Evidence for Bidirectional, Cross-Lagged Associations Between Alliance and Psychological Distress in an Unguided Mobile-Health Intervention.
Simon B Goldberg, Zishan Jiwani, Daniel M Bolt, Kevin M Riordan, Richard J Davidson, Matthew J Hirshberg
Clinical psychological science : a journal of the Association for Psychological Science May 1, 2024 DOI: 10.1177/21677026231184890 via PubMed
Summary
AI-generated from the abstractA strong working alliance significantly enhances engagement in smartphone-based interventions. In a study involving 302 participants, with 80% experiencing elevated depression or anxiety, bidirectional relationships were observed between psychological distress and alliance during a 4-week meditation program. Effect sizes ranged from -.09 to -.14, comparable to those seen in traditional psychotherapy. These findings suggest that measuring alliance could improve the effectiveness of mobile health tools, highlighting the importance of digital technology in mental health support.
Study at a glance
| Characteristics | Observational cohort Peer reviewed |
|---|---|
| Sample size | 302 |
| Population | Adults with elevated depression or anxiety |
| Intervention | smartphone-based meditation intervention |
| Duration | 4-week intervention |
| Keywords | Digital technology Mobile health Smartphone-based interventions Working alliance |
| Citations | 8 |
| Key finding | Bidirectional associations between alliance and psychological distress over a 4-week smartphone-based meditation intervention were similar in magnitude to those observed in in-person psychotherapy. |
Abstract
Bidirectional associations between changes in symptoms and alliance are established for in-person psychotherapy. Alliance may play an important role in promoting engagement and effectiveness within unguided mobile health (mHealth) interventions. Using models disaggregating alliance and psychological distress into within- and between-person components (random intercept cross-lagged panel model), we report bidirectional associations between alliance and distress over the course of a 4-week smartphone-based meditation intervention (n=302, 80.0% elevated depression/anxiety). Associations were stable across time with effect sizes similar to those observed for psychotherapy (βs=-.13 to -.14 and -.09 to -.10, for distress to alliance and alliance to distress, respectively). Alliance may be worth measuring to improve the acceptability and effectiveness of mHealth tools. Further empirical and theoretical work characterizing the role and meaning of alliance in unguided mHealth is warranted.