Telepsychotherapy for Generalized Anxiety Disorder: Impact on the Working Alliance

• Published in: Journal of psychotherapy integration 2020-06, Vol.30 (2), p.208-225
• Main Authors: Watts, Stéphanie, Marchand, André, Bouchard, Stéphane, Gosselin, Patrick, Langlois, Frédéric, Belleville, Geneviève, Dugas, Michel J.
• Format: Article
• Language: English
• Subjects: Clients; Cognitive Behavior Therapy; Female; Generalized Anxiety Disorder; Human; Male; Mental Health Services; Pandemics; Psychotherapists; Psychotherapy; Telemedicine; Test Construction; Therapeutic Alliance; Videoconferencing; Viral Infections
• ISSN: 1053-0479; 1573-3696
• DOI: 10.1037/int0000223

Telepsychotherapy represents a promising solution to problems pertaining to specialized mental health services accessibility, including when delivering psychotherapy to people who do not have access to care due to the COVID-19 pandemic. The quality of the working alliance established in such a therapeutic context remains often questioned. Moreover, no study has comparatively examined the evolution of the alliance over telepsychotherapy and conventional, face-to-face, psychotherapy. This study assesses the impact of cognitive-behavioral therapy administered via telepsychotherapy or face-to-face on the quality of the working alliance. One hundred and 15 participants suffering from generalized anxiety disorder (GAD) took part in this randomized controlled trial, 50 of whom were assigned to telepsychotherapy in videoconference and 65 of whom were assigned to conventional psychotherapy. Each client and their psychotherapist completed the Working Alliance Inventory every 2 sessions. In the current sample, telepsychotherapy did not interfere with the establishment of the working alliance over the course of the treatment for GAD. On the contrary, clients showed a stronger working alliance in telepsychotherapy delivered in videoconference than in conventional psychotherapy. Clients seemed to be more comfortable with telepsychotherapy than psychotherapists. The clinical implications of these findings are discussed. Telepsicoterapia para el trastorno de ansiedad generalizada: impacto en la Alianza de Trabajo La telepsicoterapia representa una solución prometedora a los problemas relacionados con accesibilidad especializada a servicios de salud mental, incluso cuando se brinda psicoterapia para personas que no tienen acceso al cuidado debido al COVID-19 pandemia. La calidad de la alianza de trabajo establecida en tal contexto terapéutico permanece a menudo cuestionada. Además, ningún estudio ha examinado comparativamente evolución de la alianza a través de telepsicoterapia y psicoterapia convencional, cara a cara. Este estudio evalúa el impacto de la terapia cognitiva conductual administrado por telepsicoterapia o cara a cara en la calidad de alianza de trabajo. Ciento quince participantes que sufren de trastorno de ansiedad generalizada (TAG) participaron en este ensayo controlado aleatorio, 50 de los cuales fueron asignados a telepsicoterapia en videoconferencia y 65 de los cuales fueron asignados a psicoterapia convencional. Cada cliente y su psicoterapeuta complet