An exploratory study in breast cancer of factors involved in the use and communication with health professionals of Internet information.

OBJECTIVE: To study the impact of the spontaneous use of Internet on breast cancer patients and on their relationship with health professionals. METHODS: A mixed methodology was used. Two questionnaires were designed through three focus groups, and then administered to 186 patients and 59 professionals in order to assess: (1) patients' use of Internet for health-related information and (2) the impact of this information on patients' psychological outcomes and on their relationship with professionals. RESULTS: Patients spent more time looking for illness-related information after diagnosis, using interactive communities more than static information websites. Patients and professionals disagreed about the use of Internet in terms of the knowledge it provides, and its psychological impact. The main barrier reported by patients regarding the sharing of online information with their professionals was the belief that it would damage their relationship. CONCLUSIONS: Both professionals and patients have a protectionist conception of the therapeutic relationship. This attitude tends to dismiss the positive impact that the use of Internet and the new communication tools may have in cancer patients. New resources should provide an "Internet Prescription" and modes of interaction to facilitate a more open digital communication.

Predictors of therapeutic outcome and process.

This article presents an intensive study of the outcome and process of the psychotherapeutic treatments conducted at the Blanquerna Psychotherapy Service in Barcelona. It analyzes in detail the relation between outcome (improvement) and process (therapeutic alliance). Specifically, it discusses (a) the therapeutic process in terms of the relation between therapeutic alliance and psychotherapy outcome and (b) the effects of the temporary weakening of the therapeutic alliance and temporary symptomatic relapse on therapeutic outcome and process. Two hundred thirty-nine clients were included in the study, and the assessment instruments were the CORE Outcome Measure and the short version of the Working Alliance Inventory. In addition to good outcome of psychotherapy and maintenance of therapeutic change after treatment, the results also demonstrated the significance of different aspects of the therapeutic alliance as predictors of the therapeutic outcome and process.