Potential Benefits of Incorporating Peer-to-Peer Interactions Into Digital Interventions for Psychotic Disorders: A Systematic Review

Abstract

Objective Peer-to-peer interactions and support groups mitigate experiences of social isolation and loneliness often reported by individuals with psychotic disorders. Online peer-to-peer communication can promote broader use of this form of social support. Peer-to-peer interactions occur naturally on social media platforms, but they can negatively affect mental health. Recent digital interventions for persons with psychotic disorders have harnessed the principles of social media to incorporate peer-to-peer communication. This review examined the feasibility, acceptability, and preliminary efficacy of recent digital interventions in order to identify strategies to maximize benefits of online peer-to-peer communication for persons with psychotic disorders. Methods An electronic database search of PubMed, EMBASE, PsycINFO, Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and Health Technology Assessment Database was conducted in February 2017 and yielded a total of 1,015 results. Eight publications that reported data from six independent trials and five interventions were reviewed. Results The technology supporting peer-to-peer communication varied greatly across studies, from online forums to embedded social networking. When peer-to-peer interactions were moderated by facilitators, retention, engagement, acceptability, and efficacy were higher than for interventions with no facilitators. Individuals with psychotic disorders were actively engaged with moderated peer-to-peer communication and showed improvements in perceived social support. Studies involving service users in intervention design showed higher rates of acceptability. Conclusions Individuals with psychotic disorders value and benefit from digital interventions that include moderated peer-to-peer interactions. Incorporating peer-to-peer communication into digital interventions for this population may increase compliance with other evidence-based therapies by producing more acceptable and engaging online environments.

How Inclusive, User-Centered Design Research Can Improve Psychological Therapies for Psychosis: Development of SlowMo

“…However, dependent on the trial outcomes, there are several target areas for further innovation which may involve additional behaviour change methods and technologies (e.g. embodied conversational agents, online support groups, instant messaging, wearable biofeedback and gameification) [68][69][70][71]. From an agile science perspective, SlowMo could be implemented as a module within a broader digital therapy platform for psychosis [42,72] or adapted for a range of other difficulties and settings.…”

Social Media and Mental Health: Benefits, Risks, and Opportunities for Research and Practice

“…• Individuals with mental disorders can connect with care providers and access evidence-based services • Online peer support augments existing interventions to improve client engagement and compliance • Peer networks increase social connectedness and empowerment during recovery • Interactive peer-to-peer features of social media appear beneficial for social functioning • Mobile apps offer potential to monitor symptoms, prevent relapses and help users set goals • Digital peer-based interventions are feasible and acceptable for targeting fitness and weight loss in people with mental disorders • Online networks can extend support to caregivers of those with mental disorders (Alvarez-Jimenez et al 2013Aschbrenner et al 2018aAschbrenner et al , 2016bBiagianti et al 2018;Birnbaum et al 2017b;Gleeson et al 2017;Lal et al 2018;Naslund et al 2016bNaslund et al , 2018Schlosser et al 2016Schlosser et al , 2018 Challenges 1) Impact on symptoms…”

“…With the widespread use of social media among individuals living with mental illness combined with the potential to facilitate social interaction and connect with supportive peers, as summarized above, it may be possible to leverage the popular features of social media to enhance existing mental health programs and services. A recent review by Biagianti et al (2018) found that peer-to-peer support appeared to offer feasible and acceptable ways to augment digital mental health interventions for individuals with psychotic disorders by specifically improving engagement, compliance, and adherence to the interventions and may also improve perceived social support (Biagianti et al 2018).…”

Effectiveness of digital technology interventions to reduce loneliness in adults: a protocol for a systematic review and meta-analysis

“…Interventions focusing on social network maintenance and enhancement have also been applied and found to be useful to combat loneliness 20. Social interventions could be combined with the application of technology such as online peer-to-peer interactions and support groups through social media platforms to alleviate loneliness especially in persons with psychotic disorders 35. However, loneliness in older people can create serious problems that could not be alleviated with the social support only32; other types of interventions are required such as technological interventions (eg, digital applications (apps), online social networks and social robots) to enhance emotional support and social interaction 36…”