The Efficacy and Effectiveness of Online CBT - Jeroen Ruwaard

32 Chapter 2. Online CBT of Work-Related StressHow much therapist contact is optimal? What is the effect of working alliance inInternet-based treatment?Internet-based treatment with standardized therapist contact may have distinctadvantages over face-to-face treatment. In Internet-driven treatment it is easier toensure treatment integrity than in manualized face-to-face treatment. In the presentmanual much attention is devoted to small details to ensure that the therapists usethe manual in the intended way. The manual even specifies the motivating attitudethat the therapists are required to adopt and convey to their clients. Furthermore,the weekly supervisions were intense, and exploited the full details of the exchangesbetween the therapists and their clients. The detailed manual provided the relativelyyoung and inexperienced therapists with guidance and support in treating theirclients. As a consequence, their results were on a par with the results of experiencedtherapists. Apart from the effects on clients, it is interesting to investigate the effectsof Internet-driven manuals in the education and training of therapists.