Behavioural and Cognitive Psychotherapy

Brief Clinical Reports

How Technology Influences the Therapeutic Process: Evaluation of the Patient-Therapist Relationship in Augmented Reality Exposure Therapy and In Vivo Exposure Therapy

Maja Wrzesiena1 c1, Juana Bretón-Lópeza2, Cristina Botellaa3, Jean-Marie Burkhardta4, Mariano Alcañiza5, María Ángeles Pérez-Araa6 and Antonio Riera del Amoa6

a1 Universitat Politècnica de València, Spain

a2 Universidad Jaume I, Castellón, Spain

a3 Universidad Jaume I, Castellón and Instituto de Salud Carlos III, Spain

a4 Institut Français des Sciences et Technologies des Transports, Versailles, France

a5 Universitat Politècnica de València, and Instituto de Salud Carlos III, Spain

a6 Universidad Jaume I, Castellón, Spain


Background: New technologies have slowly become a part of psychologists’ therapeutic office. However, many therapists still have doubts about the possibility of creating a good therapeutic relationship with patients in the presence of technology. Aims: This study evaluates the development of the therapeutic alliance in individuals with small animal phobia disorder who were treated with Augmented Reality Exposure Therapy or In Vivo Exposure Therapy. Method: Twenty-two participants received an intensive session of cognitive behavioural therapy in either a technology-mediated therapeutic context or in a traditional therapeutic context. Results: The results show no significant difference for the therapeutic alliance between two conditions. Conclusions: The results seem to show that technologies such as Augmented Reality do not represent a danger to negatively influence the therapeutic alliance.

(Online publication February 15 2013)


  • Therapeutic alliance;
  • Augmented-Reality;
  • in vivo exposure;
  • small animal phobias


c1 Reprint requests to Maja Wrzesien, Instituto Interuniversitario de Investigación en Bioingeniería y Tecnología Orientada al Ser Humano, Universitat Politècnica de València, I3BH/LabHuman, Cubo Azul - Edif. 8B – Acceso N, Camino de Vera s/n, 46022 Valencia, Spain. E-mail:


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