Getting Change-Space: A Grounded Theory Study of Automated eHealth Therapy

A promising tool for bettering people's health is eHealth (or "Health") programs: fully automated, web-based health interventions. However, we know surprisingly little about eHealth's working mechanisms. One possible working mechanism is that program users benefit from a collaborative "relationship"-a "working alliance"-with the program. Although evidence support the existence of a person-to-program alliance it is unclear if and how it influences change. Therefore, we conducted a grounded theory study of how relating to an eHealth program for quitting smoking influenced the participants' change processes. The ensuing model focuses on how participants got change-space-feeling free from social forcing and able to work constructively on changing-and how the relational processes "making come-alive" and "keeping un-alive" were instrumental in this process. By presenting evidence that relating may influence change in automated therapy, this study supports the person-to-program alliance as a working mechanism in eHealth.