The effectiveness and efficiency of brief strategic therapy: A comparison of in-person, online, and hybrid treatment delivery modalities

OBJECTIVE: This study evaluated the effectiveness and efficiency of brief strategic therapy (BST) in routine care settings and examined whether outcomes and therapeutic alliance, as an indicator of positive therapeutic process, differed across in-person, online, and hybrid delivery modalities. METHOD: Systemic Practice Research Network (SYPRENE) data included 1,933 clients from Western Europe who received BST in one of the modalities. The nonrandomized prospective pretest-posttest naturalistic design included measures of therapist-rated and client-rated problem resolution, as well as client-rated psychological impairment, overall well-being, and therapeutic alliance. Modality was not a significant predictor of problem resolution or change in psychological impairment, overall well-being, or therapeutic alliance; clinical significance analyses largely supported these patterns. Efficiency did not differ by modality, except in-person therapy was modestly more efficient than hybrid therapy for improving overall well-being. CONCLUSION: BST showed effectiveness, positive therapeutic process, and efficiency across delivery modalities; modality differences were negligible or small, although some were statistically significant. Findings indicate technology-mediated BST is a feasible therapeutic alternative to expand access to care.