ArticleBMJ open2020
Towards a conceptual framework of the working alliance in a blended low-intensity cognitive behavioural therapy intervention for depression in primary mental health care: a qualitative study.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
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Who cites it
11 citing papers in PubMed, 16 citations in OpenAlex.
- Therapeutic alliance in guided internet-delivered cognitive behavioural therapy: a thematic analysis of patients with non-cardiac chest pain.BMC psychology · 2026Trial
- Comparison of the Working Alliance in Blended Cognitive Behavioral Therapy and Treatment as Usual for Depression in Europe: Secondary Data Analysis of the E-COMPARED Randomized Controlled Trial.Journal of medical Internet research · 2024Trial
- The present and future of blended care: current research and introduction to the B-FIT framework.NPJ digital medicine · 2026Review
- Influence of patient satisfaction, system usability, and working alliance on depressive symptom improvement in blended cognitive behavioral therapy (bCBT): Secondary analysis of an open trial data.Internet interventions · 2025Article
- Therapeutic alliance in a stepped digital psychosocial intervention for breast cancer patients: findings from a multicentre randomised controlled trial.BJPsych open · 2025Article
- The therapeutic alliance in blended versus face-to-face cognitive behavioral therapy for adolescents and young adults with a depressive disorder.Internet interventions · 2024Article
- Working alliance in low-intensity internet-based cognitive behavioral therapy for depression in primary care in Spain: A qualitative study.Frontiers in psychology · 2023Article
- Evaluation of the Use of Digital Mental Health Platforms and Interventions: Scoping Review.International journal of environmental research and public health · 2022Article
- Practitioners' experience of the working alliance in a blended cognitive-behavioural therapy intervention for depression: qualitative study of barriers and facilitators.BJPsych open · 2022Article
- Ensuring patient and public involvement in the transition to AI-assisted mental health care: A systematic scoping review and agenda for design justice.Health expectations : an international journal of public participation in health care and health policy · 2021Article
- Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
objectivesTo examine and adapt a conceptual framework of the working alliance (WA) in the context of a low-intensity blended (psychological well-being practitioner (PWP) plus computerised program) cognitive behavioural therapy intervention (b-CBT) for depression.
designPatient involvement was enlisted to collaboratively shape the design of the project from the onset, before data collection. In-depth semi-structured interviews were carried out with participants who experienced b-CBT as part of the E-compared trial. A thematic analysis was conducted using a constant comparative method informed by grounded theory.
settingRecruitment was carried out in four psychological primary care services across the UK.
participantsNineteen trial participants with major depressive disorder who completed at least one computerised program and face-to-face session with a PWP in the b-CBT arm were recruited to the study.
resultsQualitative interviews that were guided by WA theory and patient involvement, revealed four themes: (1) a healthcare provider (PWP and computerised program) with good interpersonal competencies for building a working relationship with the client ('bond'); (2) collaborative efforts between the client and the provider to appropriately identify what the client hopes to achieve through therapy ('goals'); (3) the selection of acceptable therapeutic activities that address client goals and the availability of responsive support ('task') and (4) the promotion of active engagement and autonomous problem solving ('usability heuristics'). Participants described how the PWP and computerised program uniquely and collectively contributed to different WA needs.
conclusionsThis study is the first to offer a preliminary conceptual framework of WA in b-CBT for depression, and how such demands can be addressed through blended PWP-computerised program delivery. These findings can be used to promote WA in technological design and clinical practice, thereby promoting engagement to b-CBT interventions and effective deployment of practitioner and program resources. TRIAL REGISTRATION NUMBER: ISRCTN12388725.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.