New publication on the role of working alliance in digital health interventions
Does interaction with a digital health app contribute to treatment effects?
In our previous randomized controlled trial, we showed that CanRelax, a mobile health intervention with a conversational agent, can reduce distress in people with cancer. It was an important step in demonstrating that digital tools can meaningfully support psychological well-being.
But it also raised a deeper question: What actually drives that effect?
In our newly published paper, we explored the role of the working alliance—how well users and the digital intervention align on goals, engage in the tasks required to achieve them, and form a bond with our chatbot Lumy.
Our findings suggest that this interaction matters.
For the future of digital health interventions, this suggests that effective design requires not only clearly defined treatment elements, but also a clear concept for how to create connectedness between users and the application.
Read the full open-access paper here:
Schläpfer S, Barth J, Heinz P, Held U, Kowatsch T, Witt CM. Association between working alliance and treatment outcomes in a mobile health intervention with a conversational agent (CanRelax). Internet Interv. 2026. doi: 10.1016/j.invent.2026.100929.
Want to read more about CanRelax?
Barth J, Schläpfer S, Schneider F, Santhanam P, Kowatsch T, Heinz P, Held U, Eicher M, Witt CM. Mobile health intervention CanRelax reduces distress in people with cancer in a randomized controlled trial. NPJ Digit Med. 2025. doi: 10.1038/s41746-025-01688-x.