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

{"title":"A mobile-based, single-session intervention to empower parents of adolescents hospitalised for non-suicidal self-injury: A mixed-methods randomised controlled trial","authors":"Juan He ,&nbsp;Yidong Shen ,&nbsp;Zengyu Chen ,&nbsp;Yusheng Tian ,&nbsp;Yanting Hou ,&nbsp;Yamin Li ,&nbsp;Jianjun Ou","doi":"10.1016/j.invent.2025.100822","DOIUrl":"10.1016/j.invent.2025.100822","url":null,"abstract":"<div><h3>Background</h3><div>Adolescents hospitalised for non-suicidal self-injury (NSSI) represent a particularly severe subset within psychiatric care. The NSSI imposes significant challenges on parents, including lack of knowledge, ineffective coping strategies, and negative emotions, exacerbated by stigma. Parental empowerment is crucial for supporting adolescent recovery; however, current interventions often neglect parents. Single-session interventions (SSIs) may offer an accessible and promising approach to address this gap.</div></div><div><h3>Methods</h3><div>This mixed-methods study assessed the short-term effects of project CSH-P: a mobile-based, self-guided SSI aimed at empowering parents of adolescents hospitalised for NSSI. 88 participants were randomly assigned to CSH-P (n = 46) or control group (n = 42). Online assessments measuring knowledge, attitudes, and stigma were administered at baseline, immediately post-intervention, and one week later. Additionally, semi-structured individual interviews were conducted with participants who received CSH-P post-intervention.</div></div><div><h3>Results</h3><div>Compared to the control group, participants who received CSH-P showed significant improvements in NSSI-related knowledge (Cohen’s d = .42, p = .027) and more positive attitudes toward their adolescents (Cohen’s d = - .31, p = .047). Qualitative findings confirmed these results, with parents reporting highly positive engagement and perceived empowerment across cognitive, emotional, and behavioural dimensions. Furthermore, parents provided constructive feedback for further enhancing the intervention’s impact.</div></div><div><h3>Conclusions</h3><div>Project CSH-P demonstrates the potential to enhance parental empowerment in managing adolescent self-injurious behaviours. Its brevity, low cost, and ease of dissemination make it a promising strategy for widely applicable prevention and treatment efforts. Future research should explore the long-term sustainability of these improvements and assess the broader impact on parenting practices and adolescent treatment outcomes.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"40 ","pages":"Article 100822"},"PeriodicalIF":3.6,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725698","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}

{"title":"Feasibility, acceptability, and preliminary efficacy of a blended transdiagnostic group CBT for the treatment of emotional disorders","authors":"Noelia Jiménez-Orenga ,&nbsp;Amanda Díaz-García ,&nbsp;Rosa Lorente-Català ,&nbsp;Alberto González-Robles ,&nbsp;Macarena Paredes-Mealla ,&nbsp;Azucena García-Palacios ,&nbsp;Juana Bretón-López","doi":"10.1016/j.invent.2025.100823","DOIUrl":"10.1016/j.invent.2025.100823","url":null,"abstract":"<div><h3>Introduction</h3><div>The transdiagnostic approach and Internet-based administration can help to implement evidence-based treatments for emotional disorders (ED). However, not all patients benefit from online format and dropout rates are high. Blended format combines the strengths of face-to-face and Internet self-applied interventions to help overcome these barriers. Group format can also help to overcome these difficulties and improve the cost-effectiveness binomial. This study aimed to analyze the feasibility, acceptability, and preliminary efficacy of a blended transdiagnostic group CBT for ED.</div></div><div><h3>Methods</h3><div>A single-group, open-trial design with three measurement points: pre-treatment, post-treatment and 3-month follow-up. A total of 34 adults (mean age = 32.21 years; 79.4 % female) from a community sample with at least one ED diagnosis according to DSM-5-TR criteria participated in the study. The intervention combined 8 group sessions delivered via videoconference with the completion of 16 online modules in a web-platform.</div></div><div><h3>Results</h3><div>Of the total participants, 67.6 % completed the treatment and another 14.7 % completed at least half of the modules and attended at least half of the group sessions. The expectations and satisfaction with the treatment were high (47.39 and 49.39 out of 60, respectively). The system usability was above desirable and around ‘excellent’ (84.02 out of 100 after the first use of the platform and 80.98 out of 100 at post-treatment). Opinions on the online modules and videoconference sessions were good. Participants completed an average of 12.91 online modules out of 16 and attended an average of 5.44 sessions out of 8. There was a significant reduction in anxious and depressive symptomatology at post-treatment and follow-up compared to baseline. There was also a significant change in other secondary clinical measures.</div></div><div><h3>Conclusions</h3><div>A transdiagnostic protocol applied in blended and group formats seems to be feasible, acceptable and preliminary effective in addressing ED. However, more research is needed to test the efficacy of this innovative format.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"40 ","pages":"Article 100823"},"PeriodicalIF":3.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747821","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}

{"title":"Corrigendum to “Efficacy of online psychoeducation and relaxation training program (OnPR) on mental health problems in COVID-19 patients: A randomized controlled trial” [J. Internet Interv. vol 35 (2024), 100705]","authors":"Chotiman Chinvararak ,&nbsp;Pantri Kirdchok ,&nbsp;Chayut Wonglertwisawakorn ,&nbsp;Pachara Pumjun ,&nbsp;Orranee Srikhamdokkhae ,&nbsp;Nitchawan Kerdcharoen","doi":"10.1016/j.invent.2025.100820","DOIUrl":"10.1016/j.invent.2025.100820","url":null,"abstract":"","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"40 ","pages":"Article 100820"},"PeriodicalIF":3.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154528","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":"Developing a qualitative and quantitative ambulatory assessment-based feedback system within cognitive behavioural interventions for people with persecutory beliefs","authors":"Laura F. Bringmann ,&nbsp;Eva Tolmeijer ,&nbsp;Maarten Piot ,&nbsp;Merijn Mestdagh ,&nbsp;Stijn Verdonck ,&nbsp;Gert Stulp ,&nbsp;Felicity Waite ,&nbsp;Louise Isham ,&nbsp;Anton P.B. Staring ,&nbsp;Daniel Freeman ,&nbsp;David van den Berg","doi":"10.1016/j.invent.2025.100819","DOIUrl":"10.1016/j.invent.2025.100819","url":null,"abstract":"<div><h3>Background</h3><div>Although the application of self-monitoring (ambulatory assessment) and visual feedback in psychological interventions has yielded promising results, there are currently no reports on using self-monitoring and feedback during a complete therapy. The online m-Path platform provides a tailorable framework for integrating self-monitoring and visual feedback within different psychological interventions.</div></div><div><h3>Methods</h3><div>Therapy-specific questionnaires and visual feedback were developed within the online m-Path platform as part of the Feeling Safe-NL trial (registration number: ISRCTN25766661) for regular CBT for psychosis (CBTp) and the Feeling Safe Programme combined with peer counselling (the Feeling Safe-NL Programme). The design process involved people with lived experience, psychologists, peer counsellors, researchers, and software developers. The design principles included that the system should be 1) easy to use, 2) suitable for use during a six-month therapy, 3) focussed on positive and goal-aligned outcomes, 4) understandable by patients and professionals, and 5) informing, guiding, and promoting therapy. Design principles were evaluated using compliance data and a patient questionnaire.</div></div><div><h3>Results</h3><div>The system was used by 21 patients, of which nine completed the questionnaires for the full therapy period, 168 days on average. Usability data from patients revealed that the system was easy to use, well-explained, and suitable for use over six months of therapy. The patients also reported that the questions overall positively affected their emotions and that the feedback was insightful.</div></div><div><h3>Conclusion</h3><div>The results support the successful application of the design principles to promote the integration of the self-monitoring and visual feedback system within specific CBTp interventions.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"40 ","pages":"Article 100819"},"PeriodicalIF":3.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680803","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}

{"title":"Is one additional phone call enough? - Effectiveness of additional human support to reduce dropout from an internet-based intervention for depressive symptoms: A randomized-controlled trial","authors":"Sophie Christine Eicher,&nbsp;Manuel Heinrich,&nbsp;Pavle Zagorscak,&nbsp;Annette Brose,&nbsp;Christine Knaevelsrud","doi":"10.1016/j.invent.2025.100818","DOIUrl":"10.1016/j.invent.2025.100818","url":null,"abstract":"<div><h3>Background</h3><div>Internet-Based Interventions (IBIs) are effective treatments for mental disorders, but their implementation faces challenges, particularly in addressing high dropout rates. Adding more human support or guidance might reduce treatment dropout rates in IBIs, but it may also limit scalability. Therefore, small, easy-to-implement, guidance-based add-on interventions are warranted to reduce dropout rates. This study tests if offering one additional brief phone contact reduces treatment dropout rates in an IBI for depressive symptoms with written guidance.</div></div><div><h3>Methods</h3><div>We analyze data from <em>N</em> = 394 individuals participating in an IBI for depression. The intervention comprises seven CBT-based modules with module-wise written semi-standardized feedback from psychotherapists (guided IBI). Previous research applying the same IBI in adults with self-reported symptoms of depression found increased dropout rates after the second module. In the study group, therapists offered an additional brief phone call after the second module (<em>n</em> = 206). In the control group, no additional phone calls were offered (<em>n</em> = 188). We present descriptive statistics regarding the intervention course for both groups. We conducted a logistic regression to examine the preventive effect of the additional phone call on treatment dropout.</div></div><div><h3>Results</h3><div>Pooled dropout rates in the study group were 30.5 % (<em>n</em> = 63), and in the control group 36.1 % (<em>n</em> = 68), with a risk difference of about 6 % points favoring the study group. The odds ratios ranged from 1.25 to 1.33, and the relative risks ranged from 1.08 to 1.10. However, all confidence intervals overlap zero, indicating that all effect estimates are statistically non-significant.</div></div><div><h3>Conclusion</h3><div>We tested a strategy of additional human contact to reduce treatment dropout rates in a guided IBI for depressive symptoms. All estimates descriptively favored the study group, but were small and non-significant. Further research is needed to determine how additional contact can be employed to reduce treatment dropout.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"40 ","pages":"Article 100818"},"PeriodicalIF":3.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143620211","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}

{"title":"Study protocol for a triple-blind randomised controlled trial evaluating a machine learning-based predictive clinical decision support tool for internet-delivered cognitive behaviour therapy (ICBT) for depression and anxiety","authors":"Pontus Bjurner ,&nbsp;Nils Hentati Isacsson ,&nbsp;Fehmi Ben Abdesslem ,&nbsp;Magnus Boman ,&nbsp;Erik Forsell ,&nbsp;Viktor Kaldo","doi":"10.1016/j.invent.2025.100816","DOIUrl":"10.1016/j.invent.2025.100816","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Therapist-supported internet-based Cognitive Behavioural Therapy (ICBT) has strong scientific support, but all patients are not helped, and further improvements are needed. Personalized medicine could enhance ICBT. One promising approach uses a Machine learning (ML) based predictive decision support tool (DST) to help therapists identify patients at risk of treatment failure and adjust their treatments accordingly. ICBT is a suitable clinical context for developing and testing such predictive DST's, since its delivery is quite flexible and can quickly be adapted for probable non-responders, for example by increasing the level and nature of therapist support, to avoid treatment failures and improve overall outcomes. This type of strategy has never been tested in a triple-blind randomised controlled trial (RCT) and has rarely been studied in ICBT.&lt;/div&gt;&lt;div&gt;The aim of this protocol is to expand on previous registered protocols with more detailed descriptions of methods and analyses before analyses is being conducted.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods and analysis&lt;/h3&gt;&lt;div&gt;A triple blind RCT comparing ICBT with a DST (DST condition), to ICBT as usual (TAU condition). The primary objective is to evaluate if the DST condition is superior to the TAU condition in decreasing diagnose-specific symptoms among patients identified to be at risk of failure. Secondary objectives are to evaluate if the DST improves functioning, interaction, adherence, patient satisfaction, and therapist time efficiency and decreases the number of failed treatments. Additionally, we will investigate the therapists' experience of using the DST.&lt;/div&gt;&lt;div&gt;Patients and therapists have been recruited nationally. They were randomised and given a sham rationale for the trial to ensure allocation blindness. The total number of patients included was 401, and assessments were administered pre-treatment, weekly during treatment, at post-treatment and at 12-month follow-up. Primary outcome is one of the three diagnosis-specific symptom rating scales for respective treatment and primary analysis is difference in change from pre- to post-treatment for at-risk patients on these scales.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Human ethics and consent to participate&lt;/h3&gt;&lt;div&gt;Informed consent to participate in the study was obtained from all participants. Both therapists and patients are participants in this trial. For patients, informed consent to participate in the study was obtained when they registered interest for the study via the study's secure web platform and carried out initial screening before the diagnostic and fit for treatment assessment, they first received the research subject information and were asked for consent by digitally signing that they had read and understood the information. For therapists who were part of the study, consent was requested after they had registered their interest. Therapists then received an email with a link to the study's secure web platform with","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"40 ","pages":"Article 100816"},"PeriodicalIF":3.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549420","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}

{"title":"Initial effectiveness of an ICBT-protocol for GAD in psychiatric care – A feasibility-pilot study","authors":"Vilgot Huhn ,&nbsp;Erik Andersson ,&nbsp;Tove Wahlund ,&nbsp;Erik Forsell","doi":"10.1016/j.invent.2025.100817","DOIUrl":"10.1016/j.invent.2025.100817","url":null,"abstract":"<div><div>Generalized Anxiety Disorder (GAD) is a common and debilitating anxiety disorder with a chronic course and a low rate of spontaneous remission. Previous internet-delivered treatments for GAD in clinical routine care has been shown to be effective but tend to use a mix of many different treatment components, often based in several theoretical models. Another approach could be to instead develop more focused and theory driven treatments, potentially allowing the protocol to be shorter and less demanding for patients. In this pilot-feasibility-trial we implemented a treatment focusing on one target core construct (intolerance of uncertainty) at the internet psychiatry clinic in Stockholm. The treatment was administered to 22 individuals with GAD. We found a significant reduction in GAD symptoms of similar effect size to previous studies of CBT and ICBT for GAD in routine clinical care. Patients rated overall high levels of treatment satisfaction and treatment credibility. Only two patients dropped out from the treatment. Among the remaining patients a median of 7.5 out of 8 modules were completed. We conclude that the treatment protocol is preliminarily effective, acceptable to patients and clinicians, and feasible to implement in routine psychiatric care.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"40 ","pages":"Article 100817"},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549356","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}

{"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 ,&nbsp;Silvan Hornstein ,&nbsp;Elisabeth Reinking ,&nbsp;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}

{"title":"The effect of a universal mobile application on adolescents' mental health and well-being","authors":"Helene Høgsdal ,&nbsp;Sabine Kaiser ,&nbsp;Geraldine Mabille ,&nbsp;Monica Martinussen ,&nbsp;Reidar Jakobsen ,&nbsp;Henriette Kyrrestad","doi":"10.1016/j.invent.2025.100814","DOIUrl":"10.1016/j.invent.2025.100814","url":null,"abstract":"<div><div>Opp is a universal mental health-promoting mobile application (app) developed for adolescents, with the aim of promoting mental health and well-being and preventing mental health problems. In this randomized controlled trial, the effectiveness of Opp was tested among Norwegian adolescents aged 13 to 25 years. Mental health, well-being, self-efficacy, self-esteem, help-seeking behavior, and sleep quality were assessed at two measurement points (T1 and T2), that were approximately 11 weeks apart. Only the participants that answered at both measurement points were included in the main analyses (<em>N</em> = 399; 75 % girls; <em>Mage</em> = 16.90 years, <em>SD</em> = 1.40). The results demonstrated a statistically significant effect of the app on mental health, as measured by the SDQ Total Difficulties scale (<em>F</em>(1,790) = 4.35, <em>p</em> = .037), while no statistically significant effects were observed on the other outcomes. These results provide important insights, and a broader understanding of how mental health apps can influence the mental health and well-being of a general sample of adolescents.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"40 ","pages":"Article 100814"},"PeriodicalIF":3.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549357","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}

{"title":"Evaluation of additional resources and stories within therapist-assisted internet-delivered cognitive behaviour therapy for alcohol misuse","authors":"H.D. Hadjistavropoulos ,&nbsp;V. Peynenburg ,&nbsp;R.P. Sapkota ,&nbsp;E. Valli ,&nbsp;M. Nugent ,&nbsp;M.T. Keough ,&nbsp;C. Sundström ,&nbsp;M.P. Schaub ,&nbsp;N. Titov ,&nbsp;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}