Strengths-based CBT: Internet-Based Versus Face-to-Face Therapy in A Randomized Controlled Trial

Abstract

Background: In internet-based cognitive-behavioral therapy, explicitly strengths-based approaches are still missing. The Personal Model of Resilience (PMR) is a positive intervention that utilizes clients’ strengths to overcome problems. Up to now, it has only been evaluated in a face-to-face setting. This study aimed to compare the PMR in a guided internet-based setting (I-CBT) against the respective face-to-face intervention (FTF-CBT) and a wait-list control (WLC). Methods: In a randomized controlled design, FTF-, I-CBT and WLC were compared with respect to dimensions of psychopathology, depression, social anxiety, resilience, quality of life and therapeutic alliance in a sample of N=94 college students with psychosocial stress. Results: Mean effect sizes of I-CBT (Cohen’s d=0.36) and FTF-CBT (d=0.61) exceeded those of WLC (d=0.26) with an advantage for FTF-CBT. Also, quality of life was higher in both active intervention groups. Therapeutic alliance was significantly better in the FTF-group. Conclusion: The PMR can be implemented in an internet-based and face-to-face setting with better outcomes for face-to-face. Researchers and therapists are encouraged to integrate strengths-based approaches into CBT and to explore respective internet-based interventions.