Psychometric validation of the Chinese version of the E-Therapy Attitudes Measure (ETAM) and associated psychological factors in Taiwanese adults

E-therapy adoption has grown in Taiwan; however, challenges, including limited awareness, persist. This study aimed to psychometrically validate a Chinese version of the E-Therapy Attitudes Measure (ETAM) and to investigate attitudes toward e-therapy among adults in Taiwan. This cross-sectional web-based survey was conducted, recruiting 1483 Taiwanese participants aged 18-60 years with depressive or anxiety symptoms. Measures included a translated Chinese version of the ETAM, the Revised Adult Attachment Scale, the PHQ-9, the GAD-7, and the Perceived Stress Scale. Confirmatory factor and correlation analyses supported the validity of ETAM, showing excellent internal consistency (Cronbach's α = 0.92). Overall, 50.8% reported positive attitudes (<i>M</i> = 2.53, SD = 0.61). Further analyses revealed that higher e-therapy acceptance was associated with lower stress, anxiety, depressive symptoms, and attachment-related distress. This study successfully validates the Chinese ETAM and highlights the influence of psychological factors on the acceptance of e-therapy in the Taiwanese population.