Alliance With an Unguided Smartphone App: Validation of the Digital Working Alliance Inventory
Simon B. Goldberg, Scott A. Baldwin, Kevin M. Riordan, John Torous, Cortland J. Dahl, Richard J. Davidson, Matthew J. Hirshberg
Assessment May 18, 2021 DOI: 10.1177/10731911211015310 via OpenAlex
Summary
AI-generated from the abstractA six-item Digital Working Alliance Inventory (DWAI) measuring the working alliance in unguided smartphone-based interventions shows good psychometric properties. In a cross-sectional survey of 290 meditation app users and the intervention arm of a randomized trial with 314 participants, exploratory and confirmatory factor analyses supported a single-factor structure. The DWAI demonstrated adequate internal consistency, test-retest reliability, and discriminant validity (no association with social desirability, psychological distress, or preference for a waitlist condition). Convergent validity was supported by positive associations with perceived app effectiveness and preference for an app condition. DWAI scores positively predicted self-reported and objective app utilization. When assessed at Weeks 3 or 4, but not earlier, DWAI scores predicted pre-post reductions in psychological distress.
Study at a glance
| Characteristics | Cross-sectional survey and randomized trial intervention arm Longitudinal Peer reviewed |
|---|---|
| Sample size | 604 |
| Population | Meditation app users |
| Intervention | smartphone-based meditation app |
| Topics | Meditation |
| Keywords | Discriminant validity Clinical psychology Confirmatory factor analysis Exploratory factor analysis Distress |
| Citations | 73 |
| Key finding | The Digital Working Alliance Inventory is a valid and reliable measure of working alliance in unguided smartphone-based meditation interventions, with predictive validity for app utilization and reductions in psychological distress when assessed after 3-4 weeks. |
Abstract
The working alliance may be relevant in unguided smartphone-based interventions, but no validated measure exists. We evaluated the psychometric properties of the six-item Digital Working Alliance Inventory (DWAI) using a cross-sectional survey of meditation app users ( n = 290) and the intervention arm of a randomized trial testing a smartphone-based meditation app ( n = 314). Exploratory factor analysis suggested a single-factor solution which was replicated using longitudinal confirmatory factor analysis. The DWAI showed adequate internal consistency and test–retest reliability. Discriminant validity was supported by a lack of association with social desirability, psychological distress, and preference for a waitlist condition. Convergent validity was supported by positive associations with perceived app effectiveness and preference for an app condition. Supporting predictive validity, DWAI scores positively predicted self-reported and objective app utilization. When assessed at Weeks 3 or 4 of the intervention, but not earlier, DWAI scores predicted pre–post reductions in psychological distress.