The working alliance in a randomized controlled trial comparing online with face-to-face cognitive-behavioral therapy for depression 英文参考文献.docVIP

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The working alliance in a randomized controlled trial comparing online with face-to-face cognitive-behavioral therapy for depression 英文参考文献.doc

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The working alliance in a randomized controlled trial comparing online with face-to-face cognitive-behavioral therapy for depression 英文参考文献

Preschletal.BMCPsychiatry2011,11:189 /1471-244X/11/189 RESEARCH ARTICLE OpenAccess Theworkingallianceinarandomizedcontrolled trialcomparingonlinewithface-to-face cognitive-behavioraltherapyfordepression BarbaraPreschl1,AndreasMaercker1andBirgitWagner2* Abstract Background:Althoughnumerousefficacystudiesinrecentyearshavefoundinternet-basedinterventionsfor depressiontobeeffective,therehasbeenscantconsiderationoftherapeuticprocessfactorsintheonlinesetting. Inface-tofacetherapy,thequalityoftheworkingallianceexplainsvarianceintreatmentoutcome.However,little isyetknownabouttheimpactoftheworkingallianceininternet-basedinterventions,particularlyascompared withface-to-facetherapy. Methods:Thisstudyexploredtheworkingalliancebetweenclientandtherapistinthemiddleandattheendofa cognitive-behavioralinterventionfordepression.Theparticipantswererandomizedtoaninternet-basedtreatment group(n=25)orface-to-facegroup(n=28).Bothgroupsreceivedthesamecognitivebehavioraltherapyoveran 8-weektimeframe.ParticipantscompletedtheBeckDepressionInventory(BDI)post-treatmentandtheWorking AllianceInventoryatmid-andpost-treatment.TherapistscompletedthetherapistversionoftheWorkingAlliance Inventoryatpost-treatment. Results:Withtheexceptionoftherapists’ratingsofthetaskssubscale,whichweresignificantlyhigherinthe onlinegroup,thetwogroups’ratingsoftheworkingalliancedidnotdiffersignificantly.Further,significant correlationswerefoundbetweenclients’ratingsoftheworkingallianceandtherapyoutcomeatpost-treatmentin theonlinegroupandatbothmid-andpost-treatmentintheface-to-facegroup.Correlationanalysisrevealedthat theworkingallianceratingsdidnotsignificantlypredicttheBDIresidualgainscoreineithergroup. Conclusions:Contrarytowhatmighthavebeenexpected,theworkingallianceintheonlinegroupwas comparabletothatintheface-to-facegroup.However,theresultsshowednosignificantrelationsbetweenthe BDIresidualgainscoreandtheworkingallianceratingsineithergroup. Trialregistration:ACTRN12611000563965 Background