A literature review on the potential of computer-mediated communication (CMC) as a medium for conducting psychotherapy via the Internet revealed that CMC may mediate interpersonally rich interactions if participants are allowed sufficient time and repeated opportunities (anticipate future communications) to exchange information and build relationships. To examine the extent to which the process of online therapy resembles face-to-face therapy, online therapy transcripts were examined through a molecular approach and the results were compared to the extant, psychotherapy processes literature. The participants were six dyads formed by college graduate students enrolled in a clinical practicum course and their online adolescent clients. The clients were highschool freshmen and sophomores referred by their school counselors through the Gulf Coast GEAR UP Partnership Project. Trained undergraduate psychology majors coded therapist and client online behavior according to two well established and validated coding methods, the Helping Skills System (HSS) and the Client Behavior System (CBS; Hill & O’Brien, 1999). Although levels of client overall output (grammatical units) remained fairly constant throughout the course of therapy, the ratio of productive to non-productive output per session increased as a function of number of sessions. Using hierarchical linear modeling (HLM) methodology, the results revealed that therapist facilitating skills (approval and reassurance, restatements and rephrasing, and reflection of feelings) predicted higher client productive output, whereas interpretations and informative statements predicted lower client productive output. The results confirmed that online therapy can lead to productive therapist-client interactions and that the associations between these interactions are similar to the associations found in faceto- face therapy interactions.

This is a longitudinal multilevel analysis using third party coded data of 15 couples therapy sessions to identify which therapist Emotion Focused Therapy interventions (Management of Couple's Interaction, Working with Primary Emotion, Managing Defensive Responses, Reframing the Problem in Terms of the Cycle, and Placing Emerging Emotions into the Cycle) influenced husband-to-wife and wife-to-husband exchanges of Positive Behaviors (warmth, prosocial behaviors, communication, assertiveness, and listening). A mixed effects model was used to examine within- and between-individual variability. Men and women were modeled separately. A series of two-level multilevel models of change were examined, where Time is Level 1 and Individual is Level 2. Results indicated no significant relationship between Management of the Couple's Interaction, Managing Defensive Responses, and Reframing the Problem in Terms of the Cycle with both wife-to-husband and husband-to-wife positive behavior. Findings demonstrated that 44.5% of the variance in wife-to-husband positive behaviors and 66.5% of the variance in husband-to-wife positive behaviors was accounted for by the therapist Working with Primary Emotion and Placing Emerging Emotions in the Cycle. Specifically, these therapist interventions were significantly and negatively related to wife-to-husband and husband-to-wife positive behaviors over time in therapy. Clinical implications and directions for future research will be discussed.