Who benefits from electronic communications data in psychotherapy? Predictors of outcome and alliance in a pooled randomized trial database.

Authors

Mary Beth Connolly Gibbons, Peter P Zandi, Leslie Miller, Ipsit V Vahia, Robert Gallop, Rachel Y Chiu, Nic Kodkany, Yaz Liow, Paul Crits-Christoph

Published in

Psychotherapy research : journal of the Society for Psychotherapy Research. Pages 1-15. Sep 17, 2026. Epub Sep 17, 2026.

Abstract

Three recent pilot randomized clinical trials found no overall advantage of clinician dashboards containing information from patients' electronic communications over treatment-as-usual (TAU). The current pooled post-hoc study examined patient characteristics and electronic-communication measures as exploratory moderators of depressive-symptom outcomes and predictors of therapeutic alliance, with the goal of generating hypotheses for future trials.
Outcome measures were the Patient Health Questionnaire-8 (PHQ-8) and Working Alliance Inventory (WAI). Using pooled data across the three studies (N = 289 with PHQ-8 slopes; N = 301 in the full baseline database), regression analyses tested demographic, functioning, electronic-communication activity, and language variables, controlling for study membership.
Gender and Black racial identity showed interactions with treatment in predicting PHQ-8 slopes, although the Black racial identity finding was based on only seven intervention patients and requires caution. Number of electronic-communication platforms also interacted with treatment: high-platform users had relatively poor outcomes in TAU but improved comparably to low-platform users in the intervention. Greater first-person singular pronoun use was associated with stronger therapeutic alliance (partial r = .39).
These exploratory findings identify candidate moderators and process markers for a prospective study. Future trials should directly assess patient preference for incorporating electronic communications, standardize and measure clinician dashboard engagement, and replicate candidate moderators before clinical recommendations are made.Trial registration: ClinicalTrials.gov identifier: NCT04011540.Trial registration: ClinicalTrials.gov identifier: NCT03712267.Trial registration: ClinicalTrials.gov identifier: NCT03925038.

PMID:
42755118
Bibliographic data and abstract were imported from PubMed on 18 Sep 2026.

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