A study published in the current issue of Psychotherapy and Psychosomatics analyzes the therapeutic relationship in internet intervention. It is well known that the quality of the therapeutic relationship during face-to-face treatment contributes at least modestly to an effective treatment outcome. A recent study suggested that the patient evaluation of the therapeutic relationship in internet-based therapy is comparable to that of face-to-face treatments. However, there might be specific issues of a therapeutic relationship during internet interventions that have been neglected so far. According to the Authors, no instrument currently exists to measure internet-specific aspects of the therapeutic relationship during internet-based interventions.
The aim of the study was thus to describe sensitivity to change, associations with pre-treatment patient characteristics and associations with patient-reported treatment outcome of an instrument to measure the therapeutic relationship during an internet intervention. To do so, 98 psoriasis and rheumatoid arthritis patients who participated in the treatment arm of two ongoing trials between July 2010 and May 2014, were asked to fill out a paper-and-pencil version of the Internet-Specific Therapeutic Relationship Questionnaire (ITRQ) together with the Dutch translation of the short form of the Working Alliance Inventory (WAI-S), after an instruction session of the treatment website and again at treatment completion.
Overall findings demonstrate the feasibility of the ITRQ as a new measure for internet-specific aspects of the therapeutic relationship and supports earlier findings for the therapeutic relationship as a possible predictor for treatment outcome. As the Authors point out, future research should replicate and extend findings in other patient samples, possibly reveal which patients need support in dealing with the internet-specific aspects of internet-based interventions and aid researchers and clinicians in their understanding of the therapeutic relationship during internet-based interventions.