Therapeutic alliance in videoconferencing psychotherapy compared to psychotherapy in person: A systematic review and meta-analysis

Abstract

Introduction Videoconferencing psychotherapy (VCP) delivers treatment to individuals with limited access to face-to-face mental healthcare. VCP's effectiveness has been demonstrated for various disorders and therapeutic interventions. However, there is contradictory evidence regarding the therapeutic alliance in VCP as compared to psychotherapy in person (PIP). This meta-analysis examines whether therapeutic alliance differs by psychotherapy's delivery format, namely VCP versus PIP. Methods We searched five databases for trials comparing the therapeutic alliance in VCP and PIP, wherein the therapeutic alliance was rated by either patients or therapists or both. Eighteen publications were included, and the difference between VCP and PIP was assessed. Furthermore, we tested possible moderators of the difference in therapeutic alliance between VCP and PIP by meta-regression, and we assessed the risk of bias of this meta-analysis. Results The meta-analysis revealed no statistically significant difference in the therapeutic alliance between VCP and PIP for alliance ratings by patients (SMD = −0.09; 95% CI = −0.26; 0.07) as well as by therapists (SMD = 0.04; 95% CI = −0.17; 0.25). No significant moderators were found. Discussion In this meta-analysis, VCP and PIP did not differ with respect to the therapeutic alliance as rated by either patients or therapists. Further research is required into mechanisms driving the therapeutic alliance in VCP and PIP.

Effectiveness of One Videoconference-Based Exposure and Response Prevention Session at Home in Adjunction to Inpatient Treatment in Persons With Obsessive-Compulsive Disorder: Nonrandomized Study

“…Additionally, as patients rated working alliance in the videoconference setting as high, this might also substantially contribute to the effects shown in this study. Previous studies have already shown that the videoconference setting enables the patient and psychotherapist to establish a strong and stable working alliance that is comparable to that in traditional face-to-face treatment [ 63 , 64 ]. Several studies even highlight that a positive working alliance is predictive of substantial decreases in symptomatology [ 31 ].…”

Indikation und Kontraindikation videobasierter Psychotherapie: Eine qualitative Delphi-Befragung zur Erfassung der Reflexions- und Abwägungsprozesse von Psychotherapeut*innen

“…Insgesamt sei laut Erfahrungsberichte psychodynamisch orientierter Psychotherapeut*innen (PD) der therapeutische Prozess mit der einer Präsenztherapie vergleichbar [5]. Auch die therapeutische Beziehung im Videosetting stellt sich in aktuellen Studien, als mit dem Präsenzsetting vergleichbar heraus [10][11][12]. Quantitative Untersuchungen, welche die Effektstärken von VP mit dem F2F-Setting in der psychodynamischen Psychotherapie vergleichen, fehlen jedoch nahezu vollständig.…”

When the algorithm ‘matches’ us: The experiences of early‐career psychologists on online platform services for psychotherapy and counselling in Italy

“…Furthermore, there is debate regarding the relational limitations and preservation of the therapeutic alliance in VCP (Norwood et al, 2018; Weinberg, 2020). Updated results showed no difference in the therapeutic alliance in VCP as compared to in‐person psychotherapy (Seuling et al, 2023). On the contrary, clinicians' perspectives on the therapeutic relationship in VCP has been found to be less positive than that of clients (Cataldo et al, 2021).…”