Allard, Micheline2013-11-082013-11-0820072007Source: Dissertation Abstracts International, Volume: 69-08, Section: B, page: 5006.http://hdl.handle.net/10393/29501http://dx.doi.org/10.20381/ruor-19778Cognitive-behavior therapy is a well validated psychological treatment for anxiety disorders. However, less than 15% of people suffering from an anxiety disorder receive CBT or effective medication. One possible explanation is that patients don't have access to CBT therapists. A few studies have shown that videoconferencing can be used to increase the accessibility of validated treatment (i.e., CBT) and that CBT given via videoconferencing is as effective as CBT delivered face-to-face. However, the therapeutic alliance plays an important role in treatment efficacy, including in CBT. It is therefore important to determine if videoconferencing allows the development of a similar therapeutic alliance as observed in face-to-face CBT. The aim of this thesis is thus to compare the quality of the therapeutic alliance obtained via videoconferencing versus face-to-face CBT. Forty-five adults suffering from panic disorder with agoraphobia were SCID-diagnosed in a face-to-face assessment interview. All participants were referrals to a mental clinic in Montreal or Maniwaki (remote sites) or in Gatineau (local site). All participants received 12 individual weekly sessions of CBT. The therapeutic alliance was measured with the Working Alliance Inventory and the California Psychotherapy Alliance Scales after the first, the fifth, and 12 sessions. The efficacy measures were completed at pre- and post-treatment and included the Panic and Agoraphobia Scales and the Agoraphobic Cognitions Questionnaire. The results showed that an excellent therapeutic alliance was observed in both the videoconferencing and the face-to-face conditions and no difference were detected on the total score of the two measures of alliance used. The bond between the patient and the therapist, a subscale of one of the alliance measure, was stronger in face-to-face after the first session. However, this difference disappeared rapidly as there was no significant difference at the fifth session and at post-treatment. As for treatment outcome, significant improvement was observed for participants in both conditions. Multiple regression analyses revealed that the strength of alliance did not predict treatment outcome. The results of the study show that it is possible to develop an excellent therapeutic alliance by videoconferencing using CBT for panic disorder. At the fifth session, there were no significant differences in therapeutic alliances between the two conditions. Also, the results demonstrated that CBT delivered via videoconferencing yield similar outcomes compared to face-to-face therapy on measure of panic attacks and agoraphobic avoidance.194 p.frPsychology, Behavioral.Psychology, Clinical.Thesis