Making Come-Alive and Keeping Un-Alive: How People Relate to Self-Guided Web-Based Health Interventions

Health interventions delivered online (self-guided web-based interventions) may become more helpful through a person-to-program “working alliance.” 

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In psychotherapy, the working alliance signifies a therapeutically useful client–therapist relationship and includes an emotional bond. However, there exist no theories of how program users relate to online programs, or that explain a person-to-program bond theoretically. Addressing this gap, we conducted qualitative interviews with and collected program data from users of a self-guided web-based intervention. Taking a grounded theory approach, the analysis arrived at a model of relating based on two relational modes—making come-alive and keeping un-alive. Different combinations of these modes could describe a range of ways of relating to the program, including a nonsocial interaction, a semi-social interaction, and a semi-social relationship. A person-to-program bond is explained by the model as an experienced supportive social presence, enabled by making come-alive and a positive program interaction.

Qualitative Health Research, 2020,30 (6), 927- 941

Published Apr. 27, 2020 6:00 AM - Last modified Oct. 26, 2020 3:34 PM