Blended Treatment for Depressive Disorders in Youth: a Narrative Review

Abstract

Depressive disorders are the most prevalent mental health disorder in adolescents with detrimental consequences; effective and available treatment is crucial. Face-to-face and computerized treatments both have advantages but also downsides. Merging these two into one so-called blended treatment seems to be an optimal combination of elements. This current review addresses blended treatment for youth depression and aims to summarize existing knowledge on effectiveness as well as patients’ and therapists’ perspectives. Results showed promising significant decreases in symptoms, but no evidence for differences between blended and face-to-face treatment was found. Patients’ perspectives were mixed; they reported strong preferences for face-to-face treatment, but participants actually receiving blended treatment were mainly positive. Therapists’ attitudes were neutral, but they expressed their worries about the unknown risks on adverse events. Future research is needed and should, beside effectiveness and cost-effectiveness, pay close attention to the risks that are mentioned by therapists.

Therapeutic games to reduce anxiety and depression in young people: A systematic review and exploratory meta‐analysis of their use and effectiveness

“…These include, for example, telephone therapy (Brenes et al, 2015), therapy delivered via texting (Snoswell et al, 2021) and internet-based therapy (Barak et al, 2008;Välimäki et al, 2017). As indicated in Barak et al (2008) interactions with therapists and e-contents) and application-based therapeutic activities, also known as 'apps for mHealth' (mobile health) (Rasing, 2021). Smartphone apps, in specific, appear to be an increasingly popular digital way of accessing readily available mental health support, due to their 24-h availability, unique characteristics and increased connectivity, have been suggested to be a beneficial method for therapeutic delivery (Grist et al, 2017).…”

“…Nonetheless, clinician‐delivered digital interventions are not the only form of therapeutic support available, as there is a growing interest, particularly in younger generations, in new forms of digital interventions, including ‘blended interventions’ (encompassing live interactions with therapists and e‐contents) and application‐based therapeutic activities, also known as ‘apps for mHealth’ (mobile health) (Rasing, 2021). Smartphone apps, in specific, appear to be an increasingly popular digital way of accessing readily available mental health support, due to their 24‐h availability, unique characteristics and increased connectivity, have been suggested to be a beneficial method for therapeutic delivery (Grist et al, 2017).…”

An app-based training for adolescents with problematic digital-media use and their parents (Res@t digital): protocol for a cluster-randomized clinical trial

“…In addition, applying the Res@t app with its up-to-date treatment material within a blended therapy context might enrich and facilitate face-to-face interventions and allow multiple self-guided repetitions to consolidate content. Reviews suggest positive effects of such an approach across age groups including adolescent patients ( 73 , 74 ) with evidence of beneficial effects of guided (versus unguided) digital interventions ( 75 ). Moreover, the beneficial effects of additional face-to-face interventions are assumed to vary according to the reachability of adolescents with DMUD.…”

Pragmatic Quasi-Experimental Controlled Trial Evaluating the Outcomes of Blended CBT Compared to Face-to-Face CBT and Treatment as Usual for Adolescents with Depressive Disorders

“…A previous review demonstrated that the use of blended treatment for adolescents with a depressive disorder largely depends on acceptance by therapists as well as by patients [ 36 ]. It is likely that this acceptance increases with more insight into the effectiveness and risks of blended CBT.…”

“…Two randomized controlled trials by Topooco et al [ 34 , 35 ] showed that an online program including eight weekly chat-sessions resulted in significantly lower depressive symptoms when compared to control conditions comprising active monitoring or non-specific counseling. Although these findings provide a positive perspective on blended CBT, it is unknown whether not seeing patients face-to-face regularly increases the risk of adverse events including suicide risk [ 36 ], and whether the presented effects can be translated to adolescents treated in routine care.…”