Neue Medien in der Psychotherapie: Blended Therapy aus der Sicht ambulanter Psychotherapeuten

Paul, Johanna; Grünzig, Sasha-Denise; Baumeister, Harald; Bengel, Jürgen; Krämer, Lena Violetta

doi:10.1055/a-0824-7557

Cited by 5 publications

(20 citation statements)

References 19 publications

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“…The most frequently named barriers by the interviewed GPs concerned the use of new technologies within blended treatments, as most assumed that some patients would not be familiar with internet and technology or would be skeptical and uncertain as to whether an internet-based intervention could help them. These findings are in line with earlier research on barriers to the use of bPT by psychotherapists [34,35,55,56] as well as IMIs by clinicians (psychiatrists or GPs or psychologists) [57] or by GPs [42]. Furthermore, GPs' concerns regarding data safety were also mentioned in previous research on bPT by GPs [58] and psychotherapists [34,35,55] as well as on IMIs by GPs [42] and psychotherapists [59].…”

Section: Principal Findings and Comparison With Prior Worksupporting

confidence: 90%

“…These findings are in line with earlier research on barriers to the use of bPT by psychotherapists [34,35,55,56] as well as IMIs by clinicians (psychiatrists or GPs or psychologists) [57] or by GPs [42]. Furthermore, GPs' concerns regarding data safety were also mentioned in previous research on bPT by GPs [58] and psychotherapists [34,35,55] as well as on IMIs by GPs [42] and psychotherapists [59].…”

Section: Principal Findings and Comparison With Prior Worksupporting

confidence: 90%

“…The finding that GPs perceived younger patients to be more suitable for bPT compared with older patients is in accordance with research on IMIs in clinicians [57] and GPs [58] and on bPT in psychotherapists [34,35,55,56]. However, a meta-analysis indicated that older patients significantly profited from a stand-alone IMI for depression and to an even greater extent compared with younger patients [62].…”

Section: Principal Findings and Comparison With Prior Worksupporting

confidence: 83%

“…Further facilitators for referrals mentioned by the interviewed GPs relate to the health care system (eg, shorter waiting time, simple access, closing the treatment gap, feeling able to react to the high number of depressive patients in a better way) and are in line with research on IMIs with GPs [41,42] and bPT with GPs [58] and psychotherapists [34,35]. At the same time, GPs reported barriers such as little familiarity with treatment, missing reimbursement, and legal requirements, which correspond with research of IMIs in GPs [42] and of bPT in psychotherapists [34,55].…”

Section: Principal Findings and Comparison With Prior Worksupporting

confidence: 67%

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Barriers and Facilitators for Referrals of Primary Care Patients to Blended Internet-Based Psychotherapy for Depression: Mixed Methods Study of General Practitioners’ Views (Preprint)

Titzler¹,

Berking²,

Schlicker³

et al. 2020

Preprint

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BACKGROUND Major depressive disorder (MDD) is highly prevalent and often managed by general practitioners (GPs). GPs mostly prescribe medication and show low referral rates to psychotherapy. Many patients remain untreated. Blended psychotherapy (bPT) combines internet-based interventions with face-to-face psychotherapy and could increase treatment access and availability. Effectively implementing bPT in routine care requires an understanding of professional users’ perspectives and behavior. OBJECTIVE This study aims to identify barriers and facilitators perceived by GPs in referring patients to bPT. Explanations for variations in referral rates were examined. METHODS Semistructured interviews were conducted with 12 of 110 GPs participating in a German randomized controlled trial (RCT) to investigate barriers to and facilitators for referrals to bPT for MDD (10 web-based modules, app-based assessments, and 6 face-to-face sessions). The interview guide was based on the theoretical domains framework. The interviews were audio recorded and transcribed verbatim, and the qualitative content was analyzed by 2 independent coders (intercoder agreement, k=0.71). A follow-up survey with 12 interviewed GPs enabled the validation of emergent themes. The differences in the barriers and facilitators identified between groups with different characteristics (eg, GPs with high or low referral rates) were described. Correlations between referrals and characteristics, self-rated competences, and experiences managing depression of the RCT-GPs (n=76) were conducted. RESULTS GPs referred few patients to bPT, although varied in their referral rates, and interviewees referred more than twice as many patients as RCT-GPs (interview-GPs: mean 6.34, SD 9.42; RCT-GPs: mean 2.65, SD 3.92). A negative correlation was found between GPs’ referrals and their self-rated pharmacotherapeutic competence, <i>r</i>(73)=−0.31, <i>P</i><.001. The qualitative findings revealed a total of 19 barriers (B) and 29 facilitators (F), at the levels of GP (B=4 and F=11), patient (B=11 and F=9), GP practice (B=1 and F=3), and sociopolitical circumstances (B=3 and F=6). Key barriers stated by all interviewed GPs included “little knowledge about internet-based interventions” and “patients’ lack of familiarity with technology/internet/media” (number of statements, each k=22). Key facilitators were “perceived patient suitability, e.g. well-educated, young” (k=22) and “no conflict with GP’s role” (k=16). The follow-up survey showed a very high agreement rate of at least 75% for 71% (34/48) of the identified themes. Descriptive findings indicated differences between GPs with low and high referral rates in terms of which and how many barriers (low: mean 9.75, SD 1.83; high: mean 10.50, SD 2.38) and facilitators (low: mean 18.25, SD 4.13; high: mean 21.00; SD 3.92) they mentioned. CONCLUSIONS This study provides insights into factors influencing GPs’ referrals to bPT as gatekeepers to depression care. Barriers and facilitators should be considered when designing implementation strategies to enhance referral rates. The findings should be interpreted with care because of the small and self-selected sample and low response rates.

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Section: Principal Findings and Comparison With Prior Worksupporting

confidence: 90%

Section: Principal Findings and Comparison With Prior Worksupporting

confidence: 90%

Section: Principal Findings and Comparison With Prior Worksupporting

confidence: 83%

Section: Principal Findings and Comparison With Prior Worksupporting

confidence: 67%

See 2 more Smart Citations

Barriers and Facilitators for Referrals of Primary Care Patients to Blended Internet-Based Psychotherapy for Depression: Mixed Methods Study of General Practitioners’ Views (Preprint)

Titzler¹,

Berking²,

Schlicker³

et al. 2020

Preprint

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“…Webbasierte Meetings werden auch durch die Erfahrungen in der Corona-Krise sicher einen bleibenden höheren Anteil an unserer Kommunikationskultur haben. Dies gilt für den wissenschaftlichen wie therapeutischen Alltag [3]. Wie wir Webkonferenzen und Präsenzmeetings künftig gestalten und uns klug zwischen der digitalen und der realen Welt hin und her bewegen, müssen wir sicher noch weiter erproben.…”

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Mehnert‐Theuerkauf¹

2020

Psychother Psychosom Med Psychol

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„My God… those meetings really could all have been e-mails“ war ein witziger Cartoon in der täglichen Serie des New Yorker am Anfang der Corona-Krise, in dem ein Mann im Homeoffice mit einem erstaunten Gesichtsausdruck vor seinem Laptop sitzt 1. Im Frühjahr dieses Jahres, als die Bedrohung durch den Ausbruch des Coronavirus noch weitgehend unklar war, kamen viele Mitarbeiterinnen und Mitarbeiter in klinischen Einrichtungen kaum zum Luft holen, weil sie die Versorgung von Patienten und Angehörigen an die neuen Bedingungen anpassen mussten: veränderte Behandlungspläne wurden erstellt, Notfallszenarien festgelegt, ethische Empfehlungen zur Entscheidungsfindung und Zuteilung von Ressourcen veröffentlicht, Informationsstrategien diskutiert, webbasierte Technologien erprobt.

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Webbasierte Selbsthilfe zur Stimmungsverbesserung in der Wartezeit auf ambulante Psychotherapie – Eine qualitative Erhebung der Teilnehmerperspektive

Grünzig

Teigelkötter

Bengel

et al. 2020

Psychother Psychosom Med Psychol

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Zusammenfassung Ziel der Studie Patienten warten in Deutschland durchschnittlich 5 Monate auf den Beginn einer ambulanten Psychotherapie. Begleitete webbasierte Selbsthilfeinterventionen können depressive Symptome in der Wartezeit reduzieren. Ziel der Studie ist zu untersuchen, wie Betroffene die Teilnahme an einer webbasierten Intervention zur Stimmungsverbesserung erleben. Methodik Patienten auf den Wartelisten kooperierender Hochschulambulanzen wurden dazu eingeladen, im Rahmen einer Studie eine webbasierte Intervention zur Stimmungsverbesserung zu nutzen. Elf Teilnehmende der Intervention wurden in einem qualitativen Telefoninterview zu ihren Erfahrungen mit der Maßnahme befragt. Die Daten wurden entsprechend den Prinzipien der Grounded Theory analysiert. Ergebnisse Aus den Daten konnten 3 Kategorien extrahiert werden, welche das Erleben der Teilnehmenden hinsichtlich ihrer Erwartungen, ihrer Erfahrungen sowie ihrer Adhärenz beschreiben. Die webbasierte Intervention wurde sehr unterschiedlich erlebt und sowohl mit positiven als auch negativen Erfahrungen verbunden. Die Teilnehmenden ließen sich anhand der beschriebenen Kategorien in 3 Nutzertypen gruppieren: Den selbstständigen Typus, den überforderten Typus und den anspruchsvollen Typus. Diskussion Nicht alle Patienten machen gleichermaßen gute Erfahrungen mit der Intervention und einige scheitern an der Umsetzung. Um Patienten bestmöglich auf die Nutzung der Intervention vorzubereiten, sollten sie vorab noch ausführlicher über die Handhabung und Ziele der Intervention aufgeklärt werden. Interventionen sollten individuell entsprechend des Unterstützungsbedarfs von Patienten implementiert werden, um positive Erfahrungen zu ermöglichen und adhärenzfördernd zu wirken.

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Neue Medien in der Psychotherapie: Blended Therapy aus der Sicht ambulanter Psychotherapeuten

Cited by 5 publications

References 19 publications

Barriers and Facilitators for Referrals of Primary Care Patients to Blended Internet-Based Psychotherapy for Depression: Mixed Methods Study of General Practitioners’ Views (Preprint)

Barriers and Facilitators for Referrals of Primary Care Patients to Blended Internet-Based Psychotherapy for Depression: Mixed Methods Study of General Practitioners’ Views (Preprint)

Diese Treffen hätten wirklich alle per E-Mail stattfinden können

Webbasierte Selbsthilfe zur Stimmungsverbesserung in der Wartezeit auf ambulante Psychotherapie – Eine qualitative Erhebung der Teilnehmerperspektive

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