Beyond the therapeutic hour: an exploratory pilot study of using technology to enhance alliance and engagement within face-to-face psychotherapy

In this paper we introduce and investigate the capacity for a novel, technologically advanced system (goACT) to enhance face-to-face psychotherapy. Specifically, we explore the capacity for goACT to enhance therapeutic alliance (TA) and engagement, and reduce distress. Using a mixed-methods, multiple-baseline design we present the first study to examine the utility, effectiveness and user experience of goACT in a university psychology clinic setting. The introduction of between-session goACT use was staggered across patients (N = 7). Patients completed weekly measures of mood, patient-rated TA and clinician-rated engagement. Semi-structured interviews were used to qualitatively understand user experience of the system. Methodological limitations impacted the generalisability of multiple-baseline findings, yet qualitative results provide a significant contribution to the literature and groundwork upon which further study can be built. Results indicated that goACT built engagement and TA via novel change processes that were associated with expanding the parameters of the therapeutic encounter beyond the one-hour session. Change processes that underpin the qualitative success of goACT are discussed in terms of their theoretical implications. goACT is likely to be a useful tool for enhancing the quality and quantity of traditional face-to-face psychotherapy.