Online Therapy


Review of a Published Article Telepsychology in a University Psychology Clinic Setting: A Pilot Project. Simpson, S.G, Guerrini, L, Rochford, S. (2015).

—-Bertus Swanepoel

Full reference:

Simpson, S.G, Guerrini, L, Rochford, S. (2015). Telepsychology in a University Psychology Clinic Setting: A Pilot Project. Australian Psychologist. 50, 285-291.

Background about the study

This article was published in Australia in a journal called the Australian Psychologist in 2015. The target readers for the article was mostly for professionals as well as academics. The study was done within the University of South Australia and was aimed to compare students who received mainly CBT and Schema therapy in-person (face to face) to students receiving therapy sessions via video conferencing. A total of 23 Students participated in the study and received at least five therapy sessions each. These sessions were done with provisional psychologists busy with training. Only 6 students attended sessions online and a comparison was made between the 6 students attending the sessions online and the 17 students having the sessions face to face. The style of writing was academic with technical explanations of the detail but understandable for the casual reader.

Method of Analysis

An Independent samples t test was used to present data in a quantitative way comparing the in-person therapy group to the video therapy group in terms of:

– The levels of psychological distress rated for both groups using CORE 10.

– The levels of therapeutic alliance reported for both groups using CORE-ARM.

The study also explored in a qualitative manner the perceptions of and reaction to video therapy by doing a conventional content analysis in which categories and subcategories were identified and analysed.


The main findings of the study:

Quantitative Findings

The mean age of the video therapy group was 34 compared to the mean age of 31.75 for the in-person group. There were an equal amount of males and females in the video therapy group but a 5:12 male to female ratio in the in-person group.

The levels of distress and therapeutic alliance reported by the two groups across treatment were very similar and fell within the moderate range of clinical severity. There were no significant differences between the levels of distress of video therapy and in-person groups and no significant differences in therapeutic alliance for both groups. High levels of therapeutic alliance were reported for both groups.

Qualitative findings

Although the 6 students doing the video therapy were unfamiliar with video conferencing the initial discomfort disappeared after the first few sessions and participants grew in confidence as well as enthusiasm for the sessions. Participants did not express any concern about videoconferencing for the delivery of therapeutic services. All six video therapy participants reported positive changes regarding their mental health problems and reported a strong therapeutic relationship with their therapists. Some reported more comfort with video therapy compared to previous in-person therapy sessions.

Critical Analysis

The quantitative and the qualitative findings seem to support equivalent therapeutic alliance experienced both groups.

There were several stated limitations to the study:

– The groups were already allocated by the distance from the university. Random allocation of participants would have been more feasible.

– Pre and post therapy comparisons were not done and the fact that multiple therapists were used may have confounded results.

– An equal spread in number of participants for both groups as well as an equal spread of gender would have made the findings more reliable.


I believe that the evidence in this study is appropriate and necessary to compare the therapeutic alliance experienced between video therapy and in-person therapy. Other research sources are continuously quoted throughout the article and effort is made to integrate the findings into existing research.


The authors raised the issue that at the time of the study the University of South Australia were the only University in Australia developing training for video therapy within a university psychology clinic. They speculate that future specific competencies in video therapy might be very important in the training of professionals.


I believe that the text was well balanced and that the authors were clear on how the study was done. Limitations of the study were acknowledged and meaningful integration with existing literature was done.


This article relates well to other literature on this topic although limited to video as medium and Simpson also co-wrote a literature review reporting equivalent therapeutic alliance between the two modalities (Simpson, Reid 2014).


This article also relates well to my own experience in doing online work and I am continuously surprised how well I feel connected to my clients during video calls.


Simpson S. G (2014) also wrote another article in the online therapy field. I also accessed a video through the ACAD library link where she presented on the topic of alliance between therapist and client through the medium of Video and seems to be a good authority in online therapy research in Australia.


I believe more randomised control studies in the field of online therapy needs to be done to build an even better evidence base for its efficacy but studies like this one was a good start to measure certain aspects of online work.





Simpson, (2014). Tele-web Psychology in Rural South Australia: The Logistics of Setting Up a Remote University Clinic Staffed by Clinical Psychologists in Training. Australian Psychologist. 49, 193–199

Simpson, S.G. & Reid, C.L. (2014). Therapeutic alliance in videoconferencing psychotherapy: a review. Special Issue – Psychology in the Bush Original Research. The Australian Journal of Rural Health. Special Issue. (2014) 22, 280–299.



Futher Reading:


Why work online? The pros and cons for the therapist and for the client – by Bertus Swanepoel

Presentation notes : Creative approaches in working online and use of online resources – by Bertus Swanepoel

Article review: Telepsychology in a University Psychology Clinic Setting: A Pilot Project. Simpson, S.G, Guerrini, L, Rochford, S. (2015).- by Bertus Swanepoel