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

{"title":"Benefits, limitations and potential solutions for defining good practices in Online Counselling Chat Services for Youth","authors":"Irati Higuera-Lozano ,&nbsp;Ana M. Ramirez ,&nbsp;Noortje Breugelmans ,&nbsp;Elke Denayer ,&nbsp;Alexis Dewaele ,&nbsp;Katalin Felvinczi ,&nbsp;Lien Goossens ,&nbsp;Zsuzsa Kaló ,&nbsp;Tuuli Pitkänen ,&nbsp;Mónika Rényi ,&nbsp;Virvatuli Uusimäki ,&nbsp;María Cabello","doi":"10.1016/j.invent.2026.100902","DOIUrl":"10.1016/j.invent.2026.100902","url":null,"abstract":"<div><h3>Introduction</h3><div>Online Chat Counselling Services (OCCS) provide accessible mental health support for young people. However, systematic, cross-cultural research from the perspective of service providers is needed to improve current practices, guide future development, and share best practices.</div></div><div><h3>Aims</h3><div>This study explores the experiences of OCCS providers and counsellors in four European countries, identifying benefits, limitations, and potential solutions to improve services and inform future best practices.</div></div><div><h3>Methods</h3><div>62 counsellors or chatline coordinators from 33 OCCS in Belgium, Finland, Hungary, and Spain were interviewed online. A thematic analysis of the outputs from these interviews focused on the benefits, limitations and proposed solutions.</div></div><div><h3>Results</h3><div>Most of the participants were female (80 %). Nearly half of the services (48 %) worked with both paid counsellors and volunteers. Eighteen percent of OCCSs did not request any user information at login. In almost half of the OCCSs, counsellors were able to see whether a user had made contact previously. Six key benefits of OCCS were identified: improved accessibility, anonymity-facilitated disclosure, future-oriented services, chat-based communication advantages, positive counsellor experience, and meaningful user support. Five main limitations emerged: unclear communication, limited resources, anonymity as a barrier, uncertainty-related negative perceptions, and low visibility and utilisation. Proposed solutions included conventional strategies (e.g., enhanced training, referrals, inter-service collaboration) and innovative approaches (e.g., AI integration for risk assessment, translation, and chatbot functionalities). Certain limitations were considered intrinsic to the OCCS model and accepted accordingly.</div></div><div><h3>Conclusions</h3><div>This study explored the experiences of a diverse group of counsellors to identify the key benefits, challenges, and potential solutions within OCCS. The proposed strategies provide a valuable foundation for the cross-national implementation of best practices in this field. Future research should evaluate these recommendations, incorporating the perspectives of service users.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"43 ","pages":"Article 100902"},"PeriodicalIF":4.1,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939552","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":"Improving adherence to an online intervention for low mood by a virtual coach or personalized motivational feedback messages: A three-arm pilot randomized controlled trial","authors":"Khadicha Amarti ,&nbsp;Marketa Ciharova ,&nbsp;Simon Provoost ,&nbsp;Mieke H.J. Schulte ,&nbsp;Annet Kleiboer ,&nbsp;Ali el Hassouni ,&nbsp;Gonçalo Gonçalves ,&nbsp;Heleen Riper","doi":"10.1016/j.invent.2025.100900","DOIUrl":"10.1016/j.invent.2025.100900","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Online psychological interventions like behavioural activation (BA) can be provided with or without human support. Unguided online interventions require no human contact and are therefore easier to implement on a large scale than guided interventions. However, effectiveness and adherence rates to these interventions are generally lower. One way to increase adherence to unguided online interventions is to offer automated motivational support.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This pilot randomized controlled trial (RCT) examined whether adherence to unguided online BA for low mood could be improved by adding automated support in the form of smartphone-delivered personalized motivational messages or a motivational virtual coach.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A three-arm pilot RCT (&lt;em&gt;n&lt;/em&gt; = 106) was conducted that compared an online intervention delivered with automated motivational support by a virtual coach (&lt;em&gt;n&lt;/em&gt; = 35), or by automated personalized messages on their smartphone (&lt;em&gt;n&lt;/em&gt; = 35), to the same intervention without support (control condition; &lt;em&gt;n&lt;/em&gt; = 36). The primary outcome was level of adherence, operationalized as (1) the number of webpages of the intervention visited, and (2) the number of mood ratings completed on the smartphone application, both retrieved from participants' logfiles. Secondary outcomes were satisfaction with the intervention (CSQ-I), usability (SUS) depression scores (HADS), and motivation for treatment (SMFL), measured through online questionnaires administered at baseline or after 4 weeks.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Adherence was moderate overall, with participants visiting on average 23 pages of 55 webpages and completing on average 50 of 84 requested mood ratings. No evidence for differences in adherence rates were observed between the intervention conditions and the control condition. Satisfaction with the intervention was moderate to high. Usability scores were below the desirable threshold of 68. Depression symptoms did not change significantly across all participants (&lt;em&gt;p&lt;/em&gt; = .053). No significant changes in motivation were found over time or between groups.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Adding automated support to unguided online BA for depression did not improve overall adherence. The limited effectiveness may reflect a misalignment between the motivational strategies and the needs of the target population, who reported mild symptoms and high intrinsic motivation. The findings highlight the need to further improve both the quality of automated support and the usability of online platforms. Future research should explore additional adherence-related factors and investigate how personalization can better address different symptom severities in unguided mental health interventions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Trial registration&lt;/h3&gt;&lt;div&gt;International Clinical Trials Registry Platform: trialsearch.who.int/Trial2.aspx?TrialID=NL8110.&lt;","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"43 ","pages":"Article 100900"},"PeriodicalIF":4.1,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939555","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":"Sustained engagement with a digital youth mental health platform: A mixed-methods study","authors":"Lee Valentine ,&nbsp;Jennifer Nicholas ,&nbsp;Rory Sorenson ,&nbsp;Nicola A. Chen ,&nbsp;Carla McEnery ,&nbsp;Shona Louis ,&nbsp;Shane Cross ,&nbsp;Shaminka N. Mangelsdorf ,&nbsp;Shaunagh O'Sullivan ,&nbsp;Thomas W. Wren ,&nbsp;Sandra Bucci ,&nbsp;John Gleeson ,&nbsp;Sarah Bendall ,&nbsp;Mario Alvarez-Jimenez","doi":"10.1016/j.invent.2025.100899","DOIUrl":"10.1016/j.invent.2025.100899","url":null,"abstract":"<div><h3>Background</h3><div>Digital mental health interventions offer a scalable means of expanding access to youth mental health care. However, their capacity to achieve population-level impact is limited by persistently low and varied user engagement. A more nuanced understanding of experiential factors associated with sustained engagement is needed to inform the design of digital interventions that are both clinically effective and engaging to young people.</div></div><div><h3>Objective</h3><div>To identify experiential factors associated with sustained engagement with a large-scale, real-world digital youth mental health platform implemented across Australian youth mental health services.</div></div><div><h3>Methods</h3><div>A convergent mixed-methods approach integrated platform usage data and qualitative interviews with young people aged 16–25 years (mean = 19; <em>n</em> = 36) classified as either high or low engagers. The sample comprised 53 % female, 31 % male, and 8 % trans and/or gender diverse; 3 % identified as First Nations, and 19 % as culturally and linguistically diverse. Most participants lived in metropolitan areas (82 %), with 8 % from regional locations. Interview transcripts were thematically coded for experiential features of engagement. Code presence was quantified and tested for association with engagement level (high vs low) using Fisher's exact test. Themes were then iteratively refined, with explicit consideration of experiential patterns significantly associated with engagement.</div></div><div><h3>Results</h3><div>Two experiential factors were significantly associated with sustained engagement: (1) relational experiences, including normalisation and validation (<em>P</em> = 0.038) and, community and belonging (<em>P</em> = 0.01); and (2) the practical application of therapeutic insights in everyday life (P = 0.03). Low motivation was commonly reported as a barrier but did not significantly differentiate high from low engagers (<em>P</em> = 0.467).</div></div><div><h3>Conclusions</h3><div>This mixed methods study offers preliminary insights into experiential factors associated with engagement with a large-scale digital mental health intervention for young people. Indications suggest two experiential pathways to sustained use: relational experiences characterised by feeling understood, normalisation, and belonging, and functional utility reflected in the practical application of therapeutic strategies in daily life. Challenges reported by low-engaged young people, including cognitive overload, low motivation, and limited reminder prompting from the intervention, highlight opportunities for adaptive, low-effort re-engagement strategies. As digital mental health services continue to scale, understanding engagement as an emotional, social, and practical process may help support more sustained and inclusive participation.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"43 ","pages":"Article 100899"},"PeriodicalIF":4.1,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939553","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":"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":"A practical step-by-step approach for patient and public involvement in eHealth intervention research: Lessons learned from three case projects","authors":"Milon H.M. van Vliet ,&nbsp;Roxy A. van Eersel ,&nbsp;Charlotte C. Poot ,&nbsp;Jasper S. Faber ,&nbsp;Jiska J. Aardoom ,&nbsp;Eline Meijer ,&nbsp;Anke Versluis","doi":"10.1016/j.invent.2025.100896","DOIUrl":"10.1016/j.invent.2025.100896","url":null,"abstract":"<div><h3>Background</h3><div>The importance of patient and public involvement (PPI) in research is increasingly acknowledged. PPI is a collaborative approach in which research is conducted with or by end-users. It can enhance research quality and benefit the involved end-users. However, involving end-users in the non-linear and often interdisciplinary process of eHealth development can be challenging. While many resources on PPI exist, a functional and practical overview tailored to eHealth research is lacking. This paper presents a step-by-step approach to support PPI implementation in eHealth intervention research.</div></div><div><h3>Methods</h3><div>Three (ongoing) eHealth projects, each targeting a different population and applying different forms of PPI, informed the approach development. It was iteratively refined based on insights gained from these projects and feedback from other researchers and end-users involved in one of the projects.</div></div><div><h3>Results</h3><div>A six-step approach was developed, each step accompanied by reflective questions to support preparation and evaluation. The steps are: (1) <em>Where in the eHealth evaluation cycle is your research project positioned?</em>; (2) <em>Why do you want to use PPI?; (</em>3) <em>Who is your target population?</em>; (4) <em>How are you going to achieve your aims?</em>; (5) <em>What considerations and conditions need to be taken into account to facilitate PPI?</em>; (6) <em>How did the PPI process unfold?</em> Each step includes recommendations, lessons learned, case examples, and relevant resources (e.g., literature, websites).</div></div><div><h3>Conclusion</h3><div>The approach integrates literature with practical, field-based insights. We hope that the approach inspires and supports researchers in implementing meaningful PPI in research.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"43 ","pages":"Article 100896"},"PeriodicalIF":4.1,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939554","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}