An investigation of session impact and alliance in internet based psychotherapy: Preliminary results

Abstract

Although psychotherapy has been and continues to be a face-to-face activity primarily, a growing minority of therapists are conducting text-based (i.e. e-mail) psychotherapy over the Internet. This study compared the session impact (measured by the Session Evaluation Questionnaire, SEQ; Stiles, Gordon, & Lani, 2002) and the client-therapist alliance (measured by the Agnew Relationship Measure, ARM; Agnew-Davies, Stiles, Hardy, Barkham, & Shapiro, 1998) of the exchanges between clients and therapists who are engaged in e-mail therapy with previously published results on face-to-face therapy. According to preliminary results, the online clients provided similar session impact and therapeutic alliance ratings compared to face-to-face clients. Although online therapists followed this general trend, they evaluated the depth, smoothness, and positivity aspects of session impact and confidence aspect of therapeutic alliance more highly than face-to-face therapists.

A systematic review of Internet-based therapy for the treatment of addictions

“…Furthermore, results of a client satisfaction survey found that online counselors were equally effective in establishing the essential components of a working counseling relationship including therapeutic alliance (Murphy et al, 2009). Similarly, comparative research trials have found that Internet therapy clients reported experiencing greater ease self-disclosing, deeper and smoother exchanges and equal or greater working alliances with online therapists that were more positive as compared to face-to-face therapy clients (Cook & Doyle, 2002;Kiropoulos et al, 2008;Leibert, Archer, Munson, & York, 2006;Reynolds, D'Arcy, Stiles, & Grohol, 2006). The higher impact ratings for online therapy may be related to email communication, which allows both clients and therapists greater reflection and editing ensuring that the wording is clear and concise and provides a record for later consideration.…”

Client Satisfaction and Outcome Comparisons of Online and Face-to-Face Counselling Methods

“…Session impact and the client -therapist alliance in asynchronous cybercounselling were examined in therapist/client dyads by Reynolds et al (2006) and compared to previously published research using the same measures for face-to-face counselling (Cohen and Kerr, 1998). Online therapists rated their exchanges as 'deeper and smoother' compared to face-to-face therapists (Reynolds et al, 2006, p. 164).…”

Counseling via Avatar: Professional Practice in Virtual Worlds

“…Online clients often talk more freely when they feel they are in a safe, non-judgmental environment, frequently make deeper disclosures to the counselor, and disclose sooner than they might in person (King et al 2006;Marks 2004;Reynolds et al 2006;Suler 2004). Textbased communication creates a written record that potentially benefits clients and counselors (Suler 2004), andMarks (2004) found that clients had enhanced control of the therapy session since they could hang up, log off, or move away from the camera.…”