Prognosis Prediction Using Therapeutic Agreement of Video Conference–Delivered Cognitive Behavioral Therapy: Retrospective Secondary Analysis of a Single-Arm Pilot Trial

Background The therapist-patient therapeutic alliance is known to be an important factor in cognitive behavioral therapy (CBT). However, findings by previous studies for obsessive-compulsive disorder (OCD), panic disorder (PD), and social anxiety disorder (SAD) have not been consistent regarding whether this alliance provides symptomatic improvements. Objective This study investigated predictors of symptom improvement in patients receiving CBT via video conferencing. Methods A total of 29 patients who participated in a previous clinical trial were recruited for the current study. Therapeutic alliance and clinical background in patients with OCD, PD, and SAD were measured at first session or the eighth session, which were calculated by multiple regression analyses to estimate the impact on therapeutic response percentage change. Results The multiple regression analyses showed that, among the independent variables, only patients’ agreement in the therapeutic alliance remained viable, as other variables were a best fit for the excluded model (P=.002). The results show that patients’ agreement on therapeutic goals and tasks explains the prognosis, as the normalization factor beta was 0.54 (SE 32.73; 95% CI 1.23-5.17; P=.002) and the adjusted R2 was .266. Conclusions Patients' agreement on therapeutic goals and tasks predicts improvement after CBT via video conferencing. Trial Registration UMIN Clinical Trial Repository UMIN000026609; https://tinyurl.com/ye6dcbwt