Working alliance as a predictor of change in depression during blended cognitive behaviour therapy

Cogn Behav Ther. 2019 Jul;48(4):285-299. doi: 10.1080/16506073.2018.1533577. Epub 2018 Oct 29.

Abstract

Blended Cognitive Behaviour Therapy (bCBT) is a new form of treatment, mixing internet-based modules and face-to-face therapist sessions. How participants rate the therapeutic alliance in bCBT has not yet been thoroughly explored, and neither is it clear whether therapist- and patient-rated alliances are predictors of change in depression during treatment. Depression and alliance ratings from 73 participants in a treatment study on bCBT (part of the E-COMPARED project) were analysed using growth curve models. Alliance, as rated by both patients and therapists, was high. The therapist-rated working alliance was predictive of subsequent changes in depression scores during treatment, whereas the patient-rated alliance was not. A therapeutic alliance can be established in bCBT. The role of the therapist-rated alliance seems to be of particular importance and should be carefully considered when collecting data in future studies on bCBT.

Trial registration: ClinicalTrials.gov NCT02449447.

Keywords: Therapeutic alliance; blended treatment; depression; growth models; internet-based treatment.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cognitive Behavioral Therapy / methods*
  • Depressive Disorder, Major / therapy*
  • Female
  • Humans
  • Internet
  • Male
  • Therapeutic Alliance*
  • Therapy, Computer-Assisted
  • Treatment Outcome
  • Young Adult

Associated data

  • ClinicalTrials.gov/NCT02449447