Face-to-face versus online psychotherapy: a single-subject evaluation study

Abstract

The objective of this study was to evaluate face-to-face versus online psychotherapy using a single-subject experimental design.  Physiological indices of brainwave activity, pulse variation, and voice stress level revealed greater emotional reactivity and stress during a face-to-face psychotherapy session than during an online session.  During the online psychotherapy session, more cognitive activity and engagement occurred than during the face-to-face session.  No difference emerged between psychotherapy modalities on a measure of the psychotherapeutic working alliance.  We offer suggestions for future research and clinical practice.