Psychotherapy Using Distance Technology: A Comparison of Face -to -Face, Video, and Audio Treatments

Telemedicine is a lively current field of development, and mental health is one focus due to uneven geographical distribution of psychologists and the desirability of reducing the cost of services. Many important decisions about using distance technology in the health industry have already been made, without benefit of empirical research. This dissertation project pioneered experimental scrutiny by comparing selected process variables across three modes of psychotherapy: face-to-face, real-time video conference, and two-way audio (analogous to telephone). The process variables were chosen to represent the working alliance between the therapist and the client, a relationship widely believed to predict outcome. In a three-group, between-subjects design, each therapist-client pair was randomly assigned to face-to-face (n = 16), video (n = 16), or audio (n = 16) treatment, and an sessions were videotaped. All clients completed a five session, cognitive-behavioral treatment delivered by an advanced graduate student clinician. Therapist Exploration, Client Participation, and Client Hostility were rated from videotapes of session four of 48 therapist-client pairs. A multivariate analysis of variance (MANOVA) discovered no differences (F[6,86] = 1.36, p = .24) in the working alliance, operationalized as a system of the three process variables, among the groups experiencing face-to-face, video, or audio treatments. This finding helps legitimize the extension of teletherapy to people in restricted conditions such as prisons, hospices, military installations, nursing homes, and remote rural areas, as well as to people homebound due to physical or emotional disability. Since it appears that the therapeutic alliance can be built regardless of technological mediation, investigations of the clinical uses of distance communication are invited.

Name thesis:degree_name

Ph.D.

Level thesis:degree_level

Dissertation

Discipline thesis:degree_discipline

Education

Grantor

University of Illinois at Urbana-Champaign

Year dc:date

2015

Author dc:creator

• Day, Susan X.

Contributors dc:contributor

• Rounds, James

• Psychology, Clinical

Language dc:language

eng

Identifier

(MiAaPQ)AAI9953001

OAI identifier oai:identifier

oai:www.ideals.illinois.edu:2142/80358