How do client and therapists in online text therapy experience their exchanges and relationship?

The impact of online therapy text exchanges and the client-therapist alliance was compared to previously published means and standard deviations on face-to-face therapy using an aggregate benchmarking strategy. Further, the moderating effects of 4 participant factors found significant in the face-to-face therapy literature was investigated using mixed modeling analytic techniques. Thirty therapists and 30 clients visited an online site to report weekly to complete session impact and therapeutic alliance measures for a minimum of six weeks, which allowed for a naturalistic and nuanced examination of the process of online text psychotherapy. The impact of exchanges and client-therapist alliance in text therapy were similar to but in some respects more positive than previous evaluations of face-to-face therapy. A notable exception was substantially lower Arousal scores replicating the previously-observed online calming effect. The significance of participant factors previously found to influence impact and alliance in face-to-face therapy was not replicated except that therapists with the more symptomatic clients rated their text exchanges as less smooth and comfortable.