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Der Nervenarzt

, Volume 84, Issue 7, pp 823–831 | Cite as

Die therapeutische Beziehung in internetbasierten Therapieverfahren

Ein Überblick
  • M. KlasenEmail author
  • C. KnaevelsrudEmail author
  • M. BöttcheEmail author
Übersichten

Zusammenfassung

Die moderne Informations- und Kommunikationstechnologie hat in den letzten Jahren verstärkt Einzug in den Bereich der psychosozialen Gesundheitsversorgung gehalten. Die Qualität der therapeutischen Beziehung in einem medienvermittelten therapeutischen Kontakt ist bisher unzureichend geklärt. Ziel dieses Reviews ist es, einen systematischen Überblick vorliegender kontrollierter Evaluationsstudien zu geben, die die Qualität und Relevanz der therapeutischen Beziehung in internetbasierten Interventionen untersuchen. Die Ergebnisse deuten darauf hin, dass unabhängig vom Kommunikationsmedium eine stabile therapeutische Beziehung in internetbasierten randomisiert-kontrollierten Studien hergestellt werden kann. Diese wird vergleichbar positiv bewertet wie herkömmliche Face-to-Face-Therapien.

Schlüsselwörter

Therapeutische Beziehung Arbeitsallianz Internetbasierte Therapieverfahren Computervermittelte Kommunikation Visuelle Anonymität 

The therapeutic alliance in internet-based therapy procedures

An overview

Summary

There has been an increased use of modern information and communication technology in healthcare services in recent years; however, little is yet known about the nature of the therapeutic alliance in internet-based interventions. This review aims to give a systematic overview of controlled evaluation studies with a focus on the nature and impact of the therapeutic alliance in internet-based interventions available to date. The results of internet-based randomized controlled trials indicate that a positive therapeutic alliance can be established regardless of the medium of communication. The therapeutic alliance was rated equally satisfying as in conventional face-to-face therapy.

Keywords

Therapeutic alliance Working alliance Internet-based treatment Computer-mediated communication Visual anonymity 

Notes

Interessenkonflikt

Die korrespondierenden Autoren geben an, dass kein Interessenkonflikt besteht.

Literatur

  1. 1.
    Barak A, Grohol JM (2011) Current and future trends in internet-supported mental health interventions. J Technol Hum Serv 29:155–196CrossRefGoogle Scholar
  2. 2.
    Barak A, Hen L, Boniel-Nissim M, Shapira N (2008) A comprehensive review and a meta-analysis of the effectiveness of internet-based psychotherapeutic interventions. J Technol Hum Serv 26:109–160CrossRefGoogle Scholar
  3. 3.
    Berger T, Andersson G (2009) Internetbasierte Psychotherapien: Besonderheiten und empirische Evidenz. Psychother Psychosom Med Psychol 59:159–170PubMedCrossRefGoogle Scholar
  4. 4.
    Berger T, Caspar F (2011) Internetbasierte Psychotherapien. Psychiatr Psychother up2Date 5:29–43CrossRefGoogle Scholar
  5. 5.
    Boos M, Jonas KJ (2008) Medienvermittelte Kommunikation. In: Batinic B, Appel M (Hrsg) Medienpsychologie. Springer, Berlin, S 195–216Google Scholar
  6. 6.
    Bordin ES (1979) The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy 16:252–260CrossRefGoogle Scholar
  7. 7.
    Brusseri MA, Tyler JD (2003) Interchangeability of the Working Alliance Inventory and Working Alliance Inventory, short form. Psychol Assess 15:193–197CrossRefGoogle Scholar
  8. 8.
    Bouchard S et al (2004) Delivering cognitive-behavior therapy for panic disorder with agoraphobia in videoconference. Telemed J E Health 10:13–25PubMedCrossRefGoogle Scholar
  9. 9.
    Cuijpers P Marks IM, Straten A van et al (2009) Computer-aided psychotherapy for anxiety disorders: a meta-analytic review. Cogn Behav Ther 38:66–82PubMedCrossRefGoogle Scholar
  10. 10.
    Cuijpers P, Straten AM van, Andersson G (2008) Internet administered cognitive behavior therapy for health problems: a systematic review. J Behav Med 31:169–177PubMedCrossRefGoogle Scholar
  11. 11.
    Döring N (2003) Computervermittelte Kommunikation als therapeutisches Medium. In: Ott R, Eichenberg C (Hrsg) Klinische Psychologie und Internet. Hogrefe, Göttingen, S 117–127Google Scholar
  12. 12.
    Eichenberg C, Ott R (2011) Klinisch-psychologische Intervention im Internet:Ein Review zu empirischen Befunden störungsspezifischer Angebote. Psychotherapeut. DOI 10.1007/s00278-011-0832-5Google Scholar
  13. 13.
    Ertelt T et al (2011) Therapeutic factors affecting the cognitive behavioral treatment of ulimia nervosa via telemedicine versus face-to-face delivery. Int J Eat Disord 44:687–691PubMedCrossRefGoogle Scholar
  14. 14.
    Germain V, Marchand A, Bouchard S et al (2010) Assessment of the therapeutic alliance in face-to-face or videoconference treatment for posttraumatic stress disorder. Cyberpsychol Behav 13:29–35CrossRefGoogle Scholar
  15. 15.
    Hanson WE, Curry KT, Bandalos DL (2002) Reliability generalization of Working Alliance Inventory scale scores. Educ Psychol Measur 62:659–673CrossRefGoogle Scholar
  16. 16.
    Hard J, Ochs M (2011) Internettherapie-Chancen und Gefahren-eine erste Annäherung. Psychotherapeuten J 1:28–32Google Scholar
  17. 17.
    Hohagen F (2009) Internetgestützte Therapieprogramme: Gefahr für die traditionelle Psychotherapie? Verhaltenstherapie 19:4–5Google Scholar
  18. 18.
    Horvath AO (1994) Research on the alliance. In: Greenberg LS, Horvath AO (Hrsg) The working alliance: theory, research, and practice. Oxford, Wiley, S 259–286Google Scholar
  19. 19.
    Horvath, AO, Bedi RP (2002) The Alliance. In: Norcross JC (Hrsg) Psychotherapy relationships that work. Oxford, University Press, S 37–40Google Scholar
  20. 20.
    Horvath AO, Greenberg LS (1989) Development and validation of the Working Alliance Inventory. J Couns Psychol 36:223–233CrossRefGoogle Scholar
  21. 21.
    Kiropoulos LA, Klein B, Austin DW et al (2008) Is internet-based CBT for panic disorder and agoraphobia as effective as face- to-face CBT? J Anxiety Disord 8:1273–1284CrossRefGoogle Scholar
  22. 22.
    Klein B, Richards JC, Austin DW (2006) Efficacy of Internet therapy for panic disorder. J Behav Ther Exp Psychiatry 37:213–238PubMedCrossRefGoogle Scholar
  23. 23.
    Klein B et al (2009) Internet-based treatment for panic disorder: does frequency of therapist contact make a difference? Cogn Behav Ther 38:100–113PubMedCrossRefGoogle Scholar
  24. 24.
    Klein B et al (2010) A therapist-assisted cognivitve behavior therapy internet intervention for posstraumatic stress disorder: pre-, post- and 3-month follow-up results. J Anxiety Disord 24:635–644PubMedCrossRefGoogle Scholar
  25. 25.
    Knaevelsrud C, Jager J, Maercker A (2004) Internet-Psychotherapie: Wirksamkeit und Besonderheiten in der therapeutischen Beziehung. Verhaltenstherapie 14:174–183CrossRefGoogle Scholar
  26. 26.
    Knaevelsrud C, Maercker A (2007) Internet-based treatment for PTSD reduces distress and facilitates the development of a strong therapeutic alliance: a randomized controlled clinical trial. BMC Psychiatry 19:7–13Google Scholar
  27. 27.
    Krampen G, Wald B (2001) Kurzinstrumente für die Prozessevaluation und adaptive Indikation in der allgemeinen und differentiellen Psychotherapie und Beratung. Diagnostika 47:43–50CrossRefGoogle Scholar
  28. 28.
    Kummervold PE et al (2008) eHealth Trends in Europe 2005–2007: a population-based survey. J Med Internet Res 10:e42PubMedCrossRefGoogle Scholar
  29. 29.
    Lange A et al (2003) Interapy: A controlled randomized trial of the standardized treatment of posttraumatic stress through the Internet. J Consult Clin Psychol 71:901–909PubMedCrossRefGoogle Scholar
  30. 30.
    Lester D (2006) Etherapy: Caveats from experiences with telephone therapy. Psychol Rep 99:894–896PubMedGoogle Scholar
  31. 31.
    Ljótsson B et al (2011) Internet-delivered exposure-based treatment vs. stress management for irritable bowel syndrome: a randomized trial. Am J Gastroenterol 106:1481–1491PubMedCrossRefGoogle Scholar
  32. 32.
    Luborsky L (1985) The helping alliance questionnaire: patient version. In: Ogls B, Lambert M, Masters K (Hrsg) Assessing outcome in clinical practice. Sydney, Allyn & Bacon, S 150–151Google Scholar
  33. 33.
    Matheson K, Zanna MP (1988) The impact of computer-mediated communication on self-awareness. Comput Hum Behav 4:221–233CrossRefGoogle Scholar
  34. 34.
    Mitchell J, Crosby R et al (2008) A randomized trial comparing the efficacy of cognitive-behavioral therapy for bulimia nervosa delivered via telemedicine versus face to face. Behav Res Ther 46:581–592PubMedCrossRefGoogle Scholar
  35. 35.
    Newman MG, Szkodny LE, Llera SJ, Przeworski A (2011) A review of technology-assisted self-help and minimal contact therapies for anxiety and depression: is human contact necessary for therapeutic efficacy? Clin Psychol Rev 31:89–103PubMedCrossRefGoogle Scholar
  36. 36.
    Preschl B, Maercker A, Wagner B (2011) The working alliance in a randomized controlled trial comparing online with face-to-face cognitive-behavioral therapy for depression. BMC Psychiatry 11:189PubMedCrossRefGoogle Scholar
  37. 37.
    Roesler C (2011) Die virtuelle therapeutische Beziehung. Eine Reflexion ihrer Möglichkeiten und Grenzen. Psychother Dialog 12:107–112CrossRefGoogle Scholar
  38. 38.
    Skinner AEG, Latchford G (2006) Attitudes to counselling via the Internet: a comparison between in-person counselling clients and internet support group users. Couns Psychother Res 6:158–163CrossRefGoogle Scholar
  39. 39.
    Spek V et al (2007) Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis. Psychol Med 37:319–328PubMedCrossRefGoogle Scholar
  40. 40.
    Stiles WB et al (2002) Convergent validity of the Agnew Relationship Measure and the Working Alliance Inventory. Psychol Assess 14:209–220PubMedCrossRefGoogle Scholar
  41. 41.
    Suler J (2004) The online disinhibition effect. Cyberpsychol Behav 7:321–326PubMedCrossRefGoogle Scholar
  42. 42.
    Tracey TJ, Kokotovic AM (1989) Factor structure of the Working Alliance Inventory. Psychol Assess 1:207–210CrossRefGoogle Scholar
  43. 43.
    Trautmann E, Kröner-Herwig B (2008) Internet-based self-help training for children and adolescents with recurrent headache: a pilot study. Behav Cogn Psychother 36:24–245CrossRefGoogle Scholar
  44. 44.
    Trautmann E, Kröner-Herwig B (2010) A randomized controlled trial of Internet based self-help training for recurrent headache in childhood and adolescence. Behav Res Ther 48:28–37PubMedCrossRefGoogle Scholar
  45. 45.
    Walther JB (1996) Computer-mediated communication: Impersonal, interpersonal, and hyperpersonal interaction. Hum Commun Res 23:3–43Google Scholar
  46. 46.
    Wagner B, Brand J, Schulz W, Knaevelsrud C (2012) Online working alliance predicts treatment outcome for posttraumatic stress symptoms in arab war-traumatized patients. Depress Anxiety 29:646–651PubMedCrossRefGoogle Scholar
  47. 47.
    Wells M, Mitchell KJ, Finkelhor D, Becker-Blease KA (2007) Online Mental Health Treatment: Concerns and Considerations. Cypberpsychol Behav 10:453–459CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Catania gemeinnützige GmbH, Projekt pflegen-und-lebenBerlinDeutschland
  2. 2.Klinische Psychologie und PsychotherapieFreie Universität BerlinBerlinDeutschland
  3. 3.Klinische Psychologie und PsychotherapieBehandlungszentrum für FolteropferBerlinDeutschland

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