How does tele-mental health affect group therapy process? Secondary analysis of a noninferiority trial

Carolyn J. Greene, Leslie A. Morland, Alexandra MacDonald, B. Christopher Frueh, Kathleen M. Grubbs, Craig S. Rosen

Research output: Contribution to journalArticlepeer-review

98 Scopus citations


Objective: Video teleconferencing (VTC) is used for mental health treatment delivery to geographically remote, underserved populations. However, few studies have examined how VTC affects individual or group psychotherapy processes. This study compares process variables such as therapeutic alliance and attrition among participants receiving anger management group therapy either through traditional face-to-face delivery or by VTC. Method: The current study represents secondary analyses of a randomized noninferiority trial (Morland et al., in press) in which clinical effectiveness of VTC delivery proved noninferior to in-person delivery. Participants were male veterans (N = 112) with posttraumatic stress disorder (PTSD) and moderate to severe anger problems. The present study examined potential differences in process variables, including therapeutic alliance, satisfaction, treatment credibility, attendance, homework completion, and attrition. Results: No significant differences were found between the two modalities on most process variables. However, individuals in the VTC condition exhibited lower alliance with the group leader than those in the in-person condition. Mean self-leader alliance scores were 4.2 (SD = 0.8) and 4.5 (SD = 0.4), respectively, where 5 represents strongly agree and 4 represents agree with positive statements about the relationship, suggesting that participants in both conditions felt reasonably strong alliance in absolute terms. Individuals who had stronger alliance tended to have better anger outcomes, yet the effect was not strong enough to result in the VTC condition producing inferior aggregate outcomes. Conclusion: Our findings suggest that even if group psychotherapy via VTC differs in subtle ways from in-person delivery, VTC is a viable and effective means of delivering psychotherapy.

Original languageEnglish (US)
Pages (from-to)746-750
Number of pages5
JournalJournal of Consulting and Clinical Psychology
Issue number5
StatePublished - Oct 2010


  • group psychotherapy
  • posttraumatic stress disorder
  • tele-mental health
  • veterans
  • video teleconferencing

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


Dive into the research topics of 'How does tele-mental health affect group therapy process? Secondary analysis of a noninferiority trial'. Together they form a unique fingerprint.

Cite this