Abstract
Background: The current study explores the pace of psychological change in face-to-face (F2F) and videoconferencing psychotherapy (VCP). It also aims to offer a methodological tool for studying it and to suggest some hypotheses that could explain the pace of change in F2F and VCP. Change in therapy was predicted to be non-linear and faster in F2F than in VCP. Method: Session-by-session records of two measures of change (as assessed by therapists and clients, respectively) were collected from 113 participants from F2F (n = 57) and VCP (n = 56), resulting in 2552 therapy sessions. A non-manipulative longitudinal design was proposed in which multilevel growth curve models were performed. Different models were specified to account for the trajectories followed on average by all cases as closely as possible. Results: The chosen models for therapists’ (X2 = 4.42, p < .05, r2 = .54) and clients’ (X2 = 6.31, p < .05, r2 =
.53) data, showed large effect sizes. The results were significant and showed that change was not linear and was faster in F2F, as we had predicted. Conclusions: Our results contribute to knowledge about psychological therapy provided through the internet. Several hypotheses are suggested to explain which processes may underlie those results.
References
American Psychological Association (APA), (2013). Guidelines for the practice of telepsychology. American Psychologist, 68, 791–800. https://doi.org/10.1037/a0035001
Andersson, G., Topooco, N., Havik, O., & Nordgreen, T. (2015). Internet- supported versus face-to-face cognitive behavior therapy for depression. Expert Review of Neurotherapeutics, 16, 55–60. https://doi.org/10.1586/14737175.2015.1125783
Appelbaum, M., Cooper, H., Kline, R. B., Mayo-Wilson, E., Nezu, A. M., & Rao, S. M. (2018). Journal Article Reporting Standards for Quantitative Research in Psychology: The APA Publications and Communications Board Task Force report. American Psychologist, 73, 3–25. https://doi.org/10.1037/amp0000191
Backhaus, A., Agha, Z., Maglione, M. L., Repp, A., Ross, B., Zuest, D., Rice-Thorp, N. M., Lohr, J. & Thorp, S. R. (2012). Videoconferencing psychotherapy: A systematic review. Psychological Services, 9, 111– 131. https://doi.org/10.1037/a0027924.
Barak, A., Klein, B. & Proudfoot, J. G. (2009). Defining internet-supported therapeutic interventions. Annals of Behavioral Medicine, 38, 4–17. https://doi.org/10.1007/s12160-009-9130-7
Bates, D., Maechler, M., Bolker, B., & Walker, S. (2015). Fitting linear mixed-effects models using lme4. Journal of Statistical Software, 67, 1–48. https://doi.org/10.18637/jss.v067.i01
Beatty, L. & Binnion, C. (2016). A systematic review of predictors of, and reasons for, adherence to online psychological interventions. International Journal of Behavioral Medicine, 23, 776–794. https://doi.org/10.1007/s12529-016-9556-9
Berryhill, M. B., Culmer, N., Williams, N., Halli-Tierney, A. D., Betancourt, A., Roberts, H. & King, M. (2018). Videoconferencing psychotherapy and depression: A systematic review. Telemedicine and e-Health, 25, 1–12. https://doi.org/10.1089/tmj.2018.0058
Berryhill, M. B., Halli-Tierney, A. D., Culmer, N., Williams, N., Betancourt, A., King, M., & Ruggles, H. (2018). Videoconferencing psychological therapy and anxiety: A systematic review. Family Practice, 36, 53–63. https://doi.org/10.1093/fampra/cmy072
Calero, A., Torre, M., Pardo, R. & Santacreu, M. (2018). Características de la asistencia psicológica en el contexto universitario: La clínica universitaria de la UAM [Characteristics of psychological assistance in the university context: The UAM university clinic]. Análisis y Modificación de Conducta, 44, 37-50. https://doi.org/10.33776/amc. v44i169-70.3378
Calero, A., & Shih, P. C. (2016). Terapia psicológica a través de Internet [Psychological therapy through the Internet]. In M. Márquez-González (coord.), Tendencias actuales en intervención psicológica [Current trends in psychological intervention], (pp. 229-256). Síntesis.
Capner, M. (2000). Videoconferencing in the provision of psychological services at a distance. Journal of Telemedicine and Telecare, 6, 311–319. https://doi.org/10.1258/ 1357633001935969
Carey, T. A. (2011). Exposure and reorganization: The what and how of effective psychotherapy. Clinical Psychology Review, 31, 236–248. https://doi.org/10.1016/j.cpr.2010.04.004
Connolly, S. L., Miller, C. J., Lindsay, J. A., & Bauer, M. S. (2020). A systematic review of providers’ attitudes toward telemental health via videoconferencing. Clinical Psychology: Science and Practice, 27, Article e12311. https://doi.org/10.1111/cpsp.12311
Cuijpers, P., Karyotaki, E., Weitz, E., Andersson, G., Hollon, S. D., & van Straten, A. (2014). The effects of psychotherapies for major depression in adults on remission, recovery and improvement: A meta-analysis. Journal of affective disorders, 159, 118–126. https://doi.org/10.1016/j.jad.2014.02.026 Domhardt, M., Nowak, H., Engler, S., Baumel, A., Grund, S., Mayer, A., Terhorst, Y., & Baumeister, H. (2021). Therapeutic processes in digital interventions for anxiety: A systematic review and meta-analytic structural equation modelling of randomized controlled trials. Clinical Psychology
Review, 90, Article 102084. https://doi.org/10.1016/j.cpr.2021.102084 Doraiswamy, S., Abraham, A., Mamtani, R., & Cheema, S. (2020). Use of
telehealth during the COVID-19 pandemic: Scoping review. Journal of medical Internet research, 22,Article e24087. https://doi.org/10.2196/24087 Erbe, D., Eichert, H. C., Riper, H., & Ebert, D. D. (2017). Blending face-to- face and internet-based interventions for the treatment of mental disorders in adults: Systematic review. Journal of Medical Internet Research, 19, e306–e316. https://doi.org/10.2196/jmir.6588
Eysenbach, G. (2001). What is e-health? Journal of Medical Internet Research, 3, e20. https://doi.org/10.2196/jmir.3.2.e20
Fernandez, E., Salem, D., Swift, J. K., & Ramathal, N. (2015). Meta-analysis of dropout from cognitive-behavioral therapy: Magnitude, timing and moderators. Journal of Consulting and Clinical Psychology, 83, 1108–1122. https://doi.org/10.1037/ccp0000044
Fernández--Regueras, D., Calero-Elvira, A., & Guerrero-Escagedo, M.C. (2023). Comparison of clinical indicators between face-to-face and videoconferencing psychotherapy: Success, adherence to treatment and efficiency. Behavioral Psychology / Psicología Conductual, 31, 543–562. https://doi.org/10.51668/bp.8323306n
Field, M. (1996). Telemental health: A guide to assessing telecommunications to health care. National Academy Press
Field, A., Miles, J., & Field, Z. (2012). Discovering statistics using R. SAGE Publications Ltd.
Flückiger, C., Del Re, A. C., Wampold, B. E., & Horvath, A. O. (2018). The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 55, 316–340. https://doi.org/10.1037/pst0000172
Froján, M. X., Montaño, M. & Calero, A. (2006). ¿Por qué la gente cambia en terapia? Un estudio preliminar [Why do people change in therapy? A preliminary study]. Psicothema, 18, 797–803.
Goldfried, M. R., & Wolfe, B. E. (1996). Psychotherapy practice and research: Repairing a strained alliance. American Psychologist, 51, 1007−1016. https://doi.org/10.1037//0003-066x.51.10.1007
Hayes, A. M., Feldman, G. C., Beevers, C. G., Laurenceau, J.-P., Cardaciotto, L., & Lewis-Smith, J. (2007). Discontinuities and cognitive changes in an exposure-based cognitive therapy for depression. Journal of Consulting and Clinical Psychology, 75, 409–421. https://doi.org/10.1037/0022-006X.75.3.409
Hayes, A. M., Laurenceau, J. P., Feldman, G., Strauss, J. L., & Cardaciotto, L. (2007). Change is not always linear: The study of nonlinear and discontinuous patterns of change in psychotherapy. Clinical Psychology Review, 27, 715–723. https://doi.org/10.1016/j.cpr.2007.01.008
Hayes, A. M., Yasinski, C., Ben B. J., & Bockting L.H. (2015). Network destabilization and transition in depression: New methods for studying the dynamics of therapeutic change. Clinical Psychology Review, 41, 27–39. https://doi.org/10.1016/j.cpr.2015.06.007
Hoffman, L. (2015). Longitudinal analysis. Modeling withing-person fluctuation and change. Routledge.
Inchausti, F., García-Poveda, N.V., Prado-Abril, J., & Sánchez-Reales, S. (2020). La psicología clínica ante la Pandemia COVID-19 en España [Clinical psychology and the COVID-19 Pandemic in Spain]. Clínica y Salud, 31, 105–107. https://doi.org/10.5093/clysa2020a11
Kazdin, A. E. (2008). Evidence-Based treatments and practice. New opportunities to bridge clinical research and practice, enhance the knowledge base, and improve patient care. American psychologist, 63, 146–159. https://doi.org/10.1037/0003-066X.63.3.146
Kim, H., & Xie, B. (2017). Health literacy in the eHealth era: A systematic review of the literature. Patient Education and Counseling, 100, 1073– 1082. https://doi.org/10.1016/j.pec.2017.01.015
Kleinke, C. L. (1994). Common principles of psychotherapy. Cole Publishing.
Lambert, M. J. (2005). Early response in psychotherapy: Further evidence for the importance of common factors rather than “placebo effects”. Journal of Clinical Psychology, 61, 855−869. https://doi.org/10.1002/jclp.20130
Larroy, C., Estupiñá, F., Fernández-Arias, I., Hervás, G., Valiente, C., Gómez, M., Crespo, M., Rojo, N., Roldán, L., Vázquez, C., Ayuela, D., Lozano, B., Martínez, A., Pousada, T., Gómez, A., Asenjo, M., Rodrigo, J.J., Florido, R., Vallejo-Achón, M.,…, Pardo, R. (2020). Guía para el abordaje no presencial de las consecuencias psicológicas del brote epidémico de COVID-19 en la población general [Guidelines for the non-face-to-face management of the psychological consequences of the epidemic outbreak of COVID-19 in the general population]. Clínica Universitaria de Psicología Universidad Complutense de Madrid.
Laurenceau, J. P., Hayes, A. M., & Feldman, G. C. (2007). Some methodological and statistical issues in the study of change processes in psychotherapy. Clinical Psychology Review, 27, 682–695. https://doi.org/10.1016/j. cpr.2007.01.007
Matsumoto, K., Hamatani, S., & Shimizu, E. (2021). Effectiveness of videoconference-delivered cognitive behavioral therapy for adults with psychiatric disorders: Systematic and meta-analytic review. Journal of Medical Internet Research, 23, Article e31293. https://doi.org/10.2196/31293
McClellan, M. J., Osbaldiston, R., Wu, R., Yeager, R., Monroe, A. D., McQueen, T., & Dunlap, M. H. (2021). The effectiveness of telepsychology with veterans: A meta-analysis of services delivered by videoconference and phone. Psychological Services, 19, 294-304. https://doi.org/10.1037/ser0000522
Mogoașe, C., Cobeanu, O., David, O., Giosan, C., & Szentagotai, A. (2017). Internet‐based psychotherapy for adult depression: What about the mechanisms of change? Journal of Clinical Psychology, 73, 5–64. https://doi.org/10.1002/jclp.22326
Nakagawa, S., Schielzeth, H., & O’Hara, R. B. (2013). A general and simple method for obtaining R2 from generalized linear mixed-effects models. Methods in Ecology and Evolution, 4, 133–142. https://doi.org/10.1111/ j.2041-210x.2012.00261.x
Norwood, C., Moghaddam, N. G., Malins, S., & Sabin-Farrell, R. (2018). Working alliance and outcome effectiveness in videoconferencing psychotherapy: A systematic review and noninferiority meta-analysis. Clinical Psychology Psychotherapy, 25, 797–808. https://doi.org/10.1002/ cpp.2315
Rees, C. S., & Maclaine, E. (2015). A systematic review of videoconference- derivered psychological treatment for anxiety disorders. Australian Psychologist, 50, 259–264. https://doi.org/10.1111/ap.12122
Richardson, L. K., Frueh, B. C., Grubaugh, A. L., Johnson, R. H., Egede, L., & Elhai, J. D. (2009). Current directions in videoconferencing telemental health research. Clinical Psychology: Science and Practice, 16, 323–338. https://doi.org/10.1111/j.1468-2850.2009.01170.x
Ritterband, L. M., Andersson, G., Christensen, H. M., Carlbring, P. & Cuijpers, P. (2006). Directions for the International Society for Research on Internet Interventions (ISRII). Journal of Medical Internet Research, 8, Article e23. https://doi.org/10.2196/jmir.8.3.e23
Sammons, M. T., VandenBos, G. R., Martin, J. N., & Elchert, D. M. (2020). Psychological practice at six months of COVID-19: A follow-up to the first national survey of psychologists during the pandemic. Journal of Health Service Psychology, 46, 145–154. https://doi.org/10.1007/s42843-020- 00024-z
Simpson, S. (2009). Psychotherapy via videoconferencing: a review. British Journal of Guidance & Counselling, 37, 271–286. https://doi.org/10.1080/03069880902957007
Singmann, H., Bolker, B., & Westfall, J. (2015). Afex: Analysis of factorial experiments. R Package Version 0.15-2. http://CRAN.R-project.org/ package=afex
Snoswell, C. L., Chelberg, G., De Guzman, K. R., Haydon, H. H., Thomas, E. E., Caffery, L. J. & Smith, A. C. (2021). The clinical effectiveness
of telehealth: A systematic review of meta-analyses from 2010 to 2019. Journal of Telemedicine and Telecare, 0, 1–16. https://doi. org/10.1177/1357633X211022907
Stiles, W. B. (2001). Assimilation of problematic experiences. Psychotherapy, 38, 462−465. https://doi.org/10.1037/0033-3204.38.4.462
Suler, J. (2000). Psychotherapy in cyberspace: A 5-dimensional model of online and computer-mediated psychotherapy. Cyberpsychology and Behavior, 3, 151–159. https://doi.org/10.1089/109493100315996
de la Torre, M., & Pardo, R. (2018). Guía de intervención telepsicológica [Telepsychological intervention guide]. Colegio Oficial de la Psicología de Madrid.
Thomas, N., McDonald, C., de Boer, K., Brand, R. M., Nedeljkovic, M., & Seabrook, L. (2021). Review of the current empirical literature on using videoconferencing to deliver individual psychotherapies to adults with mental health problems. Psychology and Psychotherapy: Theory, Research and Practice, 94, 854–883. https://doi.org/10.1111/papt.12332
Wind, T. R., Rijkeboer, M., Andersson, G., & Riper, H. (2020). The COVID-19 pademic: The ‘black swan’ for mental health care and a turning point for e-health. Internet Intervention, 20, Article 100317. https://doi.org/10.1016/j. invent.2020.100317
World Health Organisation (WHO), (2006). Building foundations for e-health: Progress of members state: report of Global Observatory for eHealth. OMS. https://apps.who.int/iris/handle/10665/43599
Zach, L., Dalrymple, P. W., Rogers, M. L., & Williver-Farr, H. (2011). Assessing Internet access and use in a medically underserved population: Implications for providing enhanced health information services. Health Information & Libraries Journal, 29, 61–71. https://doi.org/10.1111/j.14711842.2011.00971.x