ArticleInternet interventions2022
Working alliance and adherence mediate the effect of guidance in a web-based program for participants with mild to moderate depressive symptoms: A secondary mediation analysis.
Article in Internet interventions, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Efficacy of an Internet-based self-help intervention with human guidance or automated messages to alleviate loneliness: a three-armed randomized controlled trial.Scientific reports · 2024Trial
- Association between working alliance and treatment outcomes in a mobile health intervention with a conversational agent (CanRelax).Internet interventions · 2026Article
- Experiences with a guided trauma-focused internet- and mobile-based intervention: a qualitative study of youth's perspectives.European journal of psychotraumatology · 2025Article
- Treatment expectations and depressive symptoms in an internet-based intervention for depression. A secondary analysis.Internet interventions · 2025Article
- What therapists do during guidance in individually tailored internet-based cognitive behavioral therapy for depressive symptoms: A content analysis.Internet interventions · 2025Article
- Clinical, genetic, and sociodemographic predictors of symptom severity after internet-delivered cognitive behavioural therapy for depression and anxiety.BMC psychiatry · 2025Article
- Article
- Working alliance and its link to guidance in an internet-based intervention for depressive disorders: a secondary analysis of a randomized controlled trial.Frontiers in psychiatry · 2024Article
- Relationship Factors in Internet-Delivered Psychological Interventions for Veterans Experiencing Postpartum Depression: Qualitative Analysis.JMIR mental health · 2023Article
- Human contact in internet-based interventions for depression: A pre-registered replication and meta-analysis of randomized trials.Internet interventions · 2023Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Guided web-based self-help programs for individuals with depressive symptoms have shown to be more efficacious than unguided programs. However, research has paid little attention to why guided interventions are superior. The present study investigated whether working alliance and adherence to the program mediated the effect of guidance on depressive symptom outcome. The study is a secondary analysis of a randomized factorial trial. In the trial, 302 adults with mild to moderate depressive symptoms (Patient Health Questionnaire-9 score: 5-14) were randomized to either a guided or an unguided group. All participants received access to a web-based self-help program based on problem-solving therapy. Working alliance with the treatment providers was assessed using an adapted version of the Working Alliance Inventory for Guided Internet Interventions two weeks (early-treatment) and eight weeks (post-treatment) after pre-treatment. The primary outcome was depressive symptoms at post-treatment. The total working alliance score was significantly higher for guided participants compared to unguided participants (at early-treatment:
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