A Conceptual Framework of Digital Therapeutic Alliance in Internet-Based Cognitive-Behavioral Therapy: A Qualitative Study.

The therapeutic alliance is a well-established predictor of psychotherapy outcomes. With the advancement of digitization, guided internet-based cognitive behavioral therapy (ICBT) has demonstrated effectiveness. However, the conceptual framework of the digital therapeutic alliance (DTA) within ICBT...

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Publicado en:Inquiry (00469580) Vol. 63; pp. 1 - 13
Autores principales: Yi, Mengyao, Hagaman, Ashley, Goldsamt, Lloyd, Sun, Shufang, Li, Mengshu, Li, Xianhong
Formato: research tables/charts Journal Article
Publicado: Sage Publications Inc. 4/10/2026
Acceso en línea:Ver este registro en EBSCOhost
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        atl: A Conceptual Framework of Digital Therapeutic Alliance in Internet-Based Cognitive-Behavioral Therapy: A Qualitative Study.
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          Yi, Mengyao
          Hagaman, Ashley
          Goldsamt, Lloyd
          Sun, Shufang
          Li, Mengshu
          Li, Xianhong
        affil: Central South University, Changsha, Hunan Province, China
      sug:
        subj:
          Conceptual Framework
          Internet-Based Intervention
          Cognitive Therapy
          Digital Health
          Human
          Funding Source
          Male
          Female
          Adult
          Middle Age
          Qualitative Studies
          Semi-Structured Interview
          Purposive Sample
          Audiorecording
          Thematic Analysis
          Descriptive Statistics
          Data Analysis Software
          Emotions
          Interpersonal Relations
          Motivation
          Trust
          Privacy and Confidentiality
          Counselors
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: The therapeutic alliance is a well-established predictor of psychotherapy outcomes. With the advancement of digitization, guided internet-based cognitive behavioral therapy (ICBT) has demonstrated effectiveness. However, the conceptual framework of the digital therapeutic alliance (DTA) within ICBT remains conceptually underdeveloped. Data were collected from a guided ICBT program in China. We conducted virtual individual semi-structured in-depth interviews among a purposive sample of intervention recipients (young sexual minority men, n = 20), and all implementers (counselors and supervisors, n = 6). Data were analyzed using qualitative template analysis. A DTA framework was developed with 4 key components: roles, interactions, characteristics, and influencing factors. Clients typically initiate the counseling process through online materials and assignments, treating the digital platform as a "safe space," "invisible friend," "warm harbor," or "repository of knowledge and tools." Counselors serve as guides and provide professional support asynchronously. High frequency of interaction and emotional connection via phone calls strengthened DTA. "Being client-driven," "fostering an equal relationship," and "being difficult to establish but easy to terminate" were identified as characteristics. Influencing factors included client-related aspects (eg, motivation), counselor-related elements (eg, response timeliness), and platform-related considerations (eg, trust, confidentiality). This study develops a DTA conceptual framework, elaborating on the roles, interactions, characteristics, and influencing factors among clients, counselors, and digital platforms in guided ICBT. Findings inform strategies to enhance engagement, counselor training, and platform design in digital psychosocial interventions.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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