Developing a novel coding tool for therapeutic alliance and exploring online engagement in a digital mental health intervention for youth with major depressive disorder

Abstract

Background: Increased prevalence of Major Depressive Disorder (MDD) in youth and limitations in effective and accessible treatments requires treatment innovations such as digital mental health interventions (DMHI) using peer support. This study developed and assessed the interrater reliability of a novel coding protocol to detect spontaneous expression of therapeutic alliance (TA) in participants' posts with peers in a DMHI for youth with depression entitled Rebound. Contingent on good reliability, the relationships between expressed peer-to-peer TA, gender and online engagement with therapy content were assessed. Method: Youth aged 15-25 (M = 20.5, SD = 3.0) in remission from MDD were recru..