Working alliance as a predictor of change in depression during blended cognitive behaviour therapy

On behalf of the E-COMPARED consortium

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Blended Cognitive Behaviour Therapy (bCBT) is a new form of treatment, mixing internet-based modules and face-to-face therapist sessions. How participants rate the therapeutic alliance in bCBT has not yet been thoroughly explored, and neither is it clear whether therapist- and patient-rated alliances are predictors of change in depression during treatment. Depression and alliance ratings from 73 participants in a treatment study on bCBT (part of the E-COMPARED project) were analysed using growth curve models. Alliance, as rated by both patients and therapists, was high. The therapist-rated working alliance was predictive of subsequent changes in depression scores during treatment, whereas the patient-rated alliance was not. A therapeutic alliance can be established in bCBT. The role of the therapist-rated alliance seems to be of particular importance and should be carefully considered when collecting data in future studies on bCBT.

Original languageEnglish
Pages (from-to)285-299
Number of pages15
JournalCognitive Behaviour Therapy
Issue number4
Publication statusPublished - 4 Jul 2019


  • Therapeutic alliance
  • blended treatment
  • depression
  • growth models
  • internet-based treatment

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