A digital therapeutic alliance in digital mental health

Technologies are increasingly being used to provide mental health interventions — either as conduits to professionally delivered care or as technological interventions. Despite a rich history of the concept of therapeutic alliance in psychotherapy interventions, researchers have struggled to define and measure digital therapeutic alliance (DTA) in a way that accounts for the unique constraints and opportunities of digital mental health interventions (DMHIs). We define DTA as a user-perceived alliance with a DMHI, including both human and technological components of the intervention. While people are sometimes averse to the idea that they could have a relationship or alliance with a digital tool, they may become more open to this idea as technological advances, such as artificial intelligence, make DMHIs more responsive and tailored to particular individuals. A more comprehensive understanding of DTA could help to design DMHIs that are more engaging and effective, increasing their impact.