La alianza terapéutica en psicoterapia online: revisión integrativa
The therapeutic alliance in online psychotherapy: integrative reviewBarra lateral del artículo
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La expansión de la psicoterapia online ha planteado interrogantes sobre la viabilidad de la alianza terapéutica en entornos digitales y sobre las competencias profesionales necesarias para sostenerla. El presente estudio se desarrolló como una revisión integrativa con enfoque sistemático cuyo objetivo fue sintetizar la evidencia empírica disponible acerca de las competencias del terapeuta asociadas con la construcción y mantenimiento de la alianza terapéutica en psicoterapia online. Se realizó una búsqueda bibliográfica en Scopus, Web of Science y PubMed, considerando publicaciones en inglés y español entre 2010 y 2026. Tras el proceso de selección se incluyeron 59 estudios empíricos, cuyos hallazgos fueron analizados mediante codificación temática. Los resultados evidencian que la alianza terapéutica online constituye un fenómeno relacional diferenciado que requiere competencias adaptativas específicas, entre ellas la gestión de interrupciones técnicas, la recalibración de señales comunicativas y el uso estratégico de recursos digitales. Asimismo, se identificó una asimetría perceptiva entre terapeutas y pacientes y la necesidad de adaptar los instrumentos tradicionales de evaluación de la alianza a contextos digitales.
The expansion of online psychotherapy has raised important questions regarding the viability of the therapeutic alliance in digital environments and the professional competencies required to sustain it. This study was conducted as an integrative review with a systematic approach aimed at synthesizing empirical evidence on therapist competencies associated with the development and maintenance of the therapeutic alliance in online psychotherapy. A structured literature search was carried out in Scopus, Web of Science, and PubMed, including publications in English and Spanish between 2010 and 2026. After the selection process, 59 empirical studies were included and analyzed through thematic coding. The findings indicate that the online therapeutic alliance represents a distinct relational phenomenon that requires specific adaptive competencies, including the management of technical disruptions, recalibration of communicative signals, and strategic use of digital resources. In addition, a perceptual asymmetry between therapists and patients was identified, along with the need to adapt traditional alliance assessment instruments to digital contexts.
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