The Advantages and Disadvantages of Online and Blended Therapy: Survey Study Amongst Licensed Psychotherapists in Austria

Abstract

BackgroundWeb-based and blended (face-to-face plus Web-based) interventions for mental health disorders are gaining significance. However, many licensed psychotherapists still have guarded attitudes toward computer-assisted therapy, hindering dissemination efforts.ObjectiveThe objective of this study was to provide a therapist-oriented evaluation of Web-based and blended therapies and identify commonalities and differences in attitudes toward both formats. Furthermore, it aimed to test the impact of an information clip on expressed attitudes.MethodsIn total, 95 Austrian psychotherapists were contacted and surveyed via their listed occupational email address. An 8-minute information video was shown to half of the therapists before 19 advantages and 13 disadvantages had to be rated on a 6-point Likert scale.ResultsThe sample resembled all assessed properties of Austrian psychotherapists (age, theoretical orientation, and region). Therapists did not hold a uniform overall preference. Instead, perceived advantages of both interventions were rated as neutral (t94=1.89, P=.06; d=0.11), whereas Web-based interventions were associated with more disadvantages and risks (t94=9.86, P<.001; d=0.81). The information clip did not excerpt any detectable effect on therapists’ attitudes (r95=−.109, P=.30). The application of modern technologies in the own therapeutic practice and cognitive behavioral orientation were positively related to the given ratings.ConclusionsThis study is the first to directly compare therapists’ attitudes toward Web-based and blended therapies. Positive attitudes play a pivotal role in the dissemination of new technologies, but unexperienced therapists seem to lack knowledge on how to benefit from technology-aided treatments. To speed up implementation, these aspects need to be addressed in the development of new interventions. Furthermore, the preference of blended treatments over Web-based interventions seems to relate to avoidance of risks. Although this study is likely to represent therapists’ attitudes in countries with less advanced electronic health services, therapists’ attitudes in more advanced countries might present differently.

Measuring therapists' attitudes toward integration of technology in psychotherapy and predicting their use of technology

“…The notion that technology in the form of multimedia might be useful for psychoeducation, expressed in the psychoeducational value factor in the present work, has also been previously reported in qualitative studies (Stallard et al, 2010; van der Vaart et al, 2014). Finally, the perceived relevance factor in this study might be comparable to Relative advantage subscale in Carper et al's study (2013) or to the concept of effort expectancy within the theoretical framework of Unified theory of acceptance and use of technology (UTAUT; Venkatesh, Morris, Davis, & Davis, 2003) investigated in other work (Schuster et al, 2018). Based on the small to medium correlation between this factor and the potential to augment factor, it appears that, while psychotherapists may believe that these innovative treatments have some added value, they can still find them not worth the effort.…”

“…Previous studies have shown that psychotherapists hold neutral to positive attitudes toward these forms of treatment (Becker & Jensen‐Doss, 2013; Schuster, Pokorny, Topooco, Berger, & Laireiter, 2018; Vigerland et al, 2014), while some studies imply that psychotherapists might be less enthusiastic than patients in light of concerns about their effectiveness and patient adherence (Newton & Sundin, 2016; Schröder et al, 2017; Whitfield & Williams, 2004). Valuable information has been gained through qualitative studies and surveys (Gun et al, 2011; Newton & Sundin, 2016; Schuster et al, 2018; van der Vaart et al, 2014). However, valid instruments are still needed for examining psychotherapists' attitudes towards technology use in psychotherapy more reliably and exploring the relationship between these attitudes and psychotherapist behavior.…”

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

“…Jedoch haben Psychothe rapeutinnen und therapeuten Vorbehalte gegenüber der thera peutischen Nutzung von Neuen Medien. Diese liegen u. a. in nicht eindeutig geregelten zeitlichen Vorgaben und Vergütungen des Medieneinsatzes [3,7], technischen Schwierigkeiten [8] oder Sor gen um den Datenschutz [9]. Zudem besitzt ein großer Anteil der Psychotherapeuten kein oder nur ein geringes Wissen über Blen ded Therapy Ansätze, bspw.…”

Therapist-related feasibility of blended group therapy (bGT): Mixed methods study of a brief online- and mobile-supported group intervention for major depression (Preprint)

“…Lastly, many therapists lack experience with this novel approach and hold more cautious attitudes towards online interventions [16]. Comparable levels of caution and awareness have been found amongst different interest parties (e.g.…”

“…****************** Figure 1 about here *********************** According to therapists, patients can profit from blended interventions in form of increased treatment accessibility and flexibility, as well as from the improvement of patients' selfmanagement and the optimal use of face-to-face sessions [31,32]. Additionally, mental health care providers, policy makers and other such organisations seem to have a more positive conception of blended therapy compared to pure online therapy [17], and therapists seem to prefer the blended format because it is associated with less risks [16]. Amongst the potential disadvantages of the integrated format, therapists frequently remark that blended therapy is not feasible for all patients, and that the format at times could hamper the therapeutic process -in particular the establishment of the therapeutic alliance [31,32].…”