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Related Experiment Video

Updated: Mar 18, 2026

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How a Fully Automated eHealth Program Simulates Three Therapeutic Processes: A Case Study.

Marianne T S Holter1, Ayna Johansen, Håvar Brendryen

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Summary

This study introduces a model for eHealth programs that simulates therapist support to enhance behavior change. By integrating working alliance, motivation, and lapse management, these digital health interventions can become more effective.

Keywords:
Internetbehavior therapycell phoneseHealthintervention mappingmotivational interviewingsmoking cessationtelemedicinetext messagingworking alliance

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Area of Science:

  • Digital Health Interventions
  • Behavior Change Technology
  • Health Psychology

Background:

  • eHealth programs can be enhanced by analyzing individual components and their interactivity.
  • Understanding how lapse management in eHealth supports working alliance, motivation, and behavior maintenance is crucial.
  • Simultaneously simulating these processes in interactive, tailored eHealth programs may improve efficacy.

Purpose of the Study:

  • To propose a theoretical model for improving fully automated behavior change eHealth programs.
  • To demonstrate how simulating therapist support can enhance program effectiveness.
  • To integrate working alliance, motivation internalization, and lapse management within a theoretical framework.

Main Methods:

  • Developed a theoretical model for automated eHealth behavior change programs.
  • Applied the model to Endre, a fully automated smoking cessation program.
  • Utilized a descriptive case study and intervention mapping protocol to illustrate process simulation.

Main Results:

  • The Endre program simulates working alliance via relational agents and motivational interviewing.
  • Computerized motivational interviewing supports internalized motivation to quit.
  • A lapse management component addresses user lapses, operationalizing key therapeutic processes.

Conclusions:

  • eHealth programs can simulate working alliance, motivation, and lapse management.
  • Interactivity and tailoring are key to simulating these therapeutic processes.
  • This approach has the potential to increase the effectiveness of automated eHealth behavior change programs.