Working Alliance and Empowerment in Group versus Individual Internet-Based Treatment: A Secondary Analysis

Internet-based interventions offer promise for addressing the growing demand for psychological support, but the mechanisms driving their effectiveness remain unclear. This study investigates the roles of empowerment and working alliance in reducing social anxiety and improving adherence in a clinician-guided group (GT) versus a clinician-guided individual treatments (IT) for social anxiety disorder (SAD). A total of 120 individuals meeting SAD diagnostic criteria were randomised into one of two active conditions. Both, empowerment and working alliance were repeatedly assessed, and their effects on social anxiety and adherence (measured by completed exercises) were analysed through correlations, t-tests, and mediation models. Results showed no significant differences in empowerment between GT and IT in empowerment or alliance, though both improved throughout the intervention. GT showed early alliance advantages, while IT had slightly better adherence and a stronger relationship between empowerment and adherence. No mediation effects were found. This study is among the first to show that online interventions can enhance empowerment. However, neither group nor individual treatment proved superior in enhancing empowerment or alliance. Further research is needed to clarify how these factors contribute to reducing social anxiety symptoms.