Working alliance and empowerment in internet-based groups versus individual treatment: a secondary analysis

Internet-based interventions show promise for meeting the increasing demand for psychological support, yet the mechanisms driving their effectiveness remain unclear. This study examines the roles of empowerment and working alliance in reducing social anxiety disorder (SAD) and improving adherence in a clinician-guided group (GT) compared to a clinician-guided individual treatment (IT). A total of 120 individuals meeting the SAD diagnostic criteria were randomized into one of the two active conditions. Both empowerment and working alliance were repeatedly assessed, and their effects on social anxiety and adherence (measured by completed exercises) were analyzed through t-tests, correlations, repeated measures ANOVA, and mediation models. Results revealed no significant differences between GT and IT in empowerment or alliance, although both improved throughout the intervention. GT demonstrated early advantages in alliance, while IT showed slightly better adherence and a stronger connection between empowerment and adherence. No mediation effects were observed. This study is among the first to indicate that online interventions can enhance empowerment. However, neither group nor individual treatment proved superior in enhancing empowerment or alliance. This could be due to power limitations; therefore, results should be interpreted as tendencies. Further research is needed to clarify how these factors help reduce symptoms of social anxiety.