Pub Date : 2025-02-18DOI: 10.1016/j.invent.2025.100815
Ece Atik , Silvan Hornstein , Elisabeth Reinking , Magnus Schückes
Blended cognitive behavioral therapy (bCBT), which involves the use of a digital application to support face-to-face psychotherapy, is increasingly offered to patients with depression amid a growing body of research on its efficacy. However, there is still limited understanding of the factors that influence the efficacy of this novel treatment method. To investigate the effects of potential factors such as patient satisfaction with the received treatment, patients' self-rated working alliance with their therapist, and patients' rating of system usability of the digital application, this secondary analysis study focused on a sample of 66 university students who completed an effective 6-week bCBT program that included weekly sessions with a therapist and access to a digital mental health application. We examined whether those three potential factors predict patients' improvement in depressive symptoms in a bCBT treatment. Patient satisfaction and working alliance are known predictors of treatment success in standard psychotherapy, yet their importance in blended treatment is largely unstudied. System usability is a factor that is frequently addressed while describing digital treatment programs, yet its contribution to the success of treatments has been mostly omitted. All the variables analyzed displayed a significant positive correlation with improvement in depressive symptoms. When taken together, all the factors account for 16.6 % of the variance in the outcome. However, when three variables were added in the backward multiple linear regression with stepwise elimination, only patient satisfaction emerged as a predictor of the outcome. Although there are significant correlations between working alliance and system usability and the improvement of depression in the bCBT program, their lack of predictive power in comparison to patient satisfaction renders the results inconclusive. Future studies could explore the potential contribution of additional variables to the improvement of depressive symptoms.
{"title":"Influence of patient satisfaction, system usability, and working alliance on depressive symptom improvement in blended cognitive behavioral therapy (bCBT): Secondary analysis of an open trial data","authors":"Ece Atik , Silvan Hornstein , Elisabeth Reinking , Magnus Schückes","doi":"10.1016/j.invent.2025.100815","DOIUrl":"10.1016/j.invent.2025.100815","url":null,"abstract":"<div><div>Blended cognitive behavioral therapy (bCBT), which involves the use of a digital application to support face-to-face psychotherapy, is increasingly offered to patients with depression amid a growing body of research on its efficacy. However, there is still limited understanding of the factors that influence the efficacy of this novel treatment method. To investigate the effects of potential factors such as patient satisfaction with the received treatment, patients' self-rated working alliance with their therapist, and patients' rating of system usability of the digital application, this secondary analysis study focused on a sample of 66 university students who completed an effective 6-week bCBT program that included weekly sessions with a therapist and access to a digital mental health application. We examined whether those three potential factors predict patients' improvement in depressive symptoms in a bCBT treatment. Patient satisfaction and working alliance are known predictors of treatment success in standard psychotherapy, yet their importance in blended treatment is largely unstudied. System usability is a factor that is frequently addressed while describing digital treatment programs, yet its contribution to the success of treatments has been mostly omitted. All the variables analyzed displayed a significant positive correlation with improvement in depressive symptoms. When taken together, all the factors account for 16.6 % of the variance in the outcome. However, when three variables were added in the backward multiple linear regression with stepwise elimination, only patient satisfaction emerged as a predictor of the outcome. Although there are significant correlations between working alliance and system usability and the improvement of depression in the bCBT program, their lack of predictive power in comparison to patient satisfaction renders the results inconclusive. Future studies could explore the potential contribution of additional variables to the improvement of depressive symptoms.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"39 ","pages":"Article 100815"},"PeriodicalIF":3.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-12DOI: 10.1016/j.invent.2025.100809
H.D. Hadjistavropoulos , V. Peynenburg , R.P. Sapkota , E. Valli , M. Nugent , M.T. Keough , C. Sundström , M.P. Schaub , N. Titov , B.F. Dear
Background
Additional resources and stories are sometimes incorporated into Internet-delivered cognitive behaviour therapy (ICBT) for alcohol misuse to enhance treatment. Little is known, however, about how patients use and evaluate additional resources and stories, and how use and evaluation of additional resources and stories relates to satisfaction and outcomes.
Methods
We examined patient use and evaluation of 8 additional resources and 8 stories among 121 patients who endorsed significant alcohol misuse and were enrolled in a 6-lesson ICBT course for alcohol misuse enhanced with additional resources and stories. The additional resources addressed anger, assertiveness and communication, cannabis use, cognitive coping, grief, PTSD, sleep, and worry. Stories varied by gender, ethnicity, occupation, and severity of alcohol problems. Primary drinking outcomes included the Timeline Follow-Back (TLFB) and heavy drinking days (HDD). Diverse secondary outcomes (e.g., depression, anxiety, cravings, anger, satisfaction) were also assessed.
Results
Large within-group effects for TLFB and HDD were found. Large effects were also observed for depression and cravings, with high treatment satisfaction. 63 % of patients accessed at least one resource (M = 2.27 resources), with anger (35 %), cognitive coping (35 %), sleep (34 %) and worry (30 %) being the most used. When accessed, patients found resources informative and/or helpful to varying degrees (25–67 %). In terms of stories, 85 % of patients indicated they read the stories, and 89 % of those found them worthwhile; 65 % felt less alone and 55 % found they gave them skills to improve wellbeing. Increased use and positive ratings of additional resources were not significantly related to outcomes or satisfaction. However, positive ratings of stories were associated with confidence in managing symptoms and an interest in future treatment. Additionally, reading stories was associated with larger improvements on several secondary outcomes, including PTSD, anger, insomnia, and work and social adjustment.
Conclusions
The findings suggest that adding resources and stories to ICBT is acceptable and worthwhile. A significant number of patients reviewed these materials and found them informative and/or helpful, which suggests it is likely valuable to retain these resources for those in need. Reading stories and positive ratings of stories, rather than use and positive ratings of additional resources, was associated with increased satisfaction and some larger improvements on secondary outcomes. Further research is warranted to identify strategies that will more effectively engage patients with additional resources tailored to their specific needs.
{"title":"Evaluation of additional resources and stories within therapist-assisted internet-delivered cognitive behaviour therapy for alcohol misuse","authors":"H.D. Hadjistavropoulos , V. Peynenburg , R.P. Sapkota , E. Valli , M. Nugent , M.T. Keough , C. Sundström , M.P. Schaub , N. Titov , B.F. Dear","doi":"10.1016/j.invent.2025.100809","DOIUrl":"10.1016/j.invent.2025.100809","url":null,"abstract":"<div><h3>Background</h3><div>Additional resources and stories are sometimes incorporated into Internet-delivered cognitive behaviour therapy (ICBT) for alcohol misuse to enhance treatment. Little is known, however, about how patients use and evaluate additional resources and stories, and how use and evaluation of additional resources and stories relates to satisfaction and outcomes.</div></div><div><h3>Methods</h3><div>We examined patient use and evaluation of 8 additional resources and 8 stories among 121 patients who endorsed significant alcohol misuse and were enrolled in a 6-lesson ICBT course for alcohol misuse enhanced with additional resources and stories. The additional resources addressed anger, assertiveness and communication, cannabis use, cognitive coping, grief, PTSD, sleep, and worry. Stories varied by gender, ethnicity, occupation, and severity of alcohol problems. Primary drinking outcomes included the Timeline Follow-Back (TLFB) and heavy drinking days (HDD). Diverse secondary outcomes (e.g., depression, anxiety, cravings, anger, satisfaction) were also assessed.</div></div><div><h3>Results</h3><div>Large within-group effects for TLFB and HDD were found. Large effects were also observed for depression and cravings, with high treatment satisfaction. 63 % of patients accessed at least one resource (<em>M</em> = 2.27 resources), with anger (35 %), cognitive coping (35 %), sleep (34 %) and worry (30 %) being the most used. When accessed, patients found resources informative and/or helpful to varying degrees (25–67 %). In terms of stories, 85 % of patients indicated they read the stories, and 89 % of those found them worthwhile; 65 % felt less alone and 55 % found they gave them skills to improve wellbeing. Increased use and positive ratings of additional resources were not significantly related to outcomes or satisfaction. However, positive ratings of stories were associated with confidence in managing symptoms and an interest in future treatment. Additionally, reading stories was associated with larger improvements on several secondary outcomes, including PTSD, anger, insomnia, and work and social adjustment.</div></div><div><h3>Conclusions</h3><div>The findings suggest that adding resources and stories to ICBT is acceptable and worthwhile. A significant number of patients reviewed these materials and found them informative and/or helpful, which suggests it is likely valuable to retain these resources for those in need. Reading stories and positive ratings of stories, rather than use and positive ratings of additional resources, was associated with increased satisfaction and some larger improvements on secondary outcomes. Further research is warranted to identify strategies that will more effectively engage patients with additional resources tailored to their specific needs.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"39 ","pages":"Article 100809"},"PeriodicalIF":3.6,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143388229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-08DOI: 10.1016/j.invent.2025.100811
Rocio Herrero , Marvin Franke , Dennis Görlich , Azucena Garcia-Palacios , Rosa Baños , Corinna Jacobi , Thomas Berger , Michael P. Schaub , Tobias Krieger , David D. Ebert , Cristina Botella
<div><div>The college stage is marked by high prevalence of mental disorders, particularly anxiety, low mood, and substance abuse. Despite this, many affected students do not receive treatment, underscoring the need for preventive strategies. In respose, the CORE program, an internet-based intervention, was developed to enhance resilience and coping skills among college students. The present study, part of the ICare project (EU-634757), aims to assess the effectiveness of the CORE intervention in improving resilience and reducing symptoms of anxiety and depression in comparison to a Waiting List (WL) condition. The study was registered at ISRCTN (<u>ISRCTN13856522</u>).</div><div>In the study the unguided internet-based intervention (CORE) was compared to a WL control group in a multicenter two-arm, single-blind, randomized controlled trial (RCT) conducted in Spain, Germany, and Switzerland. Questionnaire based evaluations occurred at baseline (BL), 8 weeks (post-intervention), 6 and 12 months after randomization. A total of 493 students with low levels of resilience participated in the study.</div><div>Participants in the intervention group gained access to an internet-based program aiming to enhance resilience by learning to cope with stressors in daily life, promote self-empowerment, and improve well-being. Participants were instructed to engage in six interactive modules delivered weekly in a sequential order. The program's therapeutic content was developed following the Ryff model of well-being.</div><div>The primary outcome measure used was the Connor-Davidson Resilience Scale (CD-RISC-25). Additionally, anxiety and depressive symptomatology, coping strategies, and well-being were measured. Participants in the CORE condition reported a significant increase in resilience compared to WL condition (Differences post-BL: d = 0.34, <em>p</em> = .0005; 6 M-BL: d = 0.24, <em>p</em> = .0171; 12 M-BL: d = 0.33, <em>p</em> = .0031). Although, a general time trend towards improvement in the resilience was observed in both groups. Participants in the CORE condition, compared to those in the WL condition, showed a significant reduction in anxiety symptoms in the short and long term (differences post-BL: d = 0.30, <em>p</em> = .0015; 6 M-BL: d = 0.18, <em>p</em> = .0857; 12 M-BL: d = 0.23, <em>p</em> = .0312) and depression in the short term. Furthermore, participants in CORE condition showed a significant improvement in positive functioning measurements, such as well-being and self-compassion compared to WL condition. (Differences post-BL: d = 0.25, <em>p</em> = .0123; 6 M-BL: d = 0.16, <em>p</em> = .1505; 12 M-BL: d = 0.13, <em>p</em> = .1835).</div><div>Adherence to fully complete the intervention was approximately 59 %.</div><div>In conclusion, our study revealed promising outcomes for the CORE program, indicating its efficacy. These results position the CORE program as a valuable and validated tool in fostering resilience, offering promising ways for
{"title":"Efficacy of the internet-based intervention “Cultivating our resilience” (CORE) for improving resilience and coping strategies in university students: A randomized controlled trial","authors":"Rocio Herrero , Marvin Franke , Dennis Görlich , Azucena Garcia-Palacios , Rosa Baños , Corinna Jacobi , Thomas Berger , Michael P. Schaub , Tobias Krieger , David D. Ebert , Cristina Botella","doi":"10.1016/j.invent.2025.100811","DOIUrl":"10.1016/j.invent.2025.100811","url":null,"abstract":"<div><div>The college stage is marked by high prevalence of mental disorders, particularly anxiety, low mood, and substance abuse. Despite this, many affected students do not receive treatment, underscoring the need for preventive strategies. In respose, the CORE program, an internet-based intervention, was developed to enhance resilience and coping skills among college students. The present study, part of the ICare project (EU-634757), aims to assess the effectiveness of the CORE intervention in improving resilience and reducing symptoms of anxiety and depression in comparison to a Waiting List (WL) condition. The study was registered at ISRCTN (<u>ISRCTN13856522</u>).</div><div>In the study the unguided internet-based intervention (CORE) was compared to a WL control group in a multicenter two-arm, single-blind, randomized controlled trial (RCT) conducted in Spain, Germany, and Switzerland. Questionnaire based evaluations occurred at baseline (BL), 8 weeks (post-intervention), 6 and 12 months after randomization. A total of 493 students with low levels of resilience participated in the study.</div><div>Participants in the intervention group gained access to an internet-based program aiming to enhance resilience by learning to cope with stressors in daily life, promote self-empowerment, and improve well-being. Participants were instructed to engage in six interactive modules delivered weekly in a sequential order. The program's therapeutic content was developed following the Ryff model of well-being.</div><div>The primary outcome measure used was the Connor-Davidson Resilience Scale (CD-RISC-25). Additionally, anxiety and depressive symptomatology, coping strategies, and well-being were measured. Participants in the CORE condition reported a significant increase in resilience compared to WL condition (Differences post-BL: d = 0.34, <em>p</em> = .0005; 6 M-BL: d = 0.24, <em>p</em> = .0171; 12 M-BL: d = 0.33, <em>p</em> = .0031). Although, a general time trend towards improvement in the resilience was observed in both groups. Participants in the CORE condition, compared to those in the WL condition, showed a significant reduction in anxiety symptoms in the short and long term (differences post-BL: d = 0.30, <em>p</em> = .0015; 6 M-BL: d = 0.18, <em>p</em> = .0857; 12 M-BL: d = 0.23, <em>p</em> = .0312) and depression in the short term. Furthermore, participants in CORE condition showed a significant improvement in positive functioning measurements, such as well-being and self-compassion compared to WL condition. (Differences post-BL: d = 0.25, <em>p</em> = .0123; 6 M-BL: d = 0.16, <em>p</em> = .1505; 12 M-BL: d = 0.13, <em>p</em> = .1835).</div><div>Adherence to fully complete the intervention was approximately 59 %.</div><div>In conclusion, our study revealed promising outcomes for the CORE program, indicating its efficacy. These results position the CORE program as a valuable and validated tool in fostering resilience, offering promising ways for","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"39 ","pages":"Article 100811"},"PeriodicalIF":3.6,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143348790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-08DOI: 10.1016/j.invent.2025.100813
Vanessa Fournier , France Talbot , Heather D. Hadjistavropoulos , Nickolai Titov , Blake Dear , Rino Lang , Valérie Saulnier , Hugo Hébert , Gabrielle Cloutier
{"title":"Pragmatic clinical trial of two bilingual therapist-guided transdiagnostic iCBT programs for anxiety and depression in outpatient clinics in Canada","authors":"Vanessa Fournier , France Talbot , Heather D. Hadjistavropoulos , Nickolai Titov , Blake Dear , Rino Lang , Valérie Saulnier , Hugo Hébert , Gabrielle Cloutier","doi":"10.1016/j.invent.2025.100813","DOIUrl":"10.1016/j.invent.2025.100813","url":null,"abstract":"","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"39 ","pages":"Article 100813"},"PeriodicalIF":3.6,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143388443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
With the aim of universal prevention, there is still a lack of non-clinician-led or self-help interventions designed for the general population experiencing psychological distress. This study aims to address this gap by exploring a convenient, single-session, and effective method for reducing anxiety using ChatGPT feedback. Using a mixed-factorial experimental design, we recruited 98 participants online to compare changes in self-compassion and anxiety before and after the intervention among three groups: self-compassion writing with ChatGPT feedback (Experimental Group 1), self-compassion writing alone (Experimental Group 2), and an Active Control Group. Results showed that both Experimental Group 1 and 2 experienced significant increases in self-compassion and Experimental Group 1 experienced significant decreases in anxiety after the intervention, with Experimental Group 1 showing greater improvements. There were no significant changes in the control group. This study demonstrates that single online self-compassion writing intervention can effectively reduce anxiety and that using ChatGPT to provide highly empathetic feedback can enhance the effectiveness, making psychological support more accessible, cost-effective, and suitable for the general population.
{"title":"Single online self-compassion writing intervention reduces anxiety: With the feedback of ChatGPT","authors":"Tomoko Kishimoto , Ximing Hao , Trimble Chang , Zhiye Luo","doi":"10.1016/j.invent.2025.100810","DOIUrl":"10.1016/j.invent.2025.100810","url":null,"abstract":"<div><div>With the aim of universal prevention, there is still a lack of non-clinician-led or self-help interventions designed for the general population experiencing psychological distress. This study aims to address this gap by exploring a convenient, single-session, and effective method for reducing anxiety using ChatGPT feedback. Using a mixed-factorial experimental design, we recruited 98 participants online to compare changes in self-compassion and anxiety before and after the intervention among three groups: self-compassion writing with ChatGPT feedback (Experimental Group 1), self-compassion writing alone (Experimental Group 2), and an Active Control Group. Results showed that both Experimental Group 1 and 2 experienced significant increases in self-compassion and Experimental Group 1 experienced significant decreases in anxiety after the intervention, with Experimental Group 1 showing greater improvements. There were no significant changes in the control group. This study demonstrates that single online self-compassion writing intervention can effectively reduce anxiety and that using ChatGPT to provide highly empathetic feedback can enhance the effectiveness, making psychological support more accessible, cost-effective, and suitable for the general population.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"39 ","pages":"Article 100810"},"PeriodicalIF":3.6,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143348789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-06DOI: 10.1016/j.invent.2025.100812
Jorge Grimaldos , Sara Fernández-Buendía , Juana Bretón-López , Clara Miguel , Pim Cuijpers , Soledad Quero
Numerous controlled trials have been conducted to evaluate the effectiveness of virtual reality (VR) in exposure treatment for different anxiety disorders. Additionally, several meta-analyses focusing on VR studies are now available. In contrast, the number of studies that focus exclusively on augmented reality (AR) is smaller, and, to the best of our knowledge, there are currently no systematic reviews or meta-analyses available on this topic. The aim of this work is to conduct a systematic review focused exclusively on studies that evaluate the effectiveness of AR in the exposure treatment of anxiety and related disorders. Systematic searches were carried out in PubMed, PsycINFO, and Embase in January 2025. After the screening of 622 references, thirteen studies were included, twelve of which focused on phobic disorders. Overall, the results of the included studies are promising for the use of AR for conducting the exposure treatment, especially for specific phobias. Furthermore, AR achieved high satisfaction rates and was perceived as less aversive than in vivo exposure based on participants' experiences. However, some limitations should be noted regarding the state of this field of research, especially regarding the small number of included articles and the lack of sufficient RCTs to draw firm conclusions about the efficacy of AR, highlighting the need for further research in this field.
{"title":"Augmented reality exposure treatments in anxiety and related disorders: A systematic review","authors":"Jorge Grimaldos , Sara Fernández-Buendía , Juana Bretón-López , Clara Miguel , Pim Cuijpers , Soledad Quero","doi":"10.1016/j.invent.2025.100812","DOIUrl":"10.1016/j.invent.2025.100812","url":null,"abstract":"<div><div>Numerous controlled trials have been conducted to evaluate the effectiveness of virtual reality (VR) in exposure treatment for different anxiety disorders. Additionally, several meta-analyses focusing on VR studies are now available. In contrast, the number of studies that focus exclusively on augmented reality (AR) is smaller, and, to the best of our knowledge, there are currently no systematic reviews or meta-analyses available on this topic. The aim of this work is to conduct a systematic review focused exclusively on studies that evaluate the effectiveness of AR in the exposure treatment of anxiety and related disorders. Systematic searches were carried out in PubMed, PsycINFO, and Embase in January 2025. After the screening of 622 references, thirteen studies were included, twelve of which focused on phobic disorders. Overall, the results of the included studies are promising for the use of AR for conducting the exposure treatment, especially for specific phobias. Furthermore, AR achieved high satisfaction rates and was perceived as less aversive than in vivo exposure based on participants' experiences. However, some limitations should be noted regarding the state of this field of research, especially regarding the small number of included articles and the lack of sufficient RCTs to draw firm conclusions about the efficacy of AR, highlighting the need for further research in this field.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"39 ","pages":"Article 100812"},"PeriodicalIF":3.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143276976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-04DOI: 10.1016/j.invent.2025.100807
Christina Seery , Rachel Hannah Cochrane , Martha Mulcahy , Ken Kilbride , Margo Wrigley , Jessica Bramham
Objective
Smartphone apps have the potential to be accessible tools to provide psychoeducation for adults with Attention-Deficit/Hyperactivity Disorder (ADHD). The Adult ADHD App aims to provide psychoeducation about ADHD and supports available in Ireland. The present study aimed to investigate acceptability and user engagement of the Adult ADHD App by auditing real-world use data and gaining qualitative feedback from app users.
Methods
App analytical data was audited from the Google Analytics platform. Fourteen app-users, nine of whom identified as women and five as men, with an age range of 26–65 (M = 40.29, SD = 11.14), participated in semi-structured interviews. Reflexive thematic analysis was employed to develop themes on app-users' experiences.
Results
The audit of app analytics indicated that over a period of one year, 12,000 people actively used the app and 6400 users returned after their initial use. We developed four themes from the interviews: ‘An evidence-based tool for understanding adult ADHD’ highlighted that the Adult ADHD App provides trustworthy psychoeducation on ADHD. ‘Recommendations for ADHD-friendly adaptations’ identified modifications to improve usability of the app. ‘Meeting the needs of different stages in the ADHD journey’ showed that while the app significantly benefitted adults new to their ADHD, adults who were familiar with their ADHD sought an app that would help them in moments of challenge. ‘Perception of public services impacts app experience’ suggested that people's attitudes and experiences of the public health system in Ireland affected their views of app content.
Conclusion
The Adult ADHD App appears to meet its aims of providing psychoeducation on adult ADHD. Elements can be modified to improve usability. Digital health tools created by public health organisations should consider how people's previous experiences with healthcare services can impact how they perceive the information in the tools.
{"title":"“A one-stop shop”: Real-world use and app-users' experiences of a psychoeducational smartphone app for adults with ADHD","authors":"Christina Seery , Rachel Hannah Cochrane , Martha Mulcahy , Ken Kilbride , Margo Wrigley , Jessica Bramham","doi":"10.1016/j.invent.2025.100807","DOIUrl":"10.1016/j.invent.2025.100807","url":null,"abstract":"<div><h3>Objective</h3><div>Smartphone apps have the potential to be accessible tools to provide psychoeducation for adults with Attention-Deficit/Hyperactivity Disorder (ADHD). The Adult ADHD App aims to provide psychoeducation about ADHD and supports available in Ireland. The present study aimed to investigate acceptability and user engagement of the Adult ADHD App by auditing real-world use data and gaining qualitative feedback from app users.</div></div><div><h3>Methods</h3><div>App analytical data was audited from the Google Analytics platform. Fourteen app-users, nine of whom identified as women and five as men, with an age range of 26–65 (<em>M</em> = 40.29, <em>SD</em> = 11.14), participated in semi-structured interviews. Reflexive thematic analysis was employed to develop themes on app-users' experiences.</div></div><div><h3>Results</h3><div>The audit of app analytics indicated that over a period of one year, 12,000 people actively used the app and 6400 users returned after their initial use. We developed four themes from the interviews: ‘An evidence-based tool for understanding adult ADHD’ highlighted that the Adult ADHD App provides trustworthy psychoeducation on ADHD. ‘Recommendations for ADHD-friendly adaptations’ identified modifications to improve usability of the app. ‘Meeting the needs of different stages in the ADHD journey’ showed that while the app significantly benefitted adults new to their ADHD, adults who were familiar with their ADHD sought an app that would help them in moments of challenge. ‘Perception of public services impacts app experience’ suggested that people's attitudes and experiences of the public health system in Ireland affected their views of app content.</div></div><div><h3>Conclusion</h3><div>The Adult ADHD App appears to meet its aims of providing psychoeducation on adult ADHD. Elements can be modified to improve usability. Digital health tools created by public health organisations should consider how people's previous experiences with healthcare services can impact how they perceive the information in the tools.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"39 ","pages":"Article 100807"},"PeriodicalIF":3.6,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143276848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-04DOI: 10.1016/j.invent.2025.100806
Linwei He , Erkan Basar , Reinout W. Wiers , Marjolijn L. Antheunis , Emiel Krahmer
Background
Cigarette smoking poses a major public health risk, requiring scalable and accessible interventions. Chatbots offer a promising solution, given their potential in providing personalized, long-term interactions. Despite their promise, limited research has examined their efficacy and the intertwined relationship between user experience and effectiveness over an extended period of time.
Methods
In this prospective, single-arm study, we developed and evaluated Roby, a 5-session chatbot intervention incorporating motivational interviewing and cognitive behavioral therapy to help smokers quit. Roby engaged Dutch adult smokers (N = 102) in conversations covering topics such as setting a quit date, managing withdrawal and cravings, and relapse prevention. The primary outcome was the continuous abstinence rate at the end of the intervention, and secondary outcomes included 7-day point prevalence abstinence, self-efficacy, and cravings. User engagement, therapeutic alliance, and interaction satisfaction were measured weekly, and the trajectory was analyzed using Linear Mixed Models.
Results
Following an intention-to-treat principle, 18.6 % of participants achieved continuous abstinence, and 37.3 % achieved 7-day point prevalence abstinence. Self-efficacy significantly improved over the intervention, and cravings decreased over time. A slight decreasing trend was observed in engagement and satisfaction, likely due to a novelty effect. However, the decrease did not affect the intervention's outcomes.
Conclusion
This study demonstrates the feasibility and initial usefulness of Roby, highlighting the potential for chatbots in long-term cessation support. Future research should further validate these findings with randomized controlled trials. Additional efforts should focus on monitoring and maintaining user experience in the long term to enhance effectiveness.
{"title":"Chatting your way to quitting: A longitudinal exploration of smokers' interaction with a cessation chatbot","authors":"Linwei He , Erkan Basar , Reinout W. Wiers , Marjolijn L. Antheunis , Emiel Krahmer","doi":"10.1016/j.invent.2025.100806","DOIUrl":"10.1016/j.invent.2025.100806","url":null,"abstract":"<div><h3>Background</h3><div>Cigarette smoking poses a major public health risk, requiring scalable and accessible interventions. Chatbots offer a promising solution, given their potential in providing personalized, long-term interactions. Despite their promise, limited research has examined their efficacy and the intertwined relationship between user experience and effectiveness over an extended period of time.</div></div><div><h3>Methods</h3><div>In this prospective, single-arm study, we developed and evaluated <em>Roby</em>, a 5-session chatbot intervention incorporating motivational interviewing and cognitive behavioral therapy to help smokers quit. <em>Roby</em> engaged Dutch adult smokers (<em>N</em> = 102) in conversations covering topics such as setting a quit date, managing withdrawal and cravings, and relapse prevention. The primary outcome was the continuous abstinence rate at the end of the intervention, and secondary outcomes included 7-day point prevalence abstinence, self-efficacy, and cravings. User engagement, therapeutic alliance, and interaction satisfaction were measured weekly, and the trajectory was analyzed using Linear Mixed Models.</div></div><div><h3>Results</h3><div>Following an intention-to-treat principle, 18.6 % of participants achieved continuous abstinence, and 37.3 % achieved 7-day point prevalence abstinence. Self-efficacy significantly improved over the intervention, and cravings decreased over time. A slight decreasing trend was observed in engagement and satisfaction, likely due to a novelty effect. However, the decrease did not affect the intervention's outcomes.</div></div><div><h3>Conclusion</h3><div>This study demonstrates the feasibility and initial usefulness of <em>Roby</em>, highlighting the potential for chatbots in long-term cessation support. Future research should further validate these findings with randomized controlled trials. Additional efforts should focus on monitoring and maintaining user experience in the long term to enhance effectiveness.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"39 ","pages":"Article 100806"},"PeriodicalIF":3.6,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143276977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-04DOI: 10.1016/j.invent.2025.100808
Elena Caroline Weitzel , Katja Schladitz , Maria Schwenke , Franziska Dinah Welzel , Georg Schomerus , Peter Schönknecht , Markus Bleckwenn , Anja Mehnert-Theuerkauf , Steffi G. Riedel-Heller , Margrit Löbner
Objective
E-mental health interventions can usefully supplement mental health care. Health care providers are important to the routine implementation. Until now, little has been known about their attitudes about e-mental health and its use in treatment. This study aims to comprehensively examine health care providers' attitudes and experiences regarding e-mental health interventions over time.
Methods
Data for this explorative analysis derive from a longitudinal study of N = 335 health care providers from four professional groups in German mental health care (GPs, specialist doctors, psychotherapists, and clinicians). In two surveys conducted one year apart, usage as well as advantages of and barriers to e-mental health interventions were assessed. Usage patterns based on self-report were examined according to socio-demographic correlates. In a binary logistic regression, correlations between use at follow-up and baseline variables were analyzed.
Results
At follow-up, the inclusion of e-mental health interventions in treatment was increased to 40 % compared to baseline (28.4 %). Also, more participants reported having better knowledge and having received information about e-mental health. Gender, age, and knowledge about e-mental health interventions were significantly associated with usage patterns. In the regression analysis, gender, age, and professional group were relevant predictors of use at follow-up.
Conclusion
Our results show that increasingly health care providers are including e-mental health interventions in treatment. This is presumably related to better knowledge. However, it is clear that e-mental health interventions are not yet an established component of health care. Rather, implementation efforts, particularly the dissemination of informational materials, are required to promote the use.
{"title":"Current trends in e-mental health interventions: Health care providers' attitudes and usage patterns","authors":"Elena Caroline Weitzel , Katja Schladitz , Maria Schwenke , Franziska Dinah Welzel , Georg Schomerus , Peter Schönknecht , Markus Bleckwenn , Anja Mehnert-Theuerkauf , Steffi G. Riedel-Heller , Margrit Löbner","doi":"10.1016/j.invent.2025.100808","DOIUrl":"10.1016/j.invent.2025.100808","url":null,"abstract":"<div><h3>Objective</h3><div><em>E</em>-mental health interventions can usefully supplement mental health care. Health care providers are important to the routine implementation. Until now, little has been known about their attitudes about e-mental health and its use in treatment. This study aims to comprehensively examine health care providers' attitudes and experiences regarding e-mental health interventions over time.</div></div><div><h3>Methods</h3><div>Data for this explorative analysis derive from a longitudinal study of <em>N</em> = 335 health care providers from four professional groups in German mental health care (GPs, specialist doctors, psychotherapists, and clinicians). In two surveys conducted one year apart, usage as well as advantages of and barriers to e-mental health interventions were assessed. Usage patterns based on self-report were examined according to socio-demographic correlates. In a binary logistic regression, correlations between use at follow-up and baseline variables were analyzed.</div></div><div><h3>Results</h3><div>At follow-up, the inclusion of e-mental health interventions in treatment was increased to 40 % compared to baseline (28.4 %). Also, more participants reported having better knowledge and having received information about e-mental health. Gender, age, and knowledge about e-mental health interventions were significantly associated with usage patterns. In the regression analysis, gender, age, and professional group were relevant predictors of use at follow-up.</div></div><div><h3>Conclusion</h3><div>Our results show that increasingly health care providers are including e-mental health interventions in treatment. This is presumably related to better knowledge. However, it is clear that e-mental health interventions are not yet an established component of health care. Rather, implementation efforts, particularly the dissemination of informational materials, are required to promote the use.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"39 ","pages":"Article 100808"},"PeriodicalIF":3.6,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143172557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-27DOI: 10.1016/j.invent.2025.100804
Kerem Böge , Niklas Bergmann , Inge Hahne , Laura Emde , Sharla Cartner , Imogen Bell , Matthias Pillny , Neil Thomas
Delusions are one of the core symptoms of schizophrenia spectrum disorders (SSD), associated with distress and impaired functioning. Traditional Cognitive Behavioral Therapy (CBT) approaches are less effective for delusions, require significant resources, and specialized staff training. Symptom-specific therapy approaches, which target factors involved in the development and maintenance of psychotic symptoms, provide a valid alternative. Recent research demonstrates the efficacy of coping strategies as an intervention element, however, so far, only in the context of auditory hallucinations. Digital technologies, such as ecological momentary assessment (EMA) and ecological momentary intervention (EMI), are gaining attention in mental health, providing enhanced assessment and intervention opportunities. The present single-arm trial aimed to investigate the feasibility, acceptability, and preliminary outcomes of a smartphone-based blended EMA/I psychological therapy approach focusing on improving coping strategies for delusions in SSD. In total, N = 10 participants received four face-to-face therapy sessions alongside German university-level treatment-as-usual over an intervention period of four to six weeks. Feasibility was assessed by completion rates of the EMA/I questionnaires, use of the application between sessions and recruitment rates. Acceptability was assessed by a satisfaction questionnaire, open feedback, and analysis of adverse effects. Clinical outcomes included self-rated and rater-based intensity and distress of delusions and comorbid symptoms at pre- and post-intervention. Findings supported the feasibility and acceptability of the DICE (DICE - Delusion Ideation in the Context of Everyday life intervention) intervention, with high retention (10/13 participants, 77 %) and completion rates for the EMA- (59 %) and EMI-questionnaires (72 %), as well as a high protocol adherence (90–97 %), exceeding all predefined benchmarks. Open feedback indicated good satisfaction, with all participants using the application between sessions, reflecting a high engagement level. Clinical outcomes displayed relevant changes in ameliorating the intensity of delusions when being measured by the Psychotic Symptom Rating Scales as well as by the Green Paranoid Thought Scale, and self-rated improvements in distress and depressive symptoms. Changes in the intensity and distress of delusions might be explained by improved coping behaviour. Further research with control conditions is needed to validate findings and analyze the efficacy as well as mechanisms of actions of the intervention in a fully powered trial.
{"title":"Feasibility, acceptability and preliminary clinical outcomes of a brief coping-focused intervention for delusions blended with smartphone-based ecological momentary assessment and intervention in persons with schizophrenia spectrum disorders: A pilot single-arm trial","authors":"Kerem Böge , Niklas Bergmann , Inge Hahne , Laura Emde , Sharla Cartner , Imogen Bell , Matthias Pillny , Neil Thomas","doi":"10.1016/j.invent.2025.100804","DOIUrl":"10.1016/j.invent.2025.100804","url":null,"abstract":"<div><div>Delusions are one of the core symptoms of schizophrenia spectrum disorders (SSD), associated with distress and impaired functioning. Traditional Cognitive Behavioral Therapy (CBT) approaches are less effective for delusions, require significant resources, and specialized staff training. Symptom-specific therapy approaches, which target factors involved in the development and maintenance of psychotic symptoms, provide a valid alternative. Recent research demonstrates the efficacy of coping strategies as an intervention element, however, so far, only in the context of auditory hallucinations. Digital technologies, such as ecological momentary assessment (EMA) and ecological momentary intervention (EMI), are gaining attention in mental health, providing enhanced assessment and intervention opportunities. The present single-arm trial aimed to investigate the feasibility, acceptability, and preliminary outcomes of a smartphone-based blended EMA/I psychological therapy approach focusing on improving coping strategies for delusions in SSD. In total, <em>N</em> = 10 participants received four face-to-face therapy sessions alongside German university-level treatment-as-usual over an intervention period of four to six weeks. Feasibility was assessed by completion rates of the EMA/I questionnaires, use of the application between sessions and recruitment rates. Acceptability was assessed by a satisfaction questionnaire, open feedback, and analysis of adverse effects. Clinical outcomes included self-rated and rater-based intensity and distress of delusions and comorbid symptoms at pre- and post-intervention. Findings supported the feasibility and acceptability of the DICE (DICE - Delusion Ideation in the Context of Everyday life intervention) intervention, with high retention (10/13 participants, 77 %) and completion rates for the EMA- (59 %) and EMI-questionnaires (72 %), as well as a high protocol adherence (90–97 %), exceeding all predefined benchmarks. Open feedback indicated good satisfaction, with all participants using the application between sessions, reflecting a high engagement level. Clinical outcomes displayed relevant changes in ameliorating the intensity of delusions when being measured by the Psychotic Symptom Rating Scales as well as by the Green Paranoid Thought Scale, and self-rated improvements in distress and depressive symptoms. Changes in the intensity and distress of delusions might be explained by improved coping behaviour. Further research with control conditions is needed to validate findings and analyze the efficacy as well as mechanisms of actions of the intervention in a fully powered trial.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"39 ","pages":"Article 100804"},"PeriodicalIF":3.6,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143172558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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