Integrating the Digital and the Traditional to Deliver Therapy for Depression

Abstract

Traditional approaches to psychotherapy emphasise face-toface contact between patients and therapists. In contrast, current computerised approaches tend to minimise this contact. This can limit the range of mental health difficulties for which computerised approaches are effective. Here, we explore an alternative approach that integrates face-to-face contact, electronic contact, online collaboration, and support for betweensession activities. Our discussion is grounded in the design of a platform to deliver psychotherapy for depression. We report findings of an 11-month pragmatic study in which 17 patients received treatment for depression via the platform. Results show how design decisions had a significant impact on the dynamics of therapeutic sessions and the establishment of patient-therapist relationships. For example, the use of instant messaging for synchronous, in-session contact slowed communication, but also provided a valuable space for reflection and helped to maintain session focus. We discuss the impact of flexibility and the potential of integrated approaches to both enhance and reduce patient engagement.

A novel smartphone‐based intervention targeting sleep difficulties in individuals experiencing psychosis: A feasibility and acceptability evaluation

“…This is a promising indication that the intervention could be made more widely available than traditional CBTi. Frequency and duration of clinician contact were participant‐led, to offer patient choice and flexibility (Stawarz et al, 2020). However, feedback indicated preference for additional guidance; therefore, regular, pre‐scheduled contact may be a more optimal method for future interventions (Shim et al, 2017).…”

Transitions in Technology-Mediated Cardiac Rehabilitation and Self-management: Qualitative Study Using the Theoretical Domains Framework

“…Although in-person emotional or mental support is preferred, there is increasing evidence in recent years that technology can play a significant role in providing support for mental health [ 56 ]. Examples range from systems specifically designed to integrate with traditional care [ 57 ] to the more exploratory use of voice interfaces and chatbots using artificial intelligence to provide emotional support [ 58 ]. Importantly, alongside negative emotional experiences, participants also expressed positive emotions such as gratitude and renewed appreciation of the natural world.…”

Factors Affecting Digital Tool Use in Client Interaction According to Mental Health Professionals: Interview Study

“…Blended therapies combine both digital and face-to-face interaction [36]. In the United Kingdom, Stawarz et al [37] reported a blended approach comprising initial face-to-face meetings, subsequent web-based therapy sessions, and independent work by the client between sessions. Generally, MHPs are more favorable toward blended approaches than unguided therapies [8,[38][39][40].…”

“…HUS has developed internet therapies for other mental disorders as well, such as depression, attention-deficit/hyperactivity disorder, and bipolar disorder [ 35 ], which are referred to in this research as “national DMHI.” Blended therapies combine both digital and face-to-face interaction [ 36 ]. In the United Kingdom, Stawarz et al [ 37 ] reported a blended approach comprising initial face-to-face meetings, subsequent web-based therapy sessions, and independent work by the client between sessions. Generally, MHPs are more favorable toward blended approaches than unguided therapies [ 8 , 38 - 40 ].…”