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 (opens in new tab)
Study at a glance
AI-extracted from the abstract| 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 findings | 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.