State of the Science: Using Digital Mental Health Interventions to Extend the Impact of Psychological Services

Behavior Therapy, Journal Year: 2024, Volume and Issue: 55(6), P. 1364 - 1379

Published: April 11, 2024

Language: Английский

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Program Evaluation of Internet-Delivered Cognitive Behavioral Treatments for Anxiety and Depression in a Digital Clinic

Journal of Mood and Anxiety Disorders, Journal Year: 2025, Volume and Issue: unknown, P. 100106 - 100106

Published: Jan. 1, 2025

Language: Английский

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Developing and Testing Tele-Support Psychotherapy through Mobile Phones for Youth (15–30 Years) with Depression in Uganda

IntechOpen eBooks, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 13, 2025

In response to the rise in mental health problems among youth during COVID-19 pandemic, we conducted a qualitative study March 2022, using user-centered design approach guided by ecological theories, adapt group support psychotherapy into tele-support (TSP) via mobile phones. The development of call platform, informed unified theory acceptance and use technology, was integrated Medical Concierge Group’s (TMCG) telehealth services under Rocket Health Africa. This platform included dedicated toll-free line for psychotherapy, connecting users with lay counselors. An open-label randomized controlled trial (PACTR202201684613316) assess feasibility, acceptability, effectiveness TSP combination standard (n = 154) compared alone 146) mild moderate major depression Kampala. Participants commonly equated illness reported significant challenges, including financial stress, substance abuse, family dysfunction. Although digital interventions were largely accepted, some participants preferred in-person services. adapted maintained gender sensitivity used folk tales, stories, riddles, creative visualizations facilitate emotional expression, acquisition coping strategies, income-generating skills, addressing both socio-economic needs.

Language: Английский

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Engagement With an Internet-Administered, Guided, Low-Intensity Cognitive Behavioral Therapy Intervention for Parents of Children Treated for Cancer: Analysis of Log-Data From the ENGAGE Feasibility Trial

JMIR Formative Research, Journal Year: 2025, Volume and Issue: 9, P. e67171 - e67171

Published: Jan. 28, 2025

Background Parents of children treated for cancer may experience psychological difficulties including depression, anxiety, and posttraumatic stress. Digital interventions, such as internet-administered cognitive behavioral therapy, offer an accessible flexible means to support parents. However, engagement with adherence digital interventions remain a significant challenge, potentially limiting efficacy. Understanding factors influencing user is crucial enhancing the acceptability, feasibility, efficacy these interventions. We developed internet-administered, guided, low-intensity therapy (LICBT)–based self-help intervention parents cancer, (EJDeR [internetbaserad självhjälp för föräldrar till barn som avslutat en behandling mot or internet-based who have completed treatment]). EJDeR included 2 LICBT techniques—behavioral activation worry management. Subsequently, we conducted ENGAGE feasibility trial was found be acceptable feasible. rates were marginally under progression criteria. Objective This study aimed (1) describe examine whether (2) sociodemographic characteristics differed between adherers nonadherers, (3) depression anxiety scores nonadherers at baseline, (4) (5) fathers mothers. Methods performed secondary analysis data, 71 participants. User data collected through log-data tracking, example, communication e-therapists, homework submissions, log-ins, minutes working EJDeR, modules completed. Chi-square tests examined differences mothers concerning categorical data. Independent-samples t regarding continuous variables. Results Module completion higher among those worked their first module versus Of 20 opened allocated, 30% (n=6) 70% (n=14) No in found. Nonadherers allocated had significantly level symptoms baseline than adherers. other Minutes number days using written messages sent participants, total exercises submitted nonadherers. There no Conclusions Straightforward techniques, activation, well-suited delivery, more complex management, require modifications improve engagement. measured behaviorally, future research should measure emotional components Trial Registration ISRCTN Registry 57233429; https://doi.org/10.1186/ISRCTN57233429

Language: Английский

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Evaluating clinical outcomes for anxiety and depression: A real-world comparison of the digital clinic and primary care

Journal of Affective Disorders, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 1, 2025

Language: Английский

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Outcomes of transdiagnostic internet-delivered cognitive behavioural therapy tailored to public safety personnel: A longitudinal observational study

Journal of Anxiety Disorders, Journal Year: 2024, Volume and Issue: 104, P. 102861 - 102861

Published: April 12, 2024

First responders and other public safety personnel (PSP) experience high rates of mental health problems face barriers to accessing healthcare. Internet-delivered cognitive behavioural therapy (ICBT) is an effective accessible treatment for various concerns. Canadian PSP report favorable attitudes toward ICBT, preliminary outcomes demonstrate that they benefit from it. Expanding on this research, the current study consisted a longitudinal observational 560 who participated in ICBT. It was designed assess longer term effectiveness ICBT moderators by gender, linguistic occupational group, years experience. We evaluated symptom change at 8, 26, 52 weeks post-enrollment, results among had elevated clinical scores, showed large reductions (Hedges' g) symptoms depression (g = 1.3), anxiety =1.48), posttraumatic stress =1.24), panic =1.19), anger =1.07) moderate social =.48-.56). Moderator analyses revealed modest differences pre-treatment certain groups but no group over time. Clients good completion materials reported satisfaction. The suggest further tailored warranted, including evaluating countries.

Language: Английский

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The digital cumulative complexity model: a framework for improving engagement in digital mental health interventions

Frontiers in Psychiatry, Journal Year: 2024, Volume and Issue: 15

Published: Sept. 3, 2024

Mental health disorders affect a substantial portion of the global population. Despite preferences for psychotherapy, access remains limited due to various barriers. Digital mental interventions (DMHIs) have emerged increase accessibility, yet engagement and treatment completion rates are concerning. Evidence across healthcare where some degree self-management is required show that negatively influenced by contextual complexity. This article examines non-random factors influencing patient in digital face-to-face psychological therapies. It reviews established models introduces an adapted version Cumulative Complexity Model (CuCoM) as framework understanding context health. Theoretical like Fogg Behavior Model, Persuasive System Design, Self-Determination Theory, Supportive Accountability aim explain disengagement. However, none adequately consider these broader their complex interactions with personal characteristics, intervention requirements technology features. We expand on proposing application CuCoM’s contexts (known DiCuCoM), focusing interplay between burden, capacity, demands. Standardized DMHIs often fail individual variations burden leading variation. DiCuCoM highlights need balancing workload capacity improve engagement. Factors such life demands, treatment, examined influence adherence. The proposes person-centered approach informed CuCoM Minimally Disruptive Medicine, emphasizing systems acknowledge address unique burdens capacities individuals. Strategies enhancing include assessing reducing utilizing predict respond New could lead better ultimately outcomes.

Language: Английский

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Attrition in Conversational Agent–Delivered Mental Health Interventions: Systematic Review and Meta-Analysis

Journal of Medical Internet Research, Journal Year: 2023, Volume and Issue: 26, P. e48168 - e48168

Published: Dec. 4, 2023

Background Conversational agents (CAs) or chatbots are computer programs that mimic human conversation. They have the potential to improve access mental health interventions through automated, scalable, and personalized delivery of psychotherapeutic content. However, digital interventions, including those delivered by CAs, often high attrition rates. Identifying factors associated with is critical improving future clinical trials. Objective This review aims estimate overall differential rates in CA-delivered (CA interventions), evaluate impact study design intervention-related aspects on attrition, describe features aimed at reducing mitigating attrition. Methods We searched PubMed, Embase (Ovid), PsycINFO Cochrane Central Register Controlled Trials, Web Science, conducted a gray literature search Google Scholar June 2022. included randomized controlled trials compared CA against control groups excluded studies lasted for 1 session only used Wizard Oz interventions. also assessed risk bias using Risk Bias Tool 2.0. Random-effects proportional meta-analysis was applied calculate pooled dropout intervention groups. compare rate narrative summarize findings. Results The systematic retrieved 4566 records from peer-reviewed databases citation searches, which 41 (0.90%) met inclusion criteria. meta-analytic group 21.84% (95% CI 16.74%-27.36%; I2=94%). Short-term ≤8 weeks showed lower (18.05%, 95% 9.91%- 27.76%; I2=94.6%) than long-term >8 (26.59%, 20.09%-33.63%; I2=93.89%). Intervention participants were more likely attrit short-term (log odds ratio 1.22, 0.99-1.50; I2=21.89%) 1.33, 1.08-1.65; I2=49.43%). Intervention-related characteristics higher include stand-alone without support, not having symptom tracker feature, no visual representation CA, comparing waitlist controls. No participant-level factor reliably predicted Conclusions Our results indicated approximately one-fifth will drop out studies. High heterogeneities made it difficult generalize suggested should adopt blended use tracking, active controls rather controls, reduce rate. Trial Registration PROSPERO International Prospective Systematic Reviews CRD42022341415; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022341415

Language: Английский

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A qualitative interview study of patients' attitudes towards and intention to use digital interventions for depressive disorders on prescription

Frontiers in Digital Health, Journal Year: 2024, Volume and Issue: 6

Published: Feb. 5, 2024

Depressive disorders are an emerging public health topic. Due to their increasing prevalence, patients with depressive suffer from the lack of therapeutic treatment. Digital interventions may offer opportunity bridge waiting times, supplement, or even substitute in-person Among others, Unified Theory Acceptance and Use Technology (UTAUT) explains that actual technology use is affected by users' behavioural intention. However, patients' perspectives on digital rarely discussed within specific context primary care provided general practitioners (GP) need further exploration.

Language: Английский

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A national evaluation of a multi‐modal, blended, digital intervention integrated within Australian youth mental health services

Acta Psychiatrica Scandinavica, Journal Year: 2024, Volume and Issue: 151(3), P. 317 - 331

Published: Sept. 11, 2024

Youth mental health (YMH) services have been established internationally to provide timely, age-appropriate, treatment and improve long-term outcomes. However, YMH face challenges including long waiting times, limited continuity of care, time-bound support. To bridge this gap, MOST was developed as a scalable, blended, multi-modal digital platform integrating real-time asynchronous clinician-delivered counselling; interactive psychotherapeutic content; vocational support; peer support, youth-focused online community. The implementation within Australian has publicly funded. primary aim study evaluate the real-world engagement, outcomes, experience during first 32 months implementation. Young people from participating were referred into MOST. Engagement metrics derived usage. Symptom satisfaction measures collected at baseline, 6, 12 (primary endpoint) weeks. Effect sizes calculated for outcomes depression anxiety secondary psychological distress wellbeing. Five thousand seven hundred two young 262 clinics signed up used least once. had an average 19 login sessions totalling 129 min over weeks use, with 71.7% using 14 days, 40.1% weeks, 18.8% 24 There statistically significant, moderate improvement in measured by PHQ4 across all users irrespective stage (d = 0.41, 95% CI 0.35-0.46). Satisfaction levels high, 93% recommending friend. One one eighteen provided written feedback, which 68% positive 31% suggested improvement. is highly promising blended intervention potential address limitations enhance impact services.

Language: Английский

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