 10.1037//0022-0167.43.4.456 · DOI
- 10.1037//0022-0167.38.2.133 · DOI
- 10.1037//1040-3590.1.3.207 · DOI · Paper page
Cited by
Sorted by citations
Items 401–500 of 502
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Lewis, S. (2014) · UPT. Syiah Kuala University Library (Syiah Kuala University) · Cited by 1
Hungerbuehler, I. (2015) · Digital Library of Theses and Dissertations (Universidade de São Paulo) · doi:10.11606/t.5.2015.tde-26102015-153921 · Cited by 1
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Rashid, S. (2018) · City Research Online (City University London) · Cited by 1
Hanley, T., & Anthony, K. (2006) · Counselling and Psychotherapy Research · doi:10.1080/14733140600874050 · Cited by 1
Webb, C. (2014) · UEA Digital Repository (University of East Anglia) · Cited by 1
Sun, Y. (2013) · KTH Publication Database DiVA (KTH Royal Institute of Technology) · Cited by 1
Bartali, V., Brandl, L., Karreman, J., & van Velsen, L. (2022) · Research Square · doi:10.21203/rs.3.rs-1994721/v1 · Cited by 1
Tudor, K., Bettman, C., Bloch‐Atefi, A., Day, E., Hsi, T., Loewenthal, D., Low, P. K., O'Neill, G., & van Deurzen, E. (2021) · Psychotherapy and Counselling Journal of Australia · doi:10.59158/001c.71231 · Cited by 1
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Phillips, N., Gaveras, G., & Person, C. L. (2025) · medRxiv · doi:10.1101/2025.05.09.25327264 · Cited by 1
Kortz, L. (2017) · Scholars Archive - University at Albany (University at Albany, State University of New York) · doi:10.54014/dkvq-a03j · Cited by 1
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Belleville, G., Lebel, J., Gagné, S., Bouchard, S., Guay, S., Jackson, P. L., Massoungue, G., Ouellet, M., Tremblay, J., & Witteman, H. O. (2025) · SSRN Electronic Journal · doi:10.2139/ssrn.5351475 · Cited by 1
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Stevenson, T. (2014) · NSUWorks (Nova Southeastern University) · Cited by 1
Guided Internet-Based Cognitive Behaviour Therapy for Chronic Pain
Buhrman, M. (2012) · KTH Publication Database DiVA (KTH Royal Institute of Technology)
De professionalisering van online therapie
de Niet, G. (2009) · Psychopraxis · doi:10.1007/bf03080443
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Deyzel, L. (2014) · Unisa Institutional Repository (University of South Africa)
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The type and experience of technology use on alliance development in email-augmented psychotherapy
Scobie, B. W. (2015) · DigitalCommons (California Polytechnic State University)
Treating anxiety and depressive disorders online : understanding the current status
Richardson, A. (2009) · Open ULeth Scholarship (OPUS) (University of Lethbridge)
Frost, N. (2015) · Scholarship at UWindsor (University of Windsor)
An Inventory of Web-Based Tools Used to Support the Developing Field of Online Therapy
Merkel, P. L. (2011) · Scholars' Bank (University of Oregon)
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van Lankveld, J. J. D. M. (2015) · Tijdschrift voor Psychotherapie · doi:10.1007/s12485-015-0101-0
Online therapy : client and counsellor experiences
Khan, S. (2014) · cIRcle (University of British Columbia) · doi:10.14288/1.0135566
David, N., Schlenker, P., Prudlo, U., & Larbig, W. (2011)
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Shi, P. (2016) · Advances in religious and cultural studies (ARCS) book series · doi:10.4018/978-1-5225-0156-5.ch020
Online Psychosocial Support for Oncology Patients: A Group Facilitation Manual
Richards, K. (2013) · The Scholars Repository - LLU (Loma Linda University)
Holland, D. (2016) · ODU Digital Commons (Old Dominion University) · doi:10.25777/9m8h-gn42
Chillemi, K. (2015) · Swinburne figshare (Swinburne University of Technology) · doi:10.25916/sut.26271118
Evaluating Use of an Online Intervention for Cancer Patients with Distress
Gorlick, A. (2013) · The Scholars Repository - LLU (Loma Linda University)
Psychosémantické aspekty vybraných fotografií z IAPS.
Urbánek, T., Czekóová, K., & Pokorná, Z. (2009)
Die Perspektive von Teilnehmern an technikbasierten Angeboten
Wolf, M., & Bauer, S. (2008) · Springer eBooks · doi:10.1007/978-3-540-75736-8_20
Vázquez, Y. G., Sexto, C. F., Aguilera, A., & Rocha, Á. (2018) · Cuadernos de Trabajo Social · doi:10.5209/cuts.52836
Bosman, M., & Swart, J. (2017) · Muma Business Review · doi:10.28945/3846
Roesler, C. (2019) · Vandenhoeck & Ruprecht eBooks · doi:10.13109/9783666403873.111
Online counseling : risks, benefits, and future development
Kenison-Severson, L. J. (2008) · UNI ScholarWorks (University of Northern Iowa)
Hernandez, T. N. (2007) · Journal of International Crisis and Risk Communication Research
McCullough, B. (2020) · ScholarsArchive (Brigham Young University)
Treatment for eating disorders in a post‐COVID world: The case of TRIANGLE
Cardi, V., Willmott, D., Ambwani, S., Rowlands, K., Bryan, D. C., & Treasure, J. L. (2020) · European Eating Disorders Review · doi:10.1002/erv.2761
Possible applications of companion systems in psychotherapy - perspectives on a new technology
Walter, S., Haase, M., Oschlies-Strobel, A., Jerg‐Bretzke, L., Traue, H. C., & Limbrecht-Ecklundt, K. (2017) · doi:10.1109/icct42709.2017.9151910
Stevens, R. (2020) · Digital Commons (Liberty University)
Walsh, J. (2021) · Oxford University Press eBooks · doi:10.1093/oso/9780197517956.003.0007
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Walsh, J. A. (2021) · Oxford University Press eBooks · doi:10.1093/oso/9780197517956.003.0011
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Walsh, J. (2021) · Oxford University Press eBooks · doi:10.1093/oso/9780197517956.003.0009
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Walsh, J. A. (2021) · Oxford University Press eBooks · doi:10.1093/oso/9780197517956.003.0014
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Walsh, J. P. (2021) · Oxford University Press eBooks · doi:10.1093/oso/9780197517956.003.0002
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Walsh, J. (2021) · Oxford University Press eBooks · doi:10.1093/oso/9780197517956.003.0012 · Cited by 1
Walsh, J. (2021) · Oxford University Press eBooks · doi:10.1093/oso/9780197517956.003.0004
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Walsh, J. (2021) · Oxford University Press eBooks · doi:10.1093/oso/9780197517956.003.0005
Aslan, A. M., & Güven, M. (2021) · The Journal of International Lingual Social and Educational Sciences · doi:10.34137/jilses.898701
Martínez-Ramírez, G. A. A., Garza-Olivares, X., León, D. A. D., & Garza-Martínez, M. C. (2021) · Advances in medical education, research, and ethics (AMERE) book series · doi:10.4018/978-1-7998-8783-6.ch004
Therapists' experiences of conducting CBT online vis-á-vis face-to-face
Bengtsson, J. (2014) · KTH Publication Database DiVA (KTH Royal Institute of Technology)
Schurr, H., Tuluca, A., & Bailey, B. (2022) · International Journal of Mental Health Promotion · doi:10.32604/ijmhp.2022.017990
Mercan, O., & Dursun, A. (2022) · Kalem Uluslararasi Egitim ve Insan Bilimleri Dergisi · doi:10.23863/kalem.2022.225
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Shi, P. (2018) · IGI Global eBooks · doi:10.4018/978-1-5225-7119-3.ch022
Walsh, J. (2021) · Oxford University Press eBooks · doi:10.1093/oso/9780197517956.003.0006 · Cited by 1
Walsh, J. (2021) · Oxford University Press eBooks · doi:10.1093/oso/9780197517956.003.0001
Walsh, J. (2021) · Oxford University Press eBooks · doi:10.1093/oso/9780197517956.003.0003
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Friedman, A. (2023) · Springer eBooks · doi:10.1007/978-3-031-25488-8_7
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Sun, W., Cheng, A., & Guo, X. (2023) · SSRN Electronic Journal · doi:10.2139/ssrn.4394719
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Scheibenbogen, O., & Jobst, F. (2023) · Springer eBooks · doi:10.1007/978-3-662-67489-5_7
Bice-Urbach, B. J., & Rysdyk, S. (2023) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-023-00347-w
الشهري, ع. ا. أ. ع., & الجلالي, ط. م. ف. (2021) · مجلة کلية التربية جامعة طنطا · doi:10.21608/mkmgt.2023.234043.1634
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File, N., Kulcar, V., Kuntschner, E., Zeppenfeld, A., & Juen, B. H. (2022) · PERSON · doi:10.24989/person.v26i1.2330
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Machado, A. S., Ferreira, B., Pereira, C. Y., Carrola, C., de Melo, B. B. V., & Campos, C. (2023) · Advances in medical technologies and clinical practice book series · doi:10.4018/978-1-6684-9251-2.ch002
Gerton, J. M., Bludworth, J., & Spanierman, L. B. (2023) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-023-00375-6
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Arya, N. (2023) · Journal of Psychological Research · doi:10.30564/jpr.v5i2.5697
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Snow, K., Martin, J. M., Kroll, T., Gharabaghi, K., Griffin, S., & Garfat, T. (2024) · doi:10.32920/25443898
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Clara, L. D. (2024) · Advances in healthcare information systems and administration book series · doi:10.4018/979-8-3693-1463-0.ch001
KİYE, S. (2024) · Abant İzzet Baysal Üniversitesi Eğitim Fakültesi Dergisi · doi:10.17240/aibuefd.2024..-1337473
Walsh, J. (2021) · Oxford University Press eBooks · doi:10.1093/oso/9780197517956.002.0003
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Person, C. L., Phillips, N., Venkatachalam, K., & Gaveras, G. (2025) · JMIR Formative Research · doi:10.2196/77243
Mulungu, C., Mindu, T., & Mulungu, K. (2024) · Figshare · doi:10.6084/m9.figshare.25367382
Mulungu, C., Mindu, T., & Mulungu, K. (2024) · Figshare · doi:10.6084/m9.figshare.25367521
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Metadata
- 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
- 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
- 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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