An online automated psychoterapeutic intervention: efficacy and therapeutic relationship

Depression and anxiety problems are widespread, lifetime risks for developing anxiety are between 6.7% and 18.1% according to the National Institute of Mental Health. Depression is often associated with unemployment and poverty, and is the leading cause of disease burden in high-income countries. Cognitive-behavioral therapy (CBT) is the best researched psychological treatment approach to emotional and behavioral problems. Lately, computerized and online CBT interventions have emerged as a cheaper, anonymous and location independent alternative to classical face-to-face therapy. Online CBT may reduce therapist time, reduce waiting lists, save travel expenses and allow access to people with disabilities, while having similar efficacy to classical therapy formats. The current study investigates the efficacy of a novel web-based therapeutic intervention in reducing depressive and anxiety symptomatology on a sub-clinical sample, as well as measuring the efficacy of a new way of improving the therapeutic relationship via animated avatars. Results show that the new treatment is efficient in reducing depressive symptoms, dysfunctional thoughts and negative emotionality. Additionally, perceived empathy was increased in the avatar-enhanced intervention, while therapeutic alliance was unaffected. Implications are discussed in the context on online CBT vs. classical face-to-face interventions.