Internet Interventions-The Application of Information Technology in Mental and Behavioural Health最新文献

{"title":"Feasibility of online group schema therapy: A preliminary study with therapists in training for future application in borderline personality disorder","authors":"Bram van der Boom ,&nbsp;Tara Donker ,&nbsp;Derek de Beurs ,&nbsp;Arnout C. Smit ,&nbsp;Lian van der Krieke ,&nbsp;Pepijn Steures ,&nbsp;Roel Pietersen ,&nbsp;Marieke van Meeteren ,&nbsp;Arnoud Arntz ,&nbsp;Heleen Riper","doi":"10.1016/j.invent.2025.100897","DOIUrl":"10.1016/j.invent.2025.100897","url":null,"abstract":"<div><h3>Background</h3><div>Borderline personality disorder (BPD) is the most prevalent personality disorder and can significantly impair patients' functioning. Evidence-based treatments exist, but can be inaccessible due to various limitations. Internet-delivered treatment could potentially increase accessibility and scalability. Before investigating patients, we planned a pilot-test of video-conferencing group schema therapy (VC-GST) as self-therapy for therapists in training.</div></div><div><h3>Objective</h3><div>This study aimed to assess the feasibility of VC-GST for therapists in training. We hypothesised VC-GST to be a feasible intervention.</div></div><div><h3>Methods</h3><div>An uncontrolled pre-post-test feasibility study was conducted on a group of 24 therapists in training and analysed via one-sample and paired-samples <em>t</em>-tests. Feasibility was assessed through system usability, client satisfaction, group cohesion, working alliance, and drop-out rates. Furthermore, the effect of the VC-GST intervention on the participants' functioning, patterns, and personality traits was evaluated.</div></div><div><h3>Results</h3><div>VC-GST showed high usability and strong client satisfaction, with marked improvement in group cohesion and working alliance, and a drop-out rate of 4 %. Additionally, participants showed an increase in adaptive and decrease in maladaptive schemas.</div></div><div><h3>Conclusions</h3><div>This study demonstrates that VC-GST could be a feasible intervention for therapists in training, warranting further research into VC-GST for a clinical population of BPD patients.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"43 ","pages":"Article 100897"},"PeriodicalIF":4.1,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145754068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring and validating themes of the eHealth Therapeutic Alliance Inventory in digital health interventions: A qualitative analysis","authors":"Ohad Ashur ,&nbsp;Chen Rayan Saar ,&nbsp;Or Brandes ,&nbsp;Amit Baumel","doi":"10.1016/j.invent.2025.100895","DOIUrl":"10.1016/j.invent.2025.100895","url":null,"abstract":"<div><h3>Objective</h3><div>Studies indicate that users can establish a therapeutic alliance (TA) with digital health interventions. However, research examining how TA unfolds in digital settings and its unique facets compared to conventional TA remains limited. This qualitative study aimed to explore and validate preliminary quantitative findings suggesting three distinct themes unique to eHealth TA.</div></div><div><h3>Methods</h3><div>Qualitative data were collected from users of a digital parent training program aiming to explore participants' general experiences with the program. Semi-structured double-blind interviews were conducted (<em>n</em> = 16), and responses to open-ended questions from a larger sample of users were collected (<em>n</em> = 64). Data were thematically analyzed using the six-step framework outlined by Braun and Clarke.</div></div><div><h3>Results</h3><div>In the deductive thematic analysis all three eHealth TA themes were identified – Sense of Relatedness (SR), Application-Induced Accountability (AIA), and Perceived Emotional Investment (PEI), along with the three sub-themes of conventional TA (Goal, Task and Bond). Two eHealth TA themes (SR, AIA) were fully represented in participant's responses, while one (PEI) was only marginally validated. Regarding conventional TA, Goal and Task were fully represented, while Bond was only marginally validated. Validation of eHealth TA themes was further supported by the analysis of the open-ended questions.</div></div><div><h3>Conclusions</h3><div>Findings reinforce prior research, indicating that TA in digital health settings unfolds in distinct ways, and underscoring the need for further exploration of eHealth TA's unique characteristics. Additionally, the study emphasizes potential advantages of employing double-blind methodology in qualitative studies.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"42 ","pages":"Article 100895"},"PeriodicalIF":4.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145747057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Help or harm? Assessing positive and unwanted effects of a self-guided internet-based intervention for gambling problems","authors":"Lara Rolvien ,&nbsp;Duygu Sönmez ,&nbsp;Lea Schuurmans ,&nbsp;Lisa Borgmann ,&nbsp;Annika Schmüser ,&nbsp;Steffen Moritz ,&nbsp;Anna Baumeister","doi":"10.1016/j.invent.2025.100893","DOIUrl":"10.1016/j.invent.2025.100893","url":null,"abstract":"<div><h3>Background</h3><div>Self-guided internet-based interventions have been established as effective tools for reducing gambling disorder. However, research on their potential negative side effects remains limited. This study investigated both unintended positive effects, and unwanted negative effects, of the self-guided internet-based intervention ‘Restart’ for individuals with self-reported gambling problems.</div></div><div><h3>Methods</h3><div>A total of 94 participants with self-reported gambling problems were investigated for positive and unwanted effects using the Positive and Negative Effects of Psychotherapy Scale for Internet-Based Intervention (PANEPS-I) after using the internet-based intervention ‘Restart’ for six weeks.</div></div><div><h3>Results</h3><div>The findings indicate that positive effects, such as increased self-efficacy (64.8 %), were reported more frequently than unwanted effects. Nonetheless, a significant proportion of participants experienced side effects (23.9 %), alleged malpractice (38.6 %), and found procedures unethical (21.5 %). Key unwanted effects included feelings of stigmatization and blaming, experiences of excessive pressure during the intervention and perceptions of the program as overly directive or as not in line with own preferences. Positive effects but not unwanted effects significantly increased the likelihood for a positive response (Odds ratio = 1.59 <em>p</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>The findings suggest that while self-guided internet-based interventions can serve as valuable tools for individuals reluctant to seek traditional therapy, they require careful refinement to address user-specific needs and reduce adverse outcomes. Future research should focus on identifying factors that predispose individuals to positive and unwanted effects and explore intervention modifications, such as integrating optional therapeutic support or personalized content adaptations.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"42 ","pages":"Article 100893"},"PeriodicalIF":4.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A personalized online intervention to enhance back pain-related self-efficacy: A two-arm randomized controlled trial (IDRIS)","authors":"Paul Hüsing ,&nbsp;Mareike Busmann ,&nbsp;Bernd Löwe ,&nbsp;Petra Engelmann","doi":"10.1016/j.invent.2025.100892","DOIUrl":"10.1016/j.invent.2025.100892","url":null,"abstract":"<div><h3>Objective</h3><div>Low back pain (LBP) affects daily functioning and strains healthcare systems. Cognitive, behavioral, and emotional factors contribute to its persistence, yet these factors are often neglected in standard care. Personalized digital interventions containing psychoeducational information on relevant biopsychosocial aspects may thus improve outcomes when applied to patients in an early stage. This trial examined whether a brief, personalized animated psychoeducational video—tailored to individual risk profiles based on patient-reported outcome measures (PROMs) and covering biopsychosocial contributors to LBP (depression, catastrophizing, health anxiety, fear of movement, pain endurance behavior, expectations, trauma, emotion regulation)—improves pain-related self-efficacy in adults with acute and subacute low back pain (0–12 weeks).</div></div><div><h3>Methods</h3><div>In this two-arm randomized controlled trial, participants with back pain (duration &lt;12 weeks) and resulting impairment were randomized to receive either a personalized animated video (intervention) or care as usual (control). Videos comprised modules (≈2–3.5 min per module) selected from eight possible topics based on baseline PROM cut-offs. Outcomes were assessed at baseline, 4 weeks and 12 weeks. Primary analysis used mixed ANOVA to examine changes in pain-related self-efficacy (FESS) over time and between groups; secondary outcomes on biopsychosocial factors were tested with repeated measures ANOVAs and group-adjusted ANCOVAs.</div></div><div><h3>Results</h3><div>75 participants were included in the analysis. Pain-related self-efficacy improved significantly over time, F(2, 148) = 6.435, <em>p</em> = .002, but without significant group differences, F(2, 148) = 2.146, <em>p</em> = .121. Most secondary outcomes also improved (all <em>p</em> &lt; .001), except pain avoidance-endurance behavior, but analyses did not yield significant differences between intervention and control group (all <em>p</em> &gt; .05. Participants rated the intervention as credible (M = 8.36), with moderate ratings for personal fit and symptom benefit. No adverse events were reported.</div></div><div><h3>Conclusion</h3><div>Although brief exposure may have limited the impact, the intervention was well-received. Future research should explore integrating personalized psychoeducation into multimodal treatments, emphasizing the importance of individualized approaches for this diverse patient population.</div></div><div><h3>Summary</h3><div>A brief personalized online intervention improved back-pain self-efficacy, without being superior to an untreated control group. High acceptance seems promising for future multimodal use.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"42 ","pages":"Article 100892"},"PeriodicalIF":4.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adaptive actions as a mechanism of change in transdiagnostic internet-delivered cognitive behavioral therapy: Comparison with homework engagement","authors":"Heather D. Hadjistavropoulos ,&nbsp;Blake F. Dear ,&nbsp;Nickolai Titov ,&nbsp;Ram P. Sapkota","doi":"10.1016/j.invent.2025.100894","DOIUrl":"10.1016/j.invent.2025.100894","url":null,"abstract":"<div><div>Adaptive actions have been identified as potential mechanisms of change in transdiagnostic internet-delivered cognitive behavioral therapy (ICBT), but their role relative to homework engagement remains unclear. This study examined whether changes in adaptive actions are maintained at follow-up, their relationship with homework engagement, their individual and joint prediction of diverse treatment outcomes, and their role as mediators and in reciprocal relationships with outcomes. Adults (<em>N</em> = 625) received a transdiagnostic ICBT program in routine care. Outcomes included depression, generalized anxiety, posttraumatic stress, panic, social anxiety, insomnia, functional impairment, and wellbeing. Adaptive actions were assessed with the Things You Do Questionnaire–15 Item (TYDQ–15) and homework engagement with the Homework Reflection Questionnaire (HWRQ). TYDQ–15 scores improved from pre- to post-treatment and were maintained at follow-up. Although correlated, mid-treatment TYDQ–15 scores more consistently predicted outcomes than homework engagement and partially mediated changes across all assessed outcomes. Reciprocal analyses revealed bidirectional relationships between adaptive actions and anxiety and wellbeing, and partially bidirectional associations with depression. Overall, mid-treatment adaptive actions emerged as a stronger and more consistent mechanism of change than homework engagement across diverse outcomes. Findings underscore the importance of research on the benefits of encouraging adaptive actions early in treatment.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"42 ","pages":"Article 100894"},"PeriodicalIF":4.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internet-delivered cognitive behavioral therapy versus standard information brochures in advanced cancer caregivers: randomized controlled trial","authors":"Yamin Guo","doi":"10.1016/j.invent.2025.100891","DOIUrl":"10.1016/j.invent.2025.100891","url":null,"abstract":"<div><h3>Background</h3><div>Cancer caregiving is associated with elevated psychological burden, yet scalable interventions remain limited. This randomized controlled trial evaluated a therapist-guided, internet-delivered cognitive behavioral therapy program versus standardized information brochures in informal caregivers of patients with advanced cancer, with caregiver burden specified as the primary outcome and anxiety, depression, and caregiver self-efficacy as secondary outcomes.</div></div><div><h3>Methods</h3><div>A parallel two-arm randomized controlled trial was conducted among 200 informal caregivers, randomized to either the cognitive-behavioral therapy intervention (<em>n</em> = 100) or the control (n = 100). The intervention comprised an 8-week online cognitive behavioral therapy program supervised by licensed therapists. Primary (caregiver burden) and secondary (anxiety, depression, and caregiver self-efficacy) outcomes were measured using the Zarit Burden Interview–22 caregiver burden scale, the Generalized Anxiety Disorder–7 anxiety scale, the Patient Health Questionnaire–9 depression scale, and the Caregiver Self-Efficacy Scale, administered at baseline, week 4, and week 8. Analyses used linear mixed-effects models with intention-to-treat and sensitivity analyses.</div></div><div><h3>Results</h3><div>At week 8, caregiver burden decreased by −11.6 ± 6.2 in the internet-delivered cognitive behavioral therapy group versus −2.1 ± 5.9 in the control group (<em>p</em> = 0.027; Cohen's d = 1.35); anxiety decreased by −5.2 versus −0.8 (<em>p</em> = 0.009; d = 1.40); depression decreased by −6.4 versus −1.2 (<em>p</em> = 0.008; d = 1.42); and caregiver self-efficacy increased by +21.9 versus +2.9 (<em>p</em> = 0.021; d = 1.44). A clinical reduction in caregiver burden occurred in 67.0 % of participants in the internet-delivered cognitive-behavioral therapy group, compared with 19.0 % in the control group (odds ratio 8.60; <em>p</em> = 0.005).</div></div><div><h3>Conclusion</h3><div>In this randomized trial, internet-delivered CBT produced greater improvements than information brochures in caregiver burden (primary outcome) and in anxiety, depression, and self-efficacy over 8 weeks.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"42 ","pages":"Article 100891"},"PeriodicalIF":4.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Five years of app evaluation: Insights from a framework in practice – a systematic review on the m-health index and navigation database","authors":"Julian Herpertz ,&nbsp;Bridget Dwyer ,&nbsp;Ellen Wagner ,&nbsp;Jane Mikkelson ,&nbsp;Nils Opel ,&nbsp;John Torous","doi":"10.1016/j.invent.2025.100888","DOIUrl":"10.1016/j.invent.2025.100888","url":null,"abstract":"<div><h3>Introduction</h3><div>As the number of health apps continues to rise, concerns about their quality, privacy standards, and adherence to evidence-based healthcare remain. While multiple frameworks exist to assess app quality, a standardized, cross-domain approach is lacking. The M-Health Index and Navigation Database (MIND) comprises a structured framework for app evaluation and a publicly accessible database that applies this framework to rate individual apps. This allows for longitudinal tracking of quality metrics and comparisons across different health app categories.</div></div><div><h3>Methods</h3><div>We conducted a systematic review to identify studies that utilized either the MIND database or its framework to evaluate health apps. Studies were included if they used MIND in their methodology to evaluate health apps. Data were synthesized descriptively, and two-proportion z-tests were applied for comparisons.</div></div><div><h3>Results</h3><div>We identified 22 studies, including 16 evaluating commercially available health apps. The most frequently assessed metrics were privacy policies, operating system compatibility, cost, and evidence backing. Only 15 % of mental health apps were supported by feasibility or efficacy studies, nearly one-fourth lacked a privacy policy, and 44 % explicitly disclosed sharing personal health information with third parties. Similar deficiencies were found across non-mental health domains, indicating that concerns regarding app quality and data privacy may not be unique to mental health.</div></div><div><h3>Discussion</h3><div>Our findings suggest that evidence and privacy concerns are prevalent across almost all health app categories, highlighting the need for stronger regulatory oversight and improved validation standards. MIND serves as a valuable tool for evaluating digital health apps, supporting both app selection and cross-domain quality comparisons.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"42 ","pages":"Article 100888"},"PeriodicalIF":4.1,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives of patients, caregivers, and healthcare providers on how the Heart@Home mobile application improves self-management in heart failure care: A qualitative study","authors":"Alicha Chumintrachark ,&nbsp;Kanokporn Pinyopornpanish ,&nbsp;Chanchanok Aramrat ,&nbsp;Chutamas Pairoj ,&nbsp;Nida Buawangpong ,&nbsp;Suphawita Pliannuom ,&nbsp;Sarapee Seesopon ,&nbsp;Mesaya Khangtanyakit ,&nbsp;Nopakoon Nantsupawat ,&nbsp;Wichuda Jiraporncharoen ,&nbsp;Chaisiri Angkurawaranon ,&nbsp;Arintaya Phrommintikul","doi":"10.1016/j.invent.2025.100890","DOIUrl":"10.1016/j.invent.2025.100890","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to investigate the perspectives of patients, caregivers, and healthcare providers on how the Heart@Home application improves self-management following a two-week period of usage and how to improve the application for further utilization.</div></div><div><h3>Methods</h3><div>This qualitative study used a case study approach. We conducted semi-structured in-depth interviews with patients, caregivers, and healthcare providers and evaluated patients' quality of life before and after using the application. Purposeful sampling was employed, and thematic analysis was performed for qualitative data analysis.</div></div><div><h3>Result</h3><div>Nine patients, seven caregivers, and two healthcare providers were included in the analysis. The potential benefits for health behavior modification were noted through several mechanisms, including increasing self-awareness of patient's current health status, guide for managing symptoms related to health status changes, and providing emotional assessment, reassurance and a sense of being cared for. In addition, more function in application is needed to increase engagement with application usage. Although the pre-post pilot analysis shows no statistically significant changes in participants' quality of life, as measured by the EQ-5D questionnaire, promising trends were observed in the domains of self-management and daily activity.</div></div><div><h3>Conclusion</h3><div>The Heart@Home mobile application shows promise in promoting self-management and behavior modification among heart failure patients. Future development should focus on improving technical stability, incorporating personalized feedback, and enabling direct messaging with healthcare providers to enhance the application's effectiveness in managing heart failure.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"42 ","pages":"Article 100890"},"PeriodicalIF":4.1,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid relief online: A randomized trial of a single-session simple-swift reconstruction approach group during the COVID-19 surge","authors":"Junkai Yang ,&nbsp;Yao Chen ,&nbsp;Yin Fan ,&nbsp;Yunge Bai ,&nbsp;Zhang Lin ,&nbsp;Huajian Li ,&nbsp;Shuangge Sui","doi":"10.1016/j.invent.2025.100889","DOIUrl":"10.1016/j.invent.2025.100889","url":null,"abstract":"<div><h3>Background</h3><div>Large-scale crises require brief, scalable, on-line mental-health interventions. We examined the effectiveness of a single 90–120 min videoconference group based on the Simple-Swift Reconstruction Approach (SSRA).</div></div><div><h3>Methods</h3><div>In a parallel-group randomized trial, 277 Chinese adults were assigned to SSRA (<em>n</em> = 143) or a waiting-list control (<em>n</em> = 134). Baseline and 2-week outcomes were the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and General Self-Efficacy Scale (GSES). The SSRA group also completed Subjective Units of Disturbance (SUD) ratings immediately before and after the session. Complete-case analyses used paired and independent <em>t</em>-tests with Cohen's <em>d</em> (two-tailed α = 0.05).</div></div><div><h3>Results</h3><div>One hundred twenty-one SSRA participants (19 % male; <em>M</em> = 34.9 years, <em>SD</em> = 11.3) attended the SSRA session and showed a large within-session SUD reduction (baseline <em>M</em> = 5.81, <em>SD</em> = 1.62; post <em>M</em> = 3.20, <em>SD</em> = 1.57; <em>t</em>(120) = 19.26, <em>p</em> &lt; .001, <em>d</em> = 1.75). Two-week follow-up data were available for 71 SSRA and 19 control participants (retention = 32.5 %). Within the SSRA group, depressive symptoms (Δ = −2.14, <em>d</em> = 0.63), anxiety (Δ = −1.89, <em>d</em> = 0.66), and self-efficacy (Δ = +2.28, <em>d</em> = 0.41) improved descriptively. However, only the between-group difference for depression (PHQ-9) reached significance (<em>t</em>(24.7) = −2.60, <em>p</em> = .015, <em>d</em> = 0.76); between-group GAD-7 and GSES were nonsignificant. Age and sex did not moderate outcomes.</div></div><div><h3>Conclusions</h3><div>A one-off, on-line SSRA group produced a large within-session reduction in subjective distress and a significant between-group improvement in depressive symptoms over two weeks, supporting SSRA as a rapid, low-intensity option during public-health emergencies. Replication with larger samples and longer follow-up is recommended.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"42 ","pages":"Article 100889"},"PeriodicalIF":4.1,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness and cost-utility of a therapist-guided online intervention provided soon after trauma: Results from a randomized controlled trial","authors":"Maria Bragesjö ,&nbsp;Filip K. Arnberg ,&nbsp;Erik Andersson","doi":"10.1016/j.invent.2025.100886","DOIUrl":"10.1016/j.invent.2025.100886","url":null,"abstract":"<div><div>This study evaluated the cost-effectiveness and cost-utility of a therapist-guided, internet-delivered early intervention for trauma. Exposure to traumatic events is common and can lead to substantial psychological distress, functional impairment, and societal costs. Early psychological interventions have the potential to mitigate these effects. We developed Condensed Internet-delivered Prolonged Exposure (CIPE), a digital intervention delivered within two months of trauma exposure. In a randomized controlled trial (<em>N</em> = 102), CIPE was more effective than a waiting-list control in reducing post-traumatic stress symptoms at post-intervention (3 weeks) and at a prespecified 7-week follow-up while the waiting-list control remained intact (prior to crossover). In this study, we evaluated CIPE from a societal cost perspective, aggregating direct medical costs (healthcare contacts, medication) and indirect costs (sick leave, reduced productivity, domestic loss) with equal weight in total cost calculations using a self-report questionnaire. Cost-effectiveness was assessed using responder status (≥10-point symptom reduction) and subthreshold symptom status on the PTSD Checklist for DSM-5. Cost-utility was assessed using quality-adjusted life years (QALYs) from the EQ-5D. Incremental cost-effectiveness ratios (ICERs) were estimated using bootstrapped regression analyses and visualized in cost-effectiveness planes and acceptability curves. CIPE showed a 95 % probability of being cost-effective at a willingness-to-pay threshold of €939–1181 per additional responder or subthreshold case. The corresponding cost per QALY gained was €2929–3636. Effects were sustained at 12-month follow-up. These findings suggest that therapist-guided digital exposure therapy delivered soon after trauma can reduce symptoms at a relatively low cost to society. Future research should examine CIPE's long-term economic impact and potential for broader implementation.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"42 ","pages":"Article 100886"},"PeriodicalIF":4.1,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}