Department of Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Occupational and Consumer Psychology, Institute of Psychology, University of Freiburg, Freiburg, Germany.
J Telemed Telecare. 2024 Dec;30(10):1521-1531. doi: 10.1177/1357633X231161774. Epub 2023 Mar 28.
Videoconferencing psychotherapy (VCP) delivers treatment to individuals with limited access to face-to-face mental healthcare. VCP's effectiveness has been demonstrated for various disorders and therapeutic interventions. However, there is contradictory evidence regarding the therapeutic alliance in VCP as compared to psychotherapy in person (PIP). This meta-analysis examines whether therapeutic alliance differs by psychotherapy's delivery format, namely VCP versus PIP.
We searched five databases for trials comparing the therapeutic alliance in VCP and PIP, wherein the therapeutic alliance was rated by either patients or therapists or both. Eighteen publications were included, and the difference between VCP and PIP was assessed. Furthermore, we tested possible moderators of the difference in therapeutic alliance between VCP and PIP by meta-regression, and we assessed the risk of bias of this meta-analysis.
The meta-analysis revealed no statistically significant difference in the therapeutic alliance between VCP and PIP for alliance ratings by patients (SMD = -0.09; 95% CI = -0.26; 0.07) as well as by therapists (SMD = 0.04; 95% CI = -0.17; 0.25). No significant moderators were found.
In this meta-analysis, VCP and PIP did not differ with respect to the therapeutic alliance as rated by either patients or therapists. Further research is required into mechanisms driving the therapeutic alliance in VCP and PIP.
视频会议心理疗法（VCP）为那些难以获得面对面心理医疗服务的个体提供治疗。VCP 已被证明对各种障碍和治疗干预都有效。然而，与面对面心理疗法（PIP）相比，VCP 中的治疗联盟的证据存在矛盾。本荟萃分析研究了治疗联盟是否因心理治疗的提供方式（即 VCP 与 PIP）而有所不同。
我们在五个数据库中搜索了比较 VCP 和 PIP 中治疗联盟的试验，其中治疗联盟由患者或治疗师或两者共同评定。纳入了 18 项研究，并评估了 VCP 和 PIP 之间治疗联盟的差异。此外，我们通过元回归测试了治疗联盟在 VCP 和 PIP 之间差异的可能调节因素，并评估了本荟萃分析的偏倚风险。
荟萃分析显示，患者（SMD=-0.09；95%CI=-0.26；0.07）和治疗师（SMD=0.04；95%CI=-0.17；0.25）评定的 VCP 和 PIP 之间的治疗联盟评分没有统计学上的显著差异。未发现显著的调节因素。
在本荟萃分析中，VCP 和 PIP 在患者或治疗师评定的治疗联盟方面没有差异。需要进一步研究 VCP 和 PIP 中驱动治疗联盟的机制。
