Psychotherapy Using Distance Technology: A Comparison of Face -to -Face, Video, and Audio Treatments
Day, Susan X.
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https://hdl.handle.net/2142/80358
Description
Title
Psychotherapy Using Distance Technology: A Comparison of Face -to -Face, Video, and Audio Treatments
Author(s)
Day, Susan X.
Issue Date
1999
Doctoral Committee Chair(s)
Rounds, James
Department of Study
Education
Discipline
Education
Degree Granting Institution
University of Illinois at Urbana-Champaign
Degree Name
Ph.D.
Degree Level
Dissertation
Keyword(s)
Psychology, Clinical
Language
eng
Abstract
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.
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