How LGBT+ Young People Use the Internet in Relation to Their Mental Health and Envisage the Use of e-Therapy: Exploratory Study

Abstract

BackgroundLesbian, gay, bisexual, and transgender (LGBT) youth and other young people diverse in terms of their sexuality and gender (LGBT+) are at an elevated risk of mental health problems such as depression. Factors such as isolation and stigma mean that accessing mental health services can be particularly challenging for LGBT+ young people, and previous studies have highlighted that many prefer to access psychological support on the Web. Research from New Zealand has demonstrated promising effectiveness and acceptability for an LGBT+ focused, serious game–based, computerized cognitive behavioral therapy program, Rainbow Smart, Positive, Active, Realistic, X-factor thoughts (SPARX). However, there has been limited research conducted in the area of electronic therapy (e-therapy) for LGBT+ people.ObjectiveThis study aimed to explore how and why LGBT+ young people use the internet to support their mental health. This study also sought to explore LGBT+ young people’s and professionals’ views about e-therapies, drawing on the example of Rainbow SPARX.MethodsA total of 3 focus groups and 5 semistructured interviews were conducted with 21 LGBT+ young people (aged 15-22 years) and 6 professionals (4 health and social care practitioners and 2 National Health Service commissioners) in England and Wales. A general inductive approach was used to analyze data.ResultsLGBT+ youth participants considered that the use of the internet was ubiquitous, and it was valuable for support and information. However, they also thought that internet use could be problematic, and they highlighted certain internet safety and personal security considerations. They drew on a range of gaming experiences and expectations to inform their feedback about Rainbow SPARX. Their responses focused on the need for this e-therapy program to be updated and refined. LGBT+ young people experienced challenges related to stigma and mistreatment, and they suggested that strategies addressing their common challenges should be included in e-therapy content. Professional study participants also emphasized the need to update and refine Rainbow SPARX. Moreover, professionals highlighted some of the issues associated with e-therapies needing to demonstrate effectiveness and challenges associated with health service commissioning processes.ConclusionsLGBT+ young people use the internet to obtain support and access information, including information related to their mental health. They are interested in LGBT-specific e-therapies; however, these must be in a contemporary format, engaging, and adequately acknowledge the experiences of LGBT+ young people.

Is Digital Treatment the Holy Grail? Literature Review on Computerized and Blended Treatment for Depressive Disorders in Youth

“…Table 1 presents details of the included studies (k = 33). Sixteen studies were aimed at computerized treatments, of which nine were unguided computerized treatments (four computer-based and five internet-based) [30][31][32][33][34][35][36][37][38] and seven studies were guided computerized treatments (one computer-based and six internet-bases) [39][40][41][42][43][44][45], two studies at blended treatment [46,47], two studies compared unguided computerized, blended-and face-to-face treatment to no treatment [48,49], and eight studies were aimed at self-help internet-based games [50][51][52][53][54][55][56][57]. Furthermore, two studies that were focused on the use of an online monitoring tool aimed at registering and monitoring treatment progression [58,59] and three studies were aimed at characteristics of online interventions or studied the preferred modes of help seeking [60][61][62].…”

“…Sixteen studies were mainly focused on the feasibility, usability, and acceptability of computerized and blended interventions. The study designs were mixed and they contained qualitative studies with focus groups of patients, healthy adolescents or mental health professionals (k = 6) [41,53,54,56,58,59], randomized controlled trials (k = 3) [43,47,48], pre-post designs without control group (k = 5) [31,46,50,51,55], and cross-sectional studies (k = 2) [32,37]. Three studies were mainly focused on the preferences of patients regarding treatment modalities [32,60,62].…”

“…The majority of adolescents would recommend Sparx to others [55,57]. Privacy can be easily guaranteed [55] and, for members from a small community, it seems to be a promising way to seek help [51,56]. Nonetheless, internet safety needs to be considered by the users [56].…”

Revising Computerized Therapy for Wider Appeal Among Adolescents: Youth Perspectives on a Revised Version of SPARX

“…Cognitive behavioral therapy (CBT) is a first-line treatment (2), but the majority of adolescents do not use professional services despite significant symptoms (3,4). Notably, many young people, particularly those from minority groups or cultures, report that they would prefer to access support from familiar people, use self-help or internetbased information, or that they would not seek any help (5)(6)(7).…”

Revising Computerized Therapy for Wider Appeal Among Adolescents: Youth Perspectives on a Revised Version of SPARX

“…Cognitive behavioral therapy (CBT) is a first-line treatment (2), but the majority of adolescents do not use professional services despite significant symptoms (3, 4). Notably, many young people, particularly those from minority groups or cultures, report that they would prefer to access support from familiar people, use self-help or internet-based information, or that they would not seek any help (5–7).…”