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.

Keywords:

• Online therapy
• session impact
• therapeutic alliance
• psychotherapy process research
• online data collection

Acknowledgments

This research was supported by grant 05.1207 from the Ohio Department of Mental Health. We thank Chelsi Day, Elizabeth Lawton, Erin Hoffman, Beth Linkhart, Carlyn Porter, and Emily Verkamp for data collection; Britt Carr and Christian Ratterman for help with the website conceptualization, implementation, and testing; and Art Cooksey and Jason Zack for recruitment assistance.