Published on in Vol 18, No 3 (2016): March

Motivation and Treatment Credibility Predicts Dropout, Treatment Adherence, and Clinical Outcomes in an Internet-Based Cognitive Behavioral Relaxation Program: A Randomized Controlled Trial

Motivation and Treatment Credibility Predicts Dropout, Treatment Adherence, and Clinical Outcomes in an Internet-Based Cognitive Behavioral Relaxation Program: A Randomized Controlled Trial

Motivation and Treatment Credibility Predicts Dropout, Treatment Adherence, and Clinical Outcomes in an Internet-Based Cognitive Behavioral Relaxation Program: A Randomized Controlled Trial

Authors of this article:

Sven Alfonsson1 Author Orcid Image ;   Erik Olsson1 Author Orcid Image ;   Timo Hursti2 Author Orcid Image


  1. Backman A, Mellblom A, Norman-Claesson E, Keith-Bodros G, Frostvittra M, Bölte S, Hirvikoski T. Internet-delivered psychoeducation for older adolescents and young adults with autism spectrum disorder (SCOPE): An open feasibility study. Research in Autism Spectrum Disorders 2018;54:51 View
  2. Yew R, Dobson K, Zyphur M, Kazantzis N. Mediators and Moderators of Homework–Outcome Relations in CBT for Depression: A Study of Engagement, Therapist Skill, and Client Factors. Cognitive Therapy and Research 2021;45(2):209 View
  3. Grönqvist H, Olsson E, Johansson B, Held C, Sjöström J, Lindahl Norberg A, Hovén E, Sanderman R, van Achterberg T, von Essen L. Fifteen Challenges in Establishing a Multidisciplinary Research Program on eHealth Research in a University Setting: A Case Study. Journal of Medical Internet Research 2017;19(5):e173 View
  4. Arndt A, Rubel J, Berger T, Lutz W. Outpatient and self-referred participants: Adherence to treatment components and outcome in an internet intervention targeting anxiety disorders. Internet Interventions 2020;20:100319 View
  5. Norouzian N, Westra H, Button M, Constantino M, Antony M. Ambivalence and the working alliance in variants of cognitive‐behavioural therapy for generalised anxiety disorder. Counselling and Psychotherapy Research 2021;21(3):587 View
  6. Kaiser J, Hanschmidt F, Kersting A. The association between therapeutic alliance and outcome in internet-based psychological interventions: A meta-analysis. Computers in Human Behavior 2021;114:106512 View
  7. Kochar B, Aldridge M, Cook S, Bright R, Mallette M, Moniz H, Shah S, LeLeiko N, Shapiro J, Sands B, Chen W, Jaeger E, Galanko J, Long M, Martin C, Sandler R, Kappelman M. Achieving Synergy: Linking an Internet-Based Inflammatory Bowel Disease Cohort to a Community-Based Inception Cohort and Multicentered Cohort in Inflammatory Bowel Disease. Journal of Medical Internet Research 2016;18(6):e124 View
  8. Patterson Silver Wolf (Adelv Unegv D, Dulmus C, Maguin E, Linn B, Hales T. Therapist–Patient Demographic Profile Matching: A Movement Toward Performance-Based Practice. Research on Social Work Practice 2019;29(6):677 View
  9. Fernández-Álvarez J, Díaz-García A, González-Robles A, Baños R, García-Palacios A, Botella C. Dropping out of a transdiagnostic online intervention: A qualitative analysis of client's experiences. Internet Interventions 2017;10:29 View
  10. Fuhr K, Schröder J, Berger T, Moritz S, Meyer B, Lutz W, Hohagen F, Hautzinger M, Klein J. The association between adherence and outcome in an Internet intervention for depression. Journal of Affective Disorders 2018;229:443 View
  11. Braun L, Titzler I, Ebert D, Buntrock C, Terhorst Y, Freund J, Thielecke J, Baumeister H. Clinical and cost-effectiveness of guided internet-based interventions in the indicated prevention of depression in green professions (PROD-A): study protocol of a 36-month follow-up pragmatic randomized controlled trial. BMC Psychiatry 2019;19(1) View
  12. Modi A, Wagner J, Smith A, Kellermann T, Michaelis R. Implementation of psychological clinical trials in epilepsy: Review and guide. Epilepsy & Behavior 2017;74:104 View
  13. Wittink H, Oosterhaven J, Dekker J, Kruitwagen C, Devillé W, Ellens E, Schroder C. Dutch Translation and Adaptation of the Treatment Beliefs Questionnaire for Chronic Pain Rehabilitation. Pain Research and Management 2019;2019:1 View
  14. Beintner I, Görlich D, Berger T, Ebert D, Zeiler M, Herrero Camarano R, Waldherr K, Jacobi C. Interrelations between participant and intervention characteristics, process variables and outcomes in online interventions: A protocol for overarching analyses within and across seven clinical trials in ICare. Internet Interventions 2019;16:86 View
  15. Carolan S, de Visser R. Employees’ Perspectives on the Facilitators and Barriers to Engaging With Digital Mental Health Interventions in the Workplace: Qualitative Study. JMIR Mental Health 2018;5(1):e8 View
  16. Rüegg N, Moritz S, Berger T, Lüdtke T, Westermann S. An internet-based intervention for people with psychosis (EviBaS): study protocol for a randomized controlled trial. BMC Psychiatry 2018;18(1) View
  17. Levis M, Levis A. Contextual assessment: evaluating a novel self-guided online therapeutic assessment. International Journal of Psychiatry in Clinical Practice 2021;25(2):206 View
  18. Vervaeke J, Van Looy J, Hoorelbeke K, Baeken C, Koster E. Gamified Cognitive Control Training for Remitted Depressed Individuals: User Requirements Analysis. JMIR Serious Games 2018;6(2):e6 View
  19. Bruijniks S, Sijbrandij M, Huibers M. The effects of retrieval versus rehearsal of online problem-solving therapy sessions on recall, problem-solving skills and distress in distressed individuals: An experimental study. Journal of Behavior Therapy and Experimental Psychiatry 2020;66:101485 View
  20. Nation J, Wertheim E, Worthington E. Evaluation of an online self‐help version of the REACH forgiveness program: Outcomes and predictors of persistence in a community sample. Journal of Clinical Psychology 2018;74(6):819 View
  21. Larsson B, Karlström A, Rubertsson C, Ternström E, Ekdahl J, Segebladh B, Hildingsson I. Birth preference in women undergoing treatment for childbirth fear: A randomised controlled trial. Women and Birth 2017;30(6):460 View
  22. Marker I, Norton P. Intermittent Motivational Interviewing and Transdiagnostic CBT for Anxiety: A Case Study. Clinical Case Studies 2019;18(4):300 View
  23. Bouwman T, van Tilburg T, Aartsen M. Attrition in an Online Loneliness Intervention for Adults Aged 50 Years and Older: Survival Analysis. JMIR Aging 2019;2(2):e13638 View
  24. Karin E, Dear B, Heller G, Crane M, Titov N. “Wish You Were Here”: Examining Characteristics, Outcomes, and Statistical Solutions for Missing Cases in Web-Based Psychotherapeutic Trials. JMIR Mental Health 2018;5(2):e22 View
  25. Arnold C, Villagonzalo K, Meyer D, Farhall J, Foley F, Kyrios M, Thomas N. Predicting engagement with an online psychosocial intervention for psychosis: Exploring individual- and intervention-level predictors. Internet Interventions 2019;18:100266 View
  26. Zarski A, Berking M, Reis D, Lehr D, Buntrock C, Schwarzer R, Ebert D. Turning Good Intentions Into Actions by Using the Health Action Process Approach to Predict Adherence to Internet-Based Depression Prevention: Secondary Analysis of a Randomized Controlled Trial. Journal of Medical Internet Research 2018;20(1):e9 View
  27. Crane M, Kho M, Kangas M, Griffin B, Karin E, Earl J, Harris C. Strengthening resilience in over 50’s: a nested clustered-randomized controlled trial of adaptive systematic self-reflection. Anxiety, Stress, & Coping 2020;33(6):623 View
  28. Hohensee N, Meyer M, Teachman B. The Effect of Confidence on Dropout Rate and Outcomes in Online Cognitive Bias Modification. Journal of Technology in Behavioral Science 2020;5(3):226 View
  29. Pahnke J, Hirvikoski T, Bjureberg J, Bölte S, Jokinen J, Bohman B, Lundgren T. Acceptance and commitment therapy for autistic adults: An open pilot study in a psychiatric outpatient context. Journal of Contextual Behavioral Science 2019;13:34 View
  30. Kok R, Beekman A, Cuijpers P, van Straten A. Adherence to a web-based pre-treatment for phobias in outpatient clinics. Internet Interventions 2017;9:38 View
  31. Sieverink F, Kelders S, van Gemert-Pijnen J. Clarifying the Concept of Adherence to eHealth Technology: Systematic Review on When Usage Becomes Adherence. Journal of Medical Internet Research 2017;19(12):e402 View
  32. Veinot T, Mitchell H, Ancker J. Good intentions are not enough: how informatics interventions can worsen inequality. Journal of the American Medical Informatics Association 2018;25(8):1080 View
  33. Hildingsson I, Rubertsson C. Childbirth experiences among women with fear of birth randomized to internet-based cognitive therapy or midwife counseling. Journal of Psychosomatic Obstetrics & Gynecology 2020;41(3):205 View
  34. Renfrew M, Morton D, Morton J, Hinze J, Przybylko G, Craig B. The Influence of Three Modes of Human Support on Attrition and Adherence to a Web- and Mobile App–Based Mental Health Promotion Intervention in a Nonclinical Cohort: Randomized Comparative Study. Journal of Medical Internet Research 2020;22(9):e19945 View
  35. Karin E, Crane M, Dear B, Nielssen O, Heller G, Kayrouz R, Titov N. Predictors, Outcomes, and Statistical Solutions of Missing Cases in Web-Based Psychotherapy: Methodological Replication and Elaboration Study. JMIR Mental Health 2021;8(2):e22700 View
  36. Smits F, de Kort G, Geuze E. Acceptability of tDCS in treating stress-related mental health disorders: a mixed methods study among military patients and caregivers. BMC Psychiatry 2021;21(1) View
  37. Andriopoulos A, Olsson E, Hägg Sylvén Y, Sjöström J, Johansson B, von Essen L, Grönqvist H. Commencement of and Retention in Web-Based Interventions and Response to Prompts and Reminders: Longitudinal Observational Study Based on Two Randomized Controlled Trials. Journal of Medical Internet Research 2021;23(3):e24590 View
  38. Thorisdottir A, Asmundson G. Internet-delivered cognitive processing therapy for individuals with a history of bullying victimization: a randomized controlled trial. Cognitive Behaviour Therapy 2022;51(2):143 View
  39. Hegy J, Abegglen S, Schade V, Hoffmann-Richter U, Znoj H. Effects of a tailored multidisciplinary counselling intervention to support the adjustment process after a traumatic injury: a randomized controlled trial. Disability and Rehabilitation 2022;44(20):6055 View
  40. Suh S, Cho N, Jeoung S, An H. Developing a Psychological Intervention for Decreasing Bedtime Procrastination: The BED-PRO Study. Behavioral Sleep Medicine 2022;20(6):659 View
  41. Hegerl U, Oehler C. Promises and risks of web-based interventions in the treatment of depression. Dialogues in Clinical Neuroscience 2020;22(2):161 View
  42. Lüdtke T, Rüegg N, Moritz S, Berger T, Westermann S. Insight and the number of completed modules predict a reduction of positive symptoms in an Internet-based intervention for people with psychosis. Psychiatry Research 2021;306:114223 View
  43. Pahnke J, Jansson-Fröjmark M, Andersson G, Bjureberg J, Jokinen J, Bohman B, Lundgren T. Acceptance and commitment therapy for autistic adults: A randomized controlled pilot study in a psychiatric outpatient setting. Autism 2023;27(5):1461 View
  44. Gan D, McGillivray L, Larsen M, Christensen H, Torok M. Technology-supported strategies for promoting user engagement with digital mental health interventions: A systematic review. DIGITAL HEALTH 2022;8:205520762210982 View
  45. Ribeiro N, Colugnati F, Kazantzis N, Sartes L. Observing the Working Alliance in Videoconferencing Psychotherapy for Alcohol Addiction: Reliability and Validity of the Working Alliance Inventory Short Revised Observer. Frontiers in Psychology 2021;12 View
  46. Ho A, Behr H, Mitchell E, Yang Q, Lee J, May C, Michaelides A, König L. Goal language is associated with attrition and weight loss on a digital program: Observational study. PLOS Digital Health 2022;1(6):e0000050 View
  47. Hatch S, Lobaina D, Doss B. Optimizing Coaching During Web-Based Relationship Education for Low-Income Couples: Protocol for Precision Medicine Research. JMIR Research Protocols 2021;10(11):e33047 View
  48. Celia G, Cavicchiolo E, Girelli L, Limone P, Cozzolino M. Effect of online counselling on emotional outcomes during the COVID‐19 pandemic: An innovative group intervention for university students using the Brain Wave Modulation Technique. Counselling and Psychotherapy Research 2022;22(4):889 View
  49. Arabatzoudis T, Rehm I, Nedeljkovic M. A needs analysis for the development of an internet-delivered cognitive-behavioural treatment (iCBT) program for trichotillomania. Journal of Obsessive-Compulsive and Related Disorders 2021;31:100689 View
  50. Hentati A, Forsell E, Ljótsson B, Kaldo V, Lindefors N, Kraepelien M. The effect of user interface on treatment engagement in a self-guided digital problem-solving intervention: A randomized controlled trial. Internet Interventions 2021;26:100448 View
  51. Mohr D, Kwasny M, Meyerhoff J, Graham A, Lattie E. The effect of depression and anxiety symptom severity on clinical outcomes and app use in digital mental health treatments: Meta-regression of three trials. Behaviour Research and Therapy 2021;147:103972 View
  52. Verbist I, Huey D, Bennett H. Predicting treatment outcomes in improving access to psychological therapy (IAPT) services. Mental Health Review Journal 2022;27(1):114 View
  53. Hentati A, Forsell E, Ljótsson B, Lindefors N, Kraepelien M. A self-guided and monitored digital problem-solving intervention for patients with symptoms of depression or anxiety on the waiting list for treatment in routine psychiatric care: feasibility study. BJPsych Open 2022;8(2) View
  54. Martínez‐Cengotitabengoa M, Sanchez‐Martinez A, Long‐Martinez D, Sanchez‐Martínez M, Peters‐Corbett A, Pugh E, Field F, Martínez‐Cengotitabengoa M. Remote video interface psychological assessment during the COVID‐19 pandemic: Experiences of consultants and clients. Journal of Investigative Psychology and Offender Profiling 2022;19(2):88 View
  55. Lam S, Kirvin-Quamme A, Goldberg S. Overall and Differential Attrition in Mindfulness-Based Interventions: a Meta-Analysis. Mindfulness 2022;13(11):2676 View
  56. Holmberg T, Sainte-Marie M, Jensen E, Linnet J, Runge E, Lichtenstein M, Tarp K. An analysis of patient motivation for seeking online treatment for binge eating disorder—A mixed methods study combining systematic text condensation with sentiment analysis. Frontiers in Psychiatry 2022;13 View
  57. Renfrew M, Morton D, Morton J, Przybylko G. The Influence of Human Support on the Effectiveness of Digital Mental Health Promotion Interventions for the General Population. Frontiers in Psychology 2021;12 View
  58. Myklebost S, Gjestad R, Inal Y, Hammar Å, Nordgreen T. Predictors of Treatment Response to an Internet-Delivered Intervention Targeting Residual Cognitive Symptoms After Major Depressive Disorder. Frontiers in Psychiatry 2022;13 View
  59. Brog N, Hegy J, Berger T, Znoj H. Age, Motivation, and Emotion Regulation Skills Predict Treatment Outcome in an Internet-Based Self-Help Intervention for COVID-19 Related Psychological Distress. Frontiers in Public Health 2022;10 View
  60. Zheng Z, Bird S, Layton J, Hyde A, Moreland A, Wong Lit Wan D, Stupans I. Patient engagement as a core element of translating clinical evidence into practice- application of the COM-B model behaviour change model. Disability and Rehabilitation 2023;45(26):4517 View
  61. Blevins D. A Faith-Based Intervention to Address Social Isolation and Loneliness in Older Adults. Journal of Christian Nursing 2023;40(1):28 View
  62. Côté-Allard U, Pham M, Schultz A, Nordgreen T, Torresen J. Adherence Forecasting for Guided Internet-Delivered Cognitive Behavioral Therapy: A Minimally Data-Sensitive Approach. IEEE Journal of Biomedical and Health Informatics 2023;27(6):2771 View
  63. Nomeikaite A, Gelezelyte O, Berger T, Andersson G, Kazlauskas E. Exploring reasons for usage discontinuation in an internet-delivered stress recovery intervention: A qualitative study. Internet Interventions 2023;34:100686 View
  64. Amanvermez Y, Karyotaki E, Cuijpers P, Ciharova M, Donker M, Hurks P, Salemink E, Spinhoven P, Struijs S, de Wit L. A Guided, Internet-Based Stress Management Intervention for University Students With High Levels of Stress: Feasibility and Acceptability Study. JMIR Formative Research 2023;7:e45725 View
  65. Lau P, Marway O, Carmona N, Starick E, Iskenderova I, Carney C. An Investigation of Further Strategies to Optimize Early Treatment Gains in Brief Therapies for Insomnia. Behavioral Sleep Medicine 2024;22(2):140 View
  66. Albert D, Ouimet M, Brown T. A randomized controlled pilot trial of brief online mindfulness training in young drivers. Accident Analysis & Prevention 2023;193:107322 View
  67. Hayward D, Richardson T, Beattie D, Bayliss P. Comparing the Predictors of Disengagement for Trauma Therapy (TF-CBT and EMDR) in an Adult Mental Health Service. Journal of EMDR Practice and Research 2023;17(4):216 View
  68. Lassen E, Lia S, Hjertaas I, Hjemdal O, Kennair L, Hagen R, Solem S. Patient motivation and adherence in metacognitive therapy for major depressive disorder: an observational study. Cognitive Behaviour Therapy 2024;53(2):220 View
  69. Hare M, Conroy K, Georgiadis C, Shaw A. Abbreviated Dialectical Behavior Therapy Virtual Skills Group for Caregivers of Adolescents: An Exploratory Study of Service User and Clinical Outcomes. Child Psychiatry & Human Development 2024 View
  70. Kim S, Shim E. The Relationship between Level of Therapist Support and Efficacy and Adherence in Internet-Based Cognitive Behavioral Therapy for Disordered Eating Behaviors. STRESS 2024;32(1):29 View
  71. Kaufman A, Nemeroff R. Motivation to change predicts college students’ utilization of self-help resources. Journal of American College Health 2024:1 View
  72. Hanano M, Rith-Najarian L, Gong-Guy E, Chavira D. Motivational variables as moderating effects of a web-based mental health program for university students: Secondary analysis of a randomized controlled trial (Preprint). JMIR Formative Research 2024 View
  73. Kramuschke M, Reinhardt J, Dölemeyer R, Kaiser J, Kersting A. The change of working alliance and the association to treatment outcome in an internet-based therapy after pregnancy loss. BMC Psychology 2024;12(1) View

Books/Policy Documents

  1. Becker D. Advances in Information and Communication Networks. View
  2. Cunha M, de Almeida R, Fernandes Â, Marques A. Trends and Applications in Information Systems and Technologies. View
  3. Agathokleous G, Taiwo A. Digital Innovations for Mental Health Support. View
  4. . Nursing and Health Interventions. View