Pub Date : 2025-07-08DOI: 10.1016/j.invent.2025.100859
Julius März , Lianne P. de Vries , Hanneke Scholten , Annabel Vreeker , Jeroen S. Legerstee , Loes Keijsers , Brenda W.J.H. Penninx , Manon H.J. Hillegers
The Experience Sampling Method (ESM) can help young people gain insight into their fluctuating emotions through multiple daily surveys. This can act as an intervention to improve well-being and mental health. However, the effectiveness of ESM interventions is expected to depend on compliance, i.e., how often participants respond to these surveys. We aimed to understand compliance patterns among young people during an ESM-based intervention, explored predictors of these patterns, and examined if the intervention's impact on well-being and mental health varied with compliance levels.
Dutch adolescents and young adults (N = 1139, 12–25 years, mean age = 17.67; 79 % female) completed baseline questionnaires, responded to five daily ESM surveys over three weeks using the Grow It! app, and completed follow-up questionnaires.
Despite overall low compliance (mean compliance = 33.8 %), latent class growth analyses identified four compliance patterns: stable high (N = 176; M = 78.8 %), stable medium (N = 193; M = 50.1 %), high initial and decreasing (N = 272; M = 30.9 %), and low initial and decreasing (N = 498; M = 13.2 %). These patterns were not consistently associated with age, gender, education, baseline well-being, or depressive and anxiety symptoms, and did not influence the intervention's effect on well-being and mental health outcomes.
We identified specific ESM compliance patterns among young people but found no clear predictors or outcomes of these patterns. To improve compliance and intervention effectiveness, future ESM interventions can potentially be enhanced by personalized designs, incorporating intrinsic and extrinsic motivators, and investigating situational factors and additional participant characteristics.
{"title":"Young people's compliance with the Experience Sampling Method (ESM): Examining patterns, predictors and associations with well-being and mental health","authors":"Julius März , Lianne P. de Vries , Hanneke Scholten , Annabel Vreeker , Jeroen S. Legerstee , Loes Keijsers , Brenda W.J.H. Penninx , Manon H.J. Hillegers","doi":"10.1016/j.invent.2025.100859","DOIUrl":"10.1016/j.invent.2025.100859","url":null,"abstract":"<div><div>The Experience Sampling Method (ESM) can help young people gain insight into their fluctuating emotions through multiple daily surveys. This can act as an intervention to improve well-being and mental health. However, the effectiveness of ESM interventions is expected to depend on compliance, i.e., how often participants respond to these surveys. We aimed to understand compliance patterns among young people during an ESM-based intervention, explored predictors of these patterns, and examined if the intervention's impact on well-being and mental health varied with compliance levels.</div><div>Dutch adolescents and young adults (<em>N</em> = 1139, 12–25 years, mean age = 17.67; 79 % female) completed baseline questionnaires, responded to five daily ESM surveys over three weeks using the Grow It! app, and completed follow-up questionnaires.</div><div>Despite overall low compliance (mean compliance = 33.8 %), latent class growth analyses identified four compliance patterns: stable high (<em>N</em> = 176; M = 78.8 %), stable medium (<em>N</em> = 193; M = 50.1 %), high initial and decreasing (<em>N</em> = 272; M = 30.9 %), and low initial and decreasing (<em>N</em> = 498; M = 13.2 %). These patterns were not consistently associated with age, gender, education, baseline well-being, or depressive and anxiety symptoms, and did not influence the intervention's effect on well-being and mental health outcomes.</div><div>We identified specific ESM compliance patterns among young people but found no clear predictors or outcomes of these patterns. To improve compliance and intervention effectiveness, future ESM interventions can potentially be enhanced by personalized designs, incorporating intrinsic and extrinsic motivators, and investigating situational factors and additional participant characteristics.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"41 ","pages":"Article 100859"},"PeriodicalIF":3.6,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144606121","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}
Technology-assisted sexual abuse (TASA) mostly involves the production and non-consensual sharing of sexual images; however, evidence-based support for young people (YP) who have experienced TASA is scant. Digital Health Interventions (DHIs) have the potential to increase access to support and provide timely therapeutic input in a familiar format to YP. However, studies describing engagement with DHIs is nascent. Our objective is to describe engagement patterns for YP people who used the i-Minds app.
Methods
The i-Minds app is a co-designed mentalisation-based DHI for YP who have experienced TASA. Usage data was collected during the 6-week intervention window using Matomo analytics software and analysed according to the AMUsED framework.
Results
Forty-one participants were onboarded to the app. Of these, 95 % completed the introductory mandatory module, and nearly half completed the remaining three modules. Median duration of app engagement was 33 days. Most participants used the app on weekdays in the afternoon. Demographic variables, namely gender not matching with sex assigned at birth/prefer not to disclose and higher baseline clinical severity were associated with higher app engagement.
Conclusions
Participants showed high module completeness and engagement duration, suggesting the potential for real-world use. Potential participant-level predictors of engagement, such as gender identity and severity of TASA related traumatic stress and emotional distress, were identified. Achieving satisfactory engagement in DHIs is challenging yet necessary for delivering effective interventions. Future studies should explore participant-level predictors of engagement to inform real-world use of DHIs with a diverse sample.
{"title":"User engagement in a digital health intervention designed for young people who have experienced technology-assisted sexual abuse (i-Minds trial)","authors":"Sandra Bucci , Xiaolong Zhang , Kaja Dabrowska , Amanda Larkin , Ethel Quayle , Matthias Schwannauer , Filippo Varese , Pauline Whelan","doi":"10.1016/j.invent.2025.100858","DOIUrl":"10.1016/j.invent.2025.100858","url":null,"abstract":"<div><h3>Background</h3><div>Technology-assisted sexual abuse (TASA) mostly involves the production and non-consensual sharing of sexual images; however, evidence-based support for young people (YP) who have experienced TASA is scant. Digital Health Interventions (DHIs) have the potential to increase access to support and provide timely therapeutic input in a familiar format to YP. However, studies describing engagement with DHIs is nascent. Our objective is to describe engagement patterns for YP people who used the i-Minds app.</div></div><div><h3>Methods</h3><div>The i-Minds app is a co-designed mentalisation-based DHI for YP who have experienced TASA. Usage data was collected during the 6-week intervention window using Matomo analytics software and analysed according to the AMUsED framework.</div></div><div><h3>Results</h3><div>Forty-one participants were onboarded to the app. Of these, 95 % completed the introductory mandatory module, and nearly half completed the remaining three modules. Median duration of app engagement was 33 days. Most participants used the app on weekdays in the afternoon. Demographic variables, namely gender not matching with sex assigned at birth/prefer not to disclose and higher baseline clinical severity were associated with higher app engagement.</div></div><div><h3>Conclusions</h3><div>Participants showed high module completeness and engagement duration, suggesting the potential for real-world use. Potential participant-level predictors of engagement, such as gender identity and severity of TASA related traumatic stress and emotional distress, were identified. Achieving satisfactory engagement in DHIs is challenging yet necessary for delivering effective interventions. Future studies should explore participant-level predictors of engagement to inform real-world use of DHIs with a diverse sample.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"41 ","pages":"Article 100858"},"PeriodicalIF":3.6,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144581155","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}
Pub Date : 2025-07-05DOI: 10.1016/j.invent.2025.100857
Nickolai Titov , Blake F. Dear , Lauren Staples , Alana Fisher , Heather D. Hadjistavropoulos , Olav Nielssen
Background
The proven success of treating high prevalence mental disorders via the internet by digital mental health services (DMHSs) has created enormous interest in the implementation of these services. In response, there are now excellent guides to support the “how” of DMHS implementation.
Method
Drawing on the authors' experiences of successfully implementing high volume DMHSs and reflecting on planning sessions with decision makers and funders, the authors identified important questions that should be considered by policy makers, funders and healthcare managers before implementing a DMHS. These questions are more concerned with the “why” of implementation and are questions not typically examined or discussed in existing implementation guides and frameworks.
Results
The authors describe eleven questions categorised by theme: 1. The nature of mental health and treatments, 2. The nature of DMHSs, and 3. Governance and eco-system. Questions include which mental health conditions to address, whether the condition even requires treatment, what type of services should be offered, where would the DMHS fit into the broader mental health system, how will they integrate with other health services, what is the optimal funding model, how will they employ technology, and what governance is required.
Conclusions
Policy makers and funders have the challenging task of determining resource allocation among competing priorities in a complex and ever-changing world. We propose that navigating the complexities of DMHSs can be facilitated by developing a robust program logic that addresses these and other important questions. It is noted that the long-term success DMHSs requires not only a clear vision and careful planning, but realistic and stable funding, and a commitment to ongoing evaluation and development.
{"title":"Key questions to ask before implementing a Digital Mental Health Service (DMHS): A primer for policy makers","authors":"Nickolai Titov , Blake F. Dear , Lauren Staples , Alana Fisher , Heather D. Hadjistavropoulos , Olav Nielssen","doi":"10.1016/j.invent.2025.100857","DOIUrl":"10.1016/j.invent.2025.100857","url":null,"abstract":"<div><h3>Background</h3><div>The proven success of treating high prevalence mental disorders via the internet by digital mental health services (DMHSs) has created enormous interest in the implementation of these services. In response, there are now excellent guides to support the “how” of DMHS implementation.</div></div><div><h3>Method</h3><div>Drawing on the authors' experiences of successfully implementing high volume DMHSs and reflecting on planning sessions with decision makers and funders, the authors identified important questions that should be considered by policy makers, funders and healthcare managers before implementing a DMHS. These questions are more concerned with the “why” of implementation and are questions not typically examined or discussed in existing implementation guides and frameworks.</div></div><div><h3>Results</h3><div>The authors describe eleven questions categorised by theme: 1. The nature of mental health and treatments, 2. The nature of DMHSs, and 3. Governance and eco-system. Questions include which mental health conditions to address, whether the condition even requires treatment, what type of services should be offered, where would the DMHS fit into the broader mental health system, how will they integrate with other health services, what is the optimal funding model, how will they employ technology, and what governance is required.</div></div><div><h3>Conclusions</h3><div>Policy makers and funders have the challenging task of determining resource allocation among competing priorities in a complex and ever-changing world. We propose that navigating the complexities of DMHSs can be facilitated by developing a robust program logic that addresses these and other important questions. It is noted that the long-term success DMHSs requires not only a clear vision and careful planning, but realistic and stable funding, and a commitment to ongoing evaluation and development.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"41 ","pages":"Article 100857"},"PeriodicalIF":3.6,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588334","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}
Pub Date : 2025-07-02DOI: 10.1016/j.invent.2025.100850
Hyunyoung Lee , Yoomi Shin , Hayoung Moon , Yuna Choi , Anna Lee
Developmental disabilities (DDs) impact individuals' cognitive, psychological, and motor functions, and result in specific neural differences. Interventions to enhance neuroplasticity are important for this population. This review examined relevant existing studies to understand the effects of digital interventions on neuroplasticity and neural functions of individuals with DDs. A systematic review was conducted on PubMed, PsycINFO, CINAHL, and Scopus databases. Studies that focused on digital interventions to enhance neuroplasticity of individuals with DDs and used neuroimaging methods to evaluate effectiveness were included. The results of the current review were synthesized based on Roy's adaptation model. Of 3433 retrieved studies, 37 were included. The included studies used cognitive training, neuromodulation, and social cognitive training integrated with digital devices such as a computer, mobile app, or virtual reality. Neuroimaging results after digital interventions demonstrated changes in brain wave patterns and increased activation in certain regions. Behavioral assessments exhibited significant improvements including attention- deficit/hyperactivity disorder symptoms, attention, emotional recognition, and social skills. Digital interventions may enhance neural functions and neuroplasticity in individuals with DDs. Further studies with diverse methodologies and a broader spectrum of DDs are essential to fully understand the potential of digital interventions in neurodevelopmental challenges among the population.
{"title":"Effects of digital interventions on neuroplasticity and brain function of individuals with developmental disabilities: A systematic review","authors":"Hyunyoung Lee , Yoomi Shin , Hayoung Moon , Yuna Choi , Anna Lee","doi":"10.1016/j.invent.2025.100850","DOIUrl":"10.1016/j.invent.2025.100850","url":null,"abstract":"<div><div>Developmental disabilities (DDs) impact individuals' cognitive, psychological, and motor functions, and result in specific neural differences. Interventions to enhance neuroplasticity are important for this population. This review examined relevant existing studies to understand the effects of digital interventions on neuroplasticity and neural functions of individuals with DDs. A systematic review was conducted on PubMed, PsycINFO, CINAHL, and Scopus databases. Studies that focused on digital interventions to enhance neuroplasticity of individuals with DDs and used neuroimaging methods to evaluate effectiveness were included. The results of the current review were synthesized based on Roy's adaptation model. Of 3433 retrieved studies, 37 were included. The included studies used cognitive training, neuromodulation, and social cognitive training integrated with digital devices such as a computer, mobile app, or virtual reality. Neuroimaging results after digital interventions demonstrated changes in brain wave patterns and increased activation in certain regions. Behavioral assessments exhibited significant improvements including attention- deficit/hyperactivity disorder symptoms, attention, emotional recognition, and social skills. Digital interventions may enhance neural functions and neuroplasticity in individuals with DDs. Further studies with diverse methodologies and a broader spectrum of DDs are essential to fully understand the potential of digital interventions in neurodevelopmental challenges among the population.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"41 ","pages":"Article 100850"},"PeriodicalIF":3.6,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522725","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}
Pub Date : 2025-07-01DOI: 10.1016/j.invent.2025.100855
Henning Monsen , Jon Vøllestad , Peter Prescott , Audun Røren , Kristin Bruvik , Torkil Berge , Pål W. Wallace , Tine Nordgreen , Nick Titov , Anders Hovland
Background
Common mental disorders (CMD) are one of the main causes for work absenteeism. While traditional cognitive behavioural therapy is effective for symptom reduction, its impact on return to work is less pronounced. Work-focused therapy for those with CMD has shown positive results on return to work, but availability of such treatment is scarce.
Objective
To investigate a transdiagnostic work-focused Internet Delivered Cognitive Behavioural Therapy (W-ICBT) intervention. Further, to investigate its feasibility in terms of use and adherence, including the participants experience of perceived effects, for outpatients on sick leave with diagnoses of depression and/or anxiety.
Method
We conducted a naturalistic feasibility study using a convergent, mixed-methods pre-post design. Outcomes included adherence and use of the treatment, return to work, work related self-efficacy, symptoms of depression and anxiety, quality of life and the experience of participants through qualitative interviews.
Results
19 patients were screened, 15 included and 11 completed the 12-week treatment. Degree of sick leave was reduced from 79 % to 32 % for the completer sample (g = 0.95, p = .003), with statistically significant results on self-efficacy (g = 1.05 p = .005), depression (g = 0.81, p = .024), quality of life (g = 1.20, p = .002). No significant changes were observed on measures of anxiety and impairment of daily living. These results were supported by the findings from the qualitative interviews.
Conclusion
W-ICBT appears to be a promising approach to reducing work absenteeism and warrants further research.
常见精神障碍（CMD）是导致旷工的主要原因之一。虽然传统的认知行为疗法对减轻症状有效，但对重返工作岗位的影响不太明显。针对CMD患者的以工作为中心的治疗在重返工作岗位后显示出积极的效果，但这种治疗的可用性很少。目的探讨以跨诊断工作为中心的网络认知行为治疗（W-ICBT）干预方法。进一步，探讨其在抑郁症和/或焦虑症门诊病人的使用和依从性方面的可行性，包括参与者对感知效果的体验。方法采用会聚、混合方法进行自然可行性研究。结果包括坚持和使用治疗、重返工作岗位、与工作相关的自我效能、抑郁和焦虑症状、生活质量和参与者通过定性访谈的体验。结果筛选19例，纳入15例，完成12周治疗11例。完成者的病假率从79%降至32% (g = 0.95, p = 0.003)，在自我效能（g = 1.05 p = 0.005）、抑郁（g = 0.81, p = 0.024）、生活质量（g = 1.20, p = 0.002）方面均有统计学意义。在焦虑和日常生活障碍方面没有观察到明显的变化。这些结果得到了定性访谈结果的支持。结论w - icbt是减少旷工的有效方法，值得进一步研究。
{"title":"Work-focused therapy in an internet-based CBT format – A mixed methods feasibility study","authors":"Henning Monsen , Jon Vøllestad , Peter Prescott , Audun Røren , Kristin Bruvik , Torkil Berge , Pål W. Wallace , Tine Nordgreen , Nick Titov , Anders Hovland","doi":"10.1016/j.invent.2025.100855","DOIUrl":"10.1016/j.invent.2025.100855","url":null,"abstract":"<div><h3>Background</h3><div>Common mental disorders (CMD) are one of the main causes for work absenteeism. While traditional cognitive behavioural therapy is effective for symptom reduction, its impact on return to work is less pronounced. Work-focused therapy for those with CMD has shown positive results on return to work, but availability of such treatment is scarce.</div></div><div><h3>Objective</h3><div>To investigate a transdiagnostic work-focused Internet Delivered Cognitive Behavioural Therapy (W-ICBT) intervention. Further, to investigate its feasibility in terms of use and adherence, including the participants experience of perceived effects, for outpatients on sick leave with diagnoses of depression and/or anxiety.</div></div><div><h3>Method</h3><div>We conducted a naturalistic feasibility study using a convergent, mixed-methods pre-post design. Outcomes included adherence and use of the treatment, return to work, work related self-efficacy, symptoms of depression and anxiety, quality of life and the experience of participants through qualitative interviews.</div></div><div><h3>Results</h3><div>19 patients were screened, 15 included and 11 completed the 12-week treatment. Degree of sick leave was reduced from 79 % to 32 % for the completer sample (<em>g</em> = 0.95, <em>p</em> = .003), with statistically significant results on self-efficacy (<em>g</em> = 1.05 <em>p</em> = .005), depression (<em>g</em> = 0.81, <em>p</em> = .024), quality of life (<em>g</em> = 1.20, <em>p</em> = .002). No significant changes were observed on measures of anxiety and impairment of daily living. These results were supported by the findings from the qualitative interviews.</div></div><div><h3>Conclusion</h3><div>W-ICBT appears to be a promising approach to reducing work absenteeism and warrants further research.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"41 ","pages":"Article 100855"},"PeriodicalIF":3.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548849","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}
Pub Date : 2025-06-29DOI: 10.1016/j.invent.2025.100851
Sanghoon Oh , Jeong hee Cha , Jungwon Joo , Ji Hyung Lee , Yunna Lee , Hyung Jun Lee , Dong Uk Yoon , Jeonghwan Lee
Background
Perfectionistic strivings characterized by excessively high standards, fears of mistakes, and critical self-evaluations can lead to avoidance, worry, procrastination, and self-criticism, negatively impacting mental health. Since individuals with perfectionism are less likely to seek face-to-face therapy, internet-based cognitive behavioral therapy (ICBT) may improve accessibility.
Objectives
This study evaluated the effectiveness of an ICBT program specifically designed to reduce perfectionistic strivings.
Methods
A total of 101 participants with significant perfectionism were randomly assigned to a 5-week unguided ICBT program or a waiting list control group. Online assessments were conducted at baseline and post-intervention using the Frost Multidimensional Perfectionism Scale (FMPS), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Perceived Stress Scale (PSS), and Satisfaction with Life Scale (SWLS). Intention-to-treat and completer analyses were performed.
Results
Of 101 participants, 62 (61.4 %) completed both assessments. The ICBT group completed an average of 3.71 out of 5 modules, with 58.8 % completing all. Compared to the control group, the ICBT group showed significant reductions in perfectionistic strivings (FMPS Concern over Mistakes: d = −0.65, 95 % CI [−1.05, −0.25]), anxiety (GAD-7: d = −0.42, 95 % CI [−0.83, −0.01]), and increased life satisfaction (SWLS: d = 0.62, 95 % CI [0.20, 1.03]).
Conclusions
The ICBT program effectively reduced perfectionistic strivings and related symptoms, highlighting its potential as a scalable and accessible intervention. Further studies are warranted to directly compare ICBT with traditional face-to-face CBT and assess the durability of treatment effects.
{"title":"Efficacy of Internet-based cognitive behavioral therapy for reducing perfectionistic strivings in the Republic of Korea: A randomized controlled trial","authors":"Sanghoon Oh , Jeong hee Cha , Jungwon Joo , Ji Hyung Lee , Yunna Lee , Hyung Jun Lee , Dong Uk Yoon , Jeonghwan Lee","doi":"10.1016/j.invent.2025.100851","DOIUrl":"10.1016/j.invent.2025.100851","url":null,"abstract":"<div><h3>Background</h3><div>Perfectionistic strivings characterized by excessively high standards, fears of mistakes, and critical self-evaluations can lead to avoidance, worry, procrastination, and self-criticism, negatively impacting mental health. Since individuals with perfectionism are less likely to seek face-to-face therapy, internet-based cognitive behavioral therapy (ICBT) may improve accessibility.</div></div><div><h3>Objectives</h3><div>This study evaluated the effectiveness of an ICBT program specifically designed to reduce perfectionistic strivings.</div></div><div><h3>Methods</h3><div>A total of 101 participants with significant perfectionism were randomly assigned to a 5-week unguided ICBT program or a waiting list control group. Online assessments were conducted at baseline and post-intervention using the Frost Multidimensional Perfectionism Scale (FMPS), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Perceived Stress Scale (PSS), and Satisfaction with Life Scale (SWLS). Intention-to-treat and completer analyses were performed.</div></div><div><h3>Results</h3><div>Of 101 participants, 62 (61.4 %) completed both assessments. The ICBT group completed an average of 3.71 out of 5 modules, with 58.8 % completing all. Compared to the control group, the ICBT group showed significant reductions in perfectionistic strivings (FMPS Concern over Mistakes: <em>d</em> = −0.65, 95 % CI [−1.05, −0.25]), anxiety (GAD-7: <em>d</em> = −0.42, 95 % CI [−0.83, −0.01]), and increased life satisfaction (SWLS: <em>d</em> = 0.62, 95 % CI [0.20, 1.03]).</div></div><div><h3>Conclusions</h3><div>The ICBT program effectively reduced perfectionistic strivings and related symptoms, highlighting its potential as a scalable and accessible intervention. Further studies are warranted to directly compare ICBT with traditional face-to-face CBT and assess the durability of treatment effects.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"41 ","pages":"Article 100851"},"PeriodicalIF":3.6,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518291","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}
Pub Date : 2025-06-27DOI: 10.1016/j.invent.2025.100849
Shane Cross , Shaminka Mangelsdorf , Lee Valentine , Shaunagh O'Sullivan , Carla McEnery , Isabelle Scott , Tamsyn Gilbertson , Shona Louis , Jon Myer , Ping Liu , Niel Mac Dhonnagáin , Tom Wren , Eleanor Carey , Daniela Cagliarini , Ross Jacobs , Roos Pot-Kolder , Imogen Bell , Jennifer Nicholas , Lucia Valmaggia , John Gleeson , Mario Alvarez-Jimenez
This paper reviews the current evidence and synthesizes fifteen years of real-world development, testing, and implementation of digital mental health interventions (DMHIs) for young people. Drawing on the work of Orygen Digital, we outline the evolution of interventions including the Moderated Online Social Therapy (MOST) platform, the Mello app, and a suite of virtual reality-based therapies; all developed to meet the complex clinical, developmental, and service needs of youth aged 12 to 25.
We identify ten key challenges and opportunities encountered in designing, developing and implementing these DMHIs: (1) meaningful co-design; (2) sustained user engagement; (3) personalization and transdiagnostic targeting; (4) optimizing intensities of human support; (5) leveraging peer support and social networking; (6) embedding DMHIs in clinical services; (7) blending digital and face-to-face care; (8) building data infrastructure and learning health systems; (9) developing sustainable and scalable business models; and (10) preparing DMHIs for large language models. Each theme reflects both achievements and persistent challenges, and is illustrated through a synthesis of the current evidence and real-world insights from our clinical trials and national-scale service implementations.
Our approach is grounded in various frameworks including clinical staging, self-determination theory, supportive accountability, and minimally disruptive medicine. Emerging innovations such as just-in-time adaptive interventions, extended reality (XR) therapies, stratified treatment models, and large language models offer promising future pathways for greater personalization, engagement, effectiveness, and scalability.
Our findings highlight the potential value of context-sensitive, co-designed, and system-integrated DMHIs, while also emphasising enduring limitations such as variable engagement, implementation barriers, and population-specific adaptation. Moving beyond controlled efficacy trials toward agile, real-world learning health systems will be essential to realising the full potential of DMHIs in transforming youth mental health care.
{"title":"Insights from fifteen years of real-world development, testing and implementation of youth digital mental health interventions","authors":"Shane Cross , Shaminka Mangelsdorf , Lee Valentine , Shaunagh O'Sullivan , Carla McEnery , Isabelle Scott , Tamsyn Gilbertson , Shona Louis , Jon Myer , Ping Liu , Niel Mac Dhonnagáin , Tom Wren , Eleanor Carey , Daniela Cagliarini , Ross Jacobs , Roos Pot-Kolder , Imogen Bell , Jennifer Nicholas , Lucia Valmaggia , John Gleeson , Mario Alvarez-Jimenez","doi":"10.1016/j.invent.2025.100849","DOIUrl":"10.1016/j.invent.2025.100849","url":null,"abstract":"<div><div>This paper reviews the current evidence and synthesizes fifteen years of real-world development, testing, and implementation of digital mental health interventions (DMHIs) for young people. Drawing on the work of Orygen Digital, we outline the evolution of interventions including the Moderated Online Social Therapy (MOST) platform, the Mello app, and a suite of virtual reality-based therapies; all developed to meet the complex clinical, developmental, and service needs of youth aged 12 to 25.</div><div>We identify ten key challenges and opportunities encountered in designing, developing and implementing these DMHIs: (1) meaningful co-design; (2) sustained user engagement; (3) personalization and transdiagnostic targeting; (4) optimizing intensities of human support; (5) leveraging peer support and social networking; (6) embedding DMHIs in clinical services; (7) blending digital and face-to-face care; (8) building data infrastructure and learning health systems; (9) developing sustainable and scalable business models; and (10) preparing DMHIs for large language models. Each theme reflects both achievements and persistent challenges, and is illustrated through a synthesis of the current evidence and real-world insights from our clinical trials and national-scale service implementations.</div><div>Our approach is grounded in various frameworks including clinical staging, self-determination theory, supportive accountability, and minimally disruptive medicine. Emerging innovations such as just-in-time adaptive interventions, extended reality (XR) therapies, stratified treatment models, and large language models offer promising future pathways for greater personalization, engagement, effectiveness, and scalability.</div><div>Our findings highlight the potential value of context-sensitive, co-designed, and system-integrated DMHIs, while also emphasising enduring limitations such as variable engagement, implementation barriers, and population-specific adaptation. Moving beyond controlled efficacy trials toward agile, real-world learning health systems will be essential to realising the full potential of DMHIs in transforming youth mental health care.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"41 ","pages":"Article 100849"},"PeriodicalIF":3.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490067","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}
Pub Date : 2025-06-26DOI: 10.1016/j.invent.2025.100852
Ram P. Sapkota , Alayna Gretton , Andrew Wilhelms , Madelyne A. Bisby , Blake Dear , Nick Titov , Heather D. Hadjistavropoulos
This feasibility study evaluated the acceptability and effectiveness of the Things You Do (TYD) intervention within a routine online therapy clinic. The TYD intervention is an ultra-brief unguided online intervention targeting symptoms of depression and anxiety by promoting engagement in empirically supported thoughts and behaviors (actions). It is comprised of one lesson, two worksheets and automated daily email reminders for one month. In total, 73 out of 112 help-seeking individuals completed the TYD intervention after being enrolled, and of these 48 completed one or more assessments at 2-, 4- or 16-weeks follow-up. weeks. High rates of participant satisfaction were observed among 30 participants who completed the satisfaction questionnaire. Qualitative comments suggested participants valued the daily email reminders, practical techniques and accessible content but some participants found the intervention too short or generic. Linear mixed-effects models examining within-group changes found significant reductions in depression (d = 0.80) and anxiety (d = 0.65) from pre- to post-intervention, with effects maintained at follow-up. Participation in the intervention was significantly associated with increased engagement in adaptive behaviors (d = 0.61), which, in turn, was linked to greater symptom improvement. Preliminary findings support the feasibility, acceptability and potential effectiveness of the TYD intervention as an accessible, ultra-brief unguided online intervention for anxiety and depression that may be valuable for some individuals seeking services from an online mental health clinic. Future research should explore its efficacy compared to control conditions among diverse populations and tailoring of content to participants.
{"title":"Feasibility trial of an unguided ultra-brief online psychological intervention within an online mental health clinic: The “things you do” intervention","authors":"Ram P. Sapkota , Alayna Gretton , Andrew Wilhelms , Madelyne A. Bisby , Blake Dear , Nick Titov , Heather D. Hadjistavropoulos","doi":"10.1016/j.invent.2025.100852","DOIUrl":"10.1016/j.invent.2025.100852","url":null,"abstract":"<div><div>This feasibility study evaluated the acceptability and effectiveness of the <em>Things You Do</em> (TYD) intervention within a routine online therapy clinic. The TYD intervention is an ultra-brief unguided online intervention targeting symptoms of depression and anxiety by promoting engagement in empirically supported thoughts and behaviors (actions). It is comprised of one lesson, two worksheets and automated daily email reminders for one month. In total, 73 out of 112 help-seeking individuals completed the TYD intervention after being enrolled, and of these 48 completed one or more assessments at 2-, 4- or 16-weeks follow-up. weeks. High rates of participant satisfaction were observed among 30 participants who completed the satisfaction questionnaire. Qualitative comments suggested participants valued the daily email reminders, practical techniques and accessible content but some participants found the intervention too short or generic. Linear mixed-effects models examining within-group changes found significant reductions in depression (<em>d</em> = 0.80) and anxiety (<em>d</em> = 0.65) from pre- to post-intervention, with effects maintained at follow-up. Participation in the intervention was significantly associated with increased engagement in adaptive behaviors (<em>d</em> = 0.61), which, in turn, was linked to greater symptom improvement. Preliminary findings support the feasibility, acceptability and potential effectiveness of the TYD intervention as an accessible, ultra-brief unguided online intervention for anxiety and depression that may be valuable for some individuals seeking services from an online mental health clinic. Future research should explore its efficacy compared to control conditions among diverse populations and tailoring of content to participants.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"41 ","pages":"Article 100852"},"PeriodicalIF":3.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480930","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}
Pub Date : 2025-06-25DOI: 10.1016/j.invent.2025.100853
Kim Donachie , Michel Hansma , Marian Adriaansen , Erik Cornel , Esther Bakker , Lilian Lechner
Background
Active surveillance (AS) is a preferred treatment for men with low- to intermediate-risk prostate cancer, but its psychosocial impact presents challenges. This study used design thinking to develop a digital psychosocial support program aimed at improving quality of life and health outcomes for men on AS.
Methods
The design process followed five phases: Empathy, Define, Ideate, Prototype, and Test. Stakeholder interviews were conducted to generate a problem statement. Brainstorming in the ideation phase conceptualized a self-management application and a framework of the application's features was developed. A prototype was developed in close collaboration with end-users and experts. The testing phase included heuristic evaluations and feedback from patients and healthcare providers.
Results
Interviews during the empathy phase highlighted the need for personalized care, timely information, and holistic and tailored support. The defined problem statement aimed at reducing the psychosocial burden and improving coping mechanisms during the first year of AS. Ideation involved multidisciplinary brainstorming sessions, resulting in the concept of a self-management application with features such as information, appointment preparation, self-reporting of medical results, lifestyle guidance, relaxation exercises, and communication tools. A prototype application was developed. Testing showed strengths in navigation and design, with recommendations for improving error handling and help documentation. Feedback led to refinements enhancing usability and clinical integration.
Conclusion
This study developed a patient-centered self-management application to address psychosocial challenges in AS. By fostering engagement, self-efficacy, and communication, the tool aims to improve outcomes in prostate cancer management. Future clinical studies will evaluate its effectiveness.
{"title":"Developing a digital psychosocial support program for men with low-risk prostate cancer during active surveillance","authors":"Kim Donachie , Michel Hansma , Marian Adriaansen , Erik Cornel , Esther Bakker , Lilian Lechner","doi":"10.1016/j.invent.2025.100853","DOIUrl":"10.1016/j.invent.2025.100853","url":null,"abstract":"<div><h3>Background</h3><div>Active surveillance (AS) is a preferred treatment for men with low- to intermediate-risk prostate cancer, but its psychosocial impact presents challenges. This study used design thinking to develop a digital psychosocial support program aimed at improving quality of life and health outcomes for men on AS.</div></div><div><h3>Methods</h3><div>The design process followed five phases: Empathy, Define, Ideate, Prototype, and Test. Stakeholder interviews were conducted to generate a problem statement. Brainstorming in the ideation phase conceptualized a self-management application and a framework of the application's features was developed. A prototype was developed in close collaboration with end-users and experts. The testing phase included heuristic evaluations and feedback from patients and healthcare providers.</div></div><div><h3>Results</h3><div>Interviews during the empathy phase highlighted the need for personalized care, timely information, and holistic and tailored support. The defined problem statement aimed at reducing the psychosocial burden and improving coping mechanisms during the first year of AS. Ideation involved multidisciplinary brainstorming sessions, resulting in the concept of a self-management application with features such as information, appointment preparation, self-reporting of medical results, lifestyle guidance, relaxation exercises, and communication tools. A prototype application was developed. Testing showed strengths in navigation and design, with recommendations for improving error handling and help documentation. Feedback led to refinements enhancing usability and clinical integration.</div></div><div><h3>Conclusion</h3><div>This study developed a patient-centered self-management application to address psychosocial challenges in AS. By fostering engagement, self-efficacy, and communication, the tool aims to improve outcomes in prostate cancer management. Future clinical studies will evaluate its effectiveness.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"41 ","pages":"Article 100853"},"PeriodicalIF":3.6,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144514299","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}
Pub Date : 2025-06-23DOI: 10.1016/j.invent.2025.100845
Jonathan G. Shalom , Maya Korem , Asher Y. Strauss , Jonathan D. Huppert , Gerhard Andersson , Idan M. Aderka
The present study examined the association between the therapeutic alliance and social anxiety symptoms during internet-delivered cognitive behavior therapy (ICBT) for social anxiety disorder (SAD). We examined 162 individuals diagnosed with SAD who underwent therapist-assisted ICBT and completed measures of the therapeutic alliance weekly during a randomized controlled trial. We used a novel modeling strategy and modeled changes in the therapeutic alliance over time using sinusoidal models. We found that a model that incorporated both a linear component and a sinusoidal component (r2 = 0.72), explained significantly more variance than models using only linear (r2 = 0.42) or only sinusoidal (r2 = 0.41) components. We also found that higher average levels of the alliance as well as greater increases in the therapeutic alliance during treatment were associated with greater reductions in social anxiety during treatment. Finally, we found that greater fluctuations around the slope of alliance were associated with greater reductions in social anxiety during treatment (above and beyond average alliance and increases in alliance). Considering fluctuations around a linear slope may be a useful model for the ups and downs experienced in the therapeutic alliance over the course of therapy. Fluctuations in alliance may not be a sign of negative processes, but could potentially indicate a healthy ebb and flow of the alliance that is predictive of better outcomes.
{"title":"Sine of the times: Can sinusoidal waves model changes in the therapeutic alliance over time?","authors":"Jonathan G. Shalom , Maya Korem , Asher Y. Strauss , Jonathan D. Huppert , Gerhard Andersson , Idan M. Aderka","doi":"10.1016/j.invent.2025.100845","DOIUrl":"10.1016/j.invent.2025.100845","url":null,"abstract":"<div><div>The present study examined the association between the therapeutic alliance and social anxiety symptoms during internet-delivered cognitive behavior therapy (ICBT) for social anxiety disorder (SAD). We examined 162 individuals diagnosed with SAD who underwent therapist-assisted ICBT and completed measures of the therapeutic alliance weekly during a randomized controlled trial. We used a novel modeling strategy and modeled changes in the therapeutic alliance over time using sinusoidal models. We found that a model that incorporated both a linear component and a sinusoidal component (<em>r</em><sup>2</sup> = 0.72), explained significantly more variance than models using only linear (<em>r</em><sup>2</sup> = 0.42) or only sinusoidal (<em>r</em><sup>2</sup> = 0.41) components. We also found that higher average levels of the alliance as well as greater increases in the therapeutic alliance during treatment were associated with greater reductions in social anxiety during treatment. Finally, we found that greater fluctuations around the slope of alliance were associated with greater reductions in social anxiety during treatment (above and beyond average alliance and increases in alliance). Considering fluctuations around a linear slope may be a useful model for the ups and downs experienced in the therapeutic alliance over the course of therapy. Fluctuations in alliance may not be a sign of negative processes, but could potentially indicate a healthy ebb and flow of the alliance that is predictive of better outcomes.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"41 ","pages":"Article 100845"},"PeriodicalIF":3.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365286","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}
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