More than 2 decades of research into CMC has examined the influence of communications media on interpersonal relationships. As with much of the literature discussed in this paper, the CMC literature is based on controlled laboratory research outside the clinical arena. One of the earliest and most straightforward approaches, sometimes referred to as cues filtered out
], suggests that bandwidth is the principle feature affecting communication and the experience of social presence in the communication partner. Bandwidth refers to the number of communication cues a medium can convey (eg, verbal content, visual cues, prosody). The assumption was that greater bandwidth would lead to greater ability to complete tasks, better interpersonal relations, and greater social presence. Thus, face-to-face communication, with its full complement of verbal, nonverbal, and contextual cues, could be assumed to provide the richest source of information. The telephone removes visual cues but retains nonverbal information found in prosody. Instant messaging is primarily content, and would be expected to strip away nonverbal information. Texting and email would eliminate the social presence provided by synchronous communication. Thus, as communication media degrade the quality of the interaction, factors such as bond, legitimacy, and the ability to provide supportive accountability would be expected to deteriorate.
However elegant this formulation is, the CMC literature has since suggested it to be overly simplistic. With time, people are able to develop communications that are effective, and emotionally and relationally rich, even in comparatively lean communications media. Indeed, American teenagers now spend almost as much time in text-based communication (text/chat) as they do in face-to-face and telephone communication, suggesting that these media can provide valued forms of communication [51
One reason that lean media are effective is that people tend to form stronger impressions based on more limited, sometimes stereotyped social and interpersonal cues. Some of these cues may even be independent of the interaction, such as knowledge about the other person’s gender, status, or other characteristics available to the person [52
]. Early in interactions using lean media, people usually make more positive, idealized attributions of their communication partners. This positive effect is heightened when there is an expectation of future contact [40
]. When making attributions about communication partners, people using lean media make attributions based on less detailed information, but their attributions tend to be stronger and more intense than those of people communicating face-to-face [53
The language that people use in text-based communication may also be different from language used in verbal communication. In general, people tend to be more willing to engage in socioemotional communication in text-based media than in face-to-face communication. For example, CMC users employ more self-disclosure than in face-to-face communications [54
]. When using CMC, people are also more willing and more likely to ask personal questions, with those questions involving greater depth; questions asked in face-to-face communication are comparatively impersonal and are marked by more superficiality. Ratings of communication effectiveness are also significantly more positive for CMC than for face-to-face. Thus, while face-to-face communication is richer in the availability of cues, people make much more use of the remaining cues and strategies in leaner communication media.
When people do not have nonverbal cues available, they are quite adaptive in developing new methods of creating impression-bearing, interpersonal cues and strategies. Examples include the use of emoticons, such as “;-)”, and abbreviations, such as LOL (laugh out loud), as methods of conveying interpersonal and emotional information. Although people use these frequently to convey such information, findings suggest that they have little effect on a reader’s interpretation of a message [40
]. However, when two people engaged in communication mirror the use of emoticons and abbreviations, they are more likely to experience high levels of mutual trust [55
]. People also use time and date stamps on CMCs as indicators of the quality of the relationship. For example, task-oriented emails sent at night tend to be perceived as expressing dominance, while personal messages sent during the day tend to be perceived as expressing affection [40
]. Longer delays in returning mail may also be perceived as expressing lack of affection.
Entrainment, the process of linguistic and paralinguistic mirroring in dyadic communication, has generally been shown to be associated with more positive relational qualities [40
]. This is likely in part because people are more comfortable when they perceive others as being like them [56
]. When language shows high similarity in content, people are likely to show higher affiliation and trust. Even the use of similar tenses is associated with greater trust [55
]. This suggests that coaches should try, within reason and within constraints established by the legitimacy principle, to mirror their clients in content and tone. Thus, a communication about future plans is best met with a question about those future plans. If it is met with questions about the past, it may be more likely to threaten trust. However, there are some limits to entrainment. For example, entrainment in expressions of negative emotions is associated with decreased trust.
While interactions via CMC have the potential to be more emotional, they also have the potential to be more carefully crafted. Users of asynchronous or text-based media often exploit the absence of cues to more purposefully craft their self-presentation [40
]. People use more time to consider whether messages reflect the information and characteristics that they wish to convey. Users also may time self-revelations to manage and serve relational goals. Indeed, the very absence of multiple, simultaneous cues from a partner and lack of environmental stimuli can heighten attention to the targeted integration of socioemotional and task-oriented content. Thus, while CMC can allow patients to be more expressive, and potentially more disclosing, it also affords patients greater ability to engage in impression management. Because cues can take on greater significance in lean communications media, subtle indications from a coach could potentially have a strong effect in shaping the information and quality of patient communications.
While much of the research has examined ways in which the “hyperpersonal” effects of leaner communication media can positively influence communication, negative effects have also been noted. The lack of cues in leaner media means that communication is more effortful [40
] and thus requires more time. When time is restricted, the likelihood of negatively interpreted responses increases. Furthermore, the positive bias that is present when beginning communication over lean media is coupled with the expectation of future interactions. These positive biases tend to vanish when there is no expectation of future interaction.
Perhaps because the positive bias is supported by greater reliance on less detailed information, the potential for information to affect the relationship negatively is also greater in lean media than in face-to-face communication. Negative communications, or communications that are perceived as not exhibiting sufficient trust, benevolence, and bond, may have a greater negative impact in leaner media than in face-to-face communications. But even cues that simply provide extraneous information have the potential to negatively affect relationships in lean media. For example, providing photographs of pairs of individuals engaged in long-term CMC reduces positive affect, compared to pairs of individuals who do not receive photographs of their communication partners [57
Of course, people outside of controlled communications experiments are typically not constrained to communicate solely through one medium. Some of the findings described above may be exaggerated, since the experience of psychological closeness is likely to be enhanced when there are no alternatives to communicating via a lean medium, and may be reduced using a lean medium when other richer media are available [58
]. People may also prefer some media over others for specific purposes. For example, media with less social presence are often preferred for more conflictual situations. In addition, people may use different media in sequences or combinations to accomplish certain goals. For example, email is often used to raise an issue prior to a telephone or face-to-face meeting. Thus, a choice of medium that is suboptimal by itself may make sense as part of a larger strategy.