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Randomized Controlled Trial
. 2014 Dec:63:139-46.
doi: 10.1016/j.brat.2014.10.003. Epub 2014 Oct 23.

Only connect: The working alliance in computer-based cognitive behavioral therapy

Brian D Kiluk  1 , Kelly Serafini  2 , Tami Frankforter  2 , Charla Nich  2 , Kathleen M Carroll  2
Affiliations
Randomized Controlled Trial

Only connect: The working alliance in computer-based cognitive behavioral therapy

Brian D Kiluk et al. Behav Res Ther. 2014 Dec.

Abstract

The limited role of therapists in some technology-based interventions raises questions as to whether clients may develop a 'working alliance' with the program, and the impact on relationships with a therapist and/or treatment outcomes. In this study, the Working Alliance Inventory (WAI), and an adapted version for technology-based interventions (WAI-Tech), were administered within a subsample (n = 66) of cocaine-dependent individuals participating in a randomized trial evaluating the efficacy of Computer-Based Training for Cognitive Behavioral Therapy (CBT4CBT) as an adjunct to treatment as usual (TAU). Results suggest the WAI-Tech has relatively similar psychometric characteristics as the standard WAI; however the 'bond' subscale scores were lower on the WAI-Tech [F(1,52) = 5.78, p < .05]. Scores on the WAI-Tech were not associated with cocaine use outcomes, whereas total scores on the WAI for those assigned to TAU were associated with the percentage of days abstinent from cocaine (r = .43, p < .05). There was little evidence that adding a technology-based intervention adversely affected the working alliance with a therapist in this sample. These preliminary findings suggest some concepts of working alliance may apply to computer-based CBT, yet the function of the alliance may be different in technology-based interventions than in face-to-face psychotherapies.

Keywords: CBT4CBT; Substance use treatment; Technology-based interventions; Therapeutic alliance; Working alliance.

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