The impact of technology on therapeutic alliance and engagement in psychotherapy: The therapist’s perspective
Open accessAbstract
ObjectiveIn this article, we investigate therapist views on their experiences using a technological adjunct (goACT) to traditional, face‐to‐face psychotherapy. goACT is a web‐based mobile interactive software application that facilitates an interactive platform, allowing therapists to connect with their clients between face‐to‐face psychotherapy sessions.MethodParticipants were six provisional psychologists and seven patients. Data were collected at two post‐therapy focus groups in order to qualitatively understand therapist experience of goACT as a therapy adjunct. Data were analysed utilising thematic analysis.ResultsFour main themes emerged: (1) “discretional use of goACT” linked to therapist preferences and client suitability; (2) “therapist concerns” linked to boundaries, workload, technological glitches, and therapeutic risks; (3) “goACT expands the parameters of therapy” through increased opportunities to provide care and connection with patients and increased access to the process of therapy; and (4) “goACT enhances therapy” through reciprocal responsibility and guided empowerment. Therapists in this study were more open to the use of technology in therapy than has been reported in previous research and did not find that it affected their workload.ConclusionTherapists indicated that when aligned to the specific needs of individual patients, an advanced mobile and web‐based interactive software application (goACT) has the potential to enhance engagement, rapport, and patient empowerment in face‐to‐face psychotherapy.
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Technology-supported ACT might limit personal engagement and therapeutic alliance, potentially reducing efficacy.
“This technological approach, while innovative, might limit aspects like personal engagement and therapeutic alliance, potentially reducing efficacy [63].”
From Acceptance and commitment therapy for patients with chronic pain: A systematic review and meta-analysis on psychological outcomes and quality of life (2024) · cites this paper as [63]
Unguided mental health apps can potentially decrease clinicians' workloads.
“In particular, unguided mental health apps (also termed fully automated mental health apps), which can be used in the absence of a clinician, can potentially decrease clinicians' workloads (16).”
From Digital Therapeutic Alliance With Fully Automated Mental Health Smartphone Apps: A Narrative Review (2022) · cites this paper as [16]
Guided apps could potentially increase healthcare professionals' workload.
“Although research shows that apps with human support are more effective than automated digital interventions (21), guided apps could potentially increase healthcare professionals' workload (16).”
From Digital Therapeutic Alliance With Fully Automated Mental Health Smartphone Apps: A Narrative Review (2022) · cites this paper as [16]
Adoption of an intervention as part of therapy depended on the therapist's digital literacy skills, past experience with mental health technology, and ability to easily integrate its use into their practice.
“The adoption of an intervention as part of therapy depended on the therapist’s digital literacy skills [244,245], their past experience with mental health technology [120], and the ability to easily integrate its use into their practice as a provider [132,195,205,211,224,226,246].”
From Barriers to and facilitators of user engagement with digital mental health interventions: Systematic review (2021) · cites this paper as [244]
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The Virtual Third: Conceptualizing Online Couple Therapy Using Grounded Theory
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Exploring Digital Therapeutic Alliance (DTA) with Artificial Intelligence (AI): A Systematic Review
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- Authors
- Richards, P., Simpson, S., Bastiampillai, T., Pietrabissa, G., & Castelnuovo, G.
- Affiliations
- University of South Australia (AU)
- The University of Adelaide (AU)
- Università Cattolica del Sacro Cuore (IT)
- Corresponding author
- Simpson, Susan
- Venue
- Clinical Psychologist
- Publisher
- Informa UK Limited
- Published
- 2018-07-01
- Volume
- 22
- Issue
- 2
- Pages
- 171-181
- ISSN
- 1328-4207 (ISSN-L)
- 1742-9552
- OpenAlex
- W2511659151
- Cited by
- 50
- References
- 51
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 6 · 2023: 8 · 2022: 7 · 2021: 10 · 2020: 7 · 2019: 3
- FWCI
- 1.54
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Clinical Psychologist (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- UniSA Research Outputs Repository (University of South Australia) (submittedVersion)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- therapeutic relationship, customer engagement, therapist perspectives, therapist workload, therapeutic boundaries, patient empowerment, face-to-face psychotherapy
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