Therapeutic Relationship in eHealth—A Pilot Study of Similarities and Differences between the Online Program Priovi and Therapists Treating Borderline Personality Disorder

Sandra Köhne, Ulrich Schweiger, Gitta A. Jacob, Diana Braakmann, Jan Philipp Klein, Stefan Borgwardt, Nele Assmann, Mirco Rogg, Anja Schaich and Eva Faßbinder
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Sandra Köhne: Department of Psychiatry and Psychotherapy, University of Lübeck, 23562 Lübeck, Germany
Ulrich Schweiger: Department of Psychiatry and Psychotherapy, University of Lübeck, 23562 Lübeck, Germany
Gitta A. Jacob: GAIA AG Hamburg, 22085 Hamburg, Germany
Diana Braakmann: Department of Psychiatry and Psychotherapy, University of Lübeck, 23562 Lübeck, Germany
Jan Philipp Klein: Department of Psychiatry and Psychotherapy, University of Lübeck, 23562 Lübeck, Germany
Stefan Borgwardt: Department of Psychiatry and Psychotherapy, University of Lübeck, 23562 Lübeck, Germany
Nele Assmann: Department of Psychiatry and Psychotherapy, University of Lübeck, 23562 Lübeck, Germany
Mirco Rogg: Department of Psychiatry and Psychotherapy, University of Lübeck, 23562 Lübeck, Germany
Anja Schaich: Department of Psychiatry and Psychotherapy, University of Lübeck, 23562 Lübeck, Germany
Eva Faßbinder: Department of Psychiatry and Psychotherapy, University of Lübeck, 23562 Lübeck, Germany

IJERPH, 2020, vol. 17, issue 17, 1-15

Abstract: eHealth programs have been found to be effective in treating many psychological conditions. Regarding Borderline Personality Disorder (BPD), few programs have been tested; nevertheless, results are promising. The therapeutic alliance is an important factor predicting treatment outcome in BPD. However, we do not know yet to what extent BPD patients form a therapeutic alliance with an eHealth tool and how this relationship differs from the relationship with their human therapist. This study aims to address this question using priovi, an interactive schema therapy-based eHealth tool for BPD. Semi-structured interviews were conducted to explore how patients perceived the therapeutic alliance with priovi and its differences compared to the alliance with their human therapist (N = 9). Interview data were analyzed following the procedures of qualitative content analysis. Additionally, the Working Alliance Inventory (WAI-SR) was administered in two versions (regarding the human therapist and priovi, N = 16) every three months during the treatment phase of one year. Results indicate that patients were able to form a good therapeutic relationship with priovi, but it differed from the relationship to their human therapist. Important categories were “priovi is helpful, supportive and always there” and “priovi is less flexible”. WAI ratings for the task subscale were high in both relationships but significantly higher in WAI therapist compared to WAI priovi in two measurements (nine-months measurement: t = 2.76, df = 15, p = 0.015; twelve-months measurement: t = 3.44, df = 15, p = 0.004). These results indicate that BPD patients can form a functioning alliance with an eHealth program and that eHealth programs may be especially useful for psychoeducation and cognitive exercises.

Keywords: eHealth; borderline personality disorder; therapeutic alliance; schema therapy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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