A Task Analysis of Therapeutic Engagement in a Professionally Facilitated Online Intervention for Young Couples Affected By Breast Cancer

Engagement in online intervention, defined as the extent to which participants are involved in and attentive to the contents of the intervention, has been shown to predict treatment outcome. Because professional facilitation has been shown to increase intervention participation and effectiveness, the therapeutic alliance that develops between facilitators and participants might be one factor that influences engagement. Thus, in this study a modified task analysis was conducted in order to examine how facilitators develop a therapeutic alliance with participants to increase engagement in an online intervention for couples affected by breast cancer, called Couplelinks. Our findings suggest that engagement promotion involves three meta-processes, designated as ‘friendly and positive yet firm approach,’ ‘inclusive empathic attitude,’ and ‘humanizing the technology,’ as well as various behavioural facilitator interventions. In the process of measuring engagement, we also found that couples could be separated into ‘engagement-types.’ Implications, limitations, and suggestions for future research are discussed.