scholarly journals Is Digital Treatment the Holy Grail? Literature Review on Computerized and Blended Treatment for Depressive Disorders in Youth

Author(s):  
Sanne P. A. Rasing ◽  
Yvonne A. J. Stikkelbroek ◽  
Denise H. M. Bodden

Computerized and blended treatments seem to be an attractive treatment for adolescents as an alternative to face-to-face treatment, but mental health professionals seem hesitant to use these treatment modalities. This review provides an overview of factors contributing to and withholding from using computerized or blended treatment in routine care. Three databases were searched with terms related to (1) adolescents, (2) depression, (3) computerized or blended, and (4) treatment. Of the 33 articles identified, 10 focused on unguided computerized treatments, six on guided, two on blended, two compared unguided, blended- and face-to-face treatment to no treatment, and eight studies on games. Further, two articles that were focused on an online monitoring tool and three on intervention characteristics or preferred modes of help-seeking. Evidence for effectiveness, adherence, drop-out, and forming therapeutic relations were suspected to be barriers, but are no reason to reject computerized or blended treatment. Improvement in mental health literacy and the possibility to tailor the intervention are facilitators. However, adolescents’ intention to seek help, acceptability of computerized treatment, symptom severity, time spent by therapist, and other facilities are identified as barriers and they need to be taken into account when using computerized or blended interventions. Nevertheless, computerized and blended are promising treatments for depressed youth.

2021 ◽  
Vol 38 ◽  
Author(s):  
Rodrigo Teixeira LOPES ◽  
Maria Adriana SVACINA ◽  
Juan Martín GÓMEZ-PENEDO ◽  
Andrés ROUSSOS ◽  
Björn MEYER ◽  
...  

Abstract Specific psychological treatments for depressive disorders delivered on the Internet have shown effectiveness and presented advantages over face-to-face treatments (potentially less expensive, flexible schedules, available in remote areas). This paper aims to describe the characteristics of those who sought help from an online self-guided intervention for depression and to explore hypotheses about predictors of enrollment to the program. Based on a sample of 282 of individuals who filled in screening questionnaires, we verified that the respondents were mainly female, were on average 34.36 years old, were primarily recruited through Facebook, had been previously diagnosed by mental health professionals, presented moderate self-efficacy perception, and had moderately severe symptoms of depression. Respondents who reported comorbid conditions were more likely to attend enrollment interviews, and being in treatment or not did not influence attendance. Such characterization may provide strategies to reach more people and to optimize the design of interventions targeting help-seeking depressed individuals in Brazil.


Author(s):  
Sanne P. A. Rasing

Abstract Depressive disorders are the most prevalent mental health disorder in adolescents with detrimental consequences; effective and available treatment is crucial. Face-to-face and computerized treatments both have advantages but also downsides. Merging these two into one so-called blended treatment seems to be an optimal combination of elements. This current review addresses blended treatment for youth depression and aims to summarize existing knowledge on effectiveness as well as patients’ and therapists’ perspectives. Results showed promising significant decreases in symptoms, but no evidence for differences between blended and face-to-face treatment was found. Patients’ perspectives were mixed; they reported strong preferences for face-to-face treatment, but participants actually receiving blended treatment were mainly positive. Therapists’ attitudes were neutral, but they expressed their worries about the unknown risks on adverse events. Future research is needed and should, beside effectiveness and cost-effectiveness, pay close attention to the risks that are mentioned by therapists.


2016 ◽  
Vol 3 (1) ◽  
pp. e9 ◽  
Author(s):  
Jobke Wentzel ◽  
Rosalie van der Vaart ◽  
Ernst T Bohlmeijer ◽  
Julia E W C van Gemert-Pijnen

Blended care, a combination of online and face-to-face therapy, is increasingly being applied in mental health care to obtain optimal benefit from the advantages these two treatment modalities have. Promising results have been reported, but a variety in descriptions and ways of operationalizing blended care exists. Currently, what type of “blend” works for whom, and why, is unclear. Furthermore, a rationale for setting up blended care is often lacking. In this viewpoint paper, we describe postulates for blended care and provide an instrument (Fit for Blended Care) that aims to assist therapists and patients whether and how to set up blended care treatment. A review of the literature, two focus groups (n=5 and n=5), interviews with therapists (n=14), and interviews with clients (n=2) were conducted to develop postulates of eHealth and blended care and an instrument to assist therapists and clients in setting up optimal blended care. Important postulates for blended care are the notion that both treatment modalities should complement each other and that set up of blended treatment should be based on shared decision making between patient and therapist. The “Fit for Blended Care” instrument is presented which addresses the following relevant themes: possible barriers to receiving blended treatment such as the risk of crisis, issues in communication (at a distance), as well as possible facilitators such as social support. More research into the reasons why and for whom blended care works is needed. To benefit from blended care, face-to-face and online care should be combined in such way that the potentials of both treatment modalities are used optimally, depending on patient abilities, needs, and preferences. To facilitate the process of setting up a personalized blended treatment, the Fit for Blended Care instrument can be used. By applying this approach in research and practice, more insight into the working mechanisms and optimal (personal) “blends” of online and face-to-face therapy becomes within reach.


2016 ◽  
Vol 27 (1) ◽  
pp. 84-93 ◽  
Author(s):  
L. Picco ◽  
E. Abdin ◽  
S. Pang ◽  
J. A. Vaingankar ◽  
A. Jeyagurunathan ◽  
...  

Aims.The ability to recognise a mental illness has important implications as it can aid in timely and appropriate help-seeking, and ultimately improve outcomes for people with mental illness. This study aims to explore the association between recognition and help-seeking preferences and stigmatising attitudes, for alcohol abuse, dementia, depression, obsessive-compulsive disorder (OCD) and schizophrenia, using a vignette-based approach.Methods.This was a population-based, cross-sectional survey conducted among Singapore Residents (n = 3006) aged 18–65 years. All respondents were asked what they think is wrong with the person in the vignette and who they should seek help from. Respondents were also administered the Personal and Perceived sub scales of the Depression Stigma Scale and the Social Distance Scale. Weighted frequencies and percentages were calculated for categorical variables. A series of multiple logistic and linear regression models were performed separately by vignette to generate odd ratios and 95% confidence intervals for the relationship between help-seeking preference, and recognition and beta coefficients and 95% confidence intervals for the relationship between stigma and recognition.Results.Correct recognition was associated with less preference to seek help from family and friends for depression and schizophrenia. Recognition was also associated with increased odds of endorsing seeking help from a psychiatric hospital for dementia, depression and schizophrenia, while there was also an increased preference to seek help from a psychologist and psychiatrist for depression. Recognition was associated with less personal and perceived stigma for OCD and less personal stigma for schizophrenia, however, increased odds of social distancing for dementia.Conclusion.The ability to correctly recognise a mental illness was associated with less preference to seek help from informal sources, whilst increased preference to seek help from mental health professionals and services and less personal and perceived stigma. These findings re-emphasise the need to improve mental health literacy and reinforce the potential benefits recognition can have to individuals and the wider community in Singapore.


2021 ◽  
pp. 002076402110392
Author(s):  
Daniel Cavanagh ◽  
Tomas Jurcik ◽  
Morteza Charkhabi

Background: Depression is a major contributor to the global burden of disease that affects more than 300 million people worldwide. Cross cultural studies find that culture influences levels of trust which can impact upon an individual’s likelihood to seek psychological help when experiencing Depression. Aims: Help seeking is essential for improved mental health outcomes. This study aims to consider how trust affects help-seeking as well as examine the differences in stigma and social distance between participants in Russia and Australia. Method: Participants consisted of two separate samples from Australian ( n = 229) and Russia ( n = 259) which were recruited based on a vignette of a diagnostically unlabelled psychiatric case history with Depression using a cross-cultural research design. They completed items on the level of trust in health professionals, stigma and endorsement of help-seeking. Results: Findings suggest that trust can predict the endorsement of seeking help from a psychologist. Moreover, trust was lower for participants in Russia compared to those in Australia for mental health professionals. Participants in Russia had higher levels of stigma and social distance than their counterparts in Australia. Overall, participants in Australia were more likely to seek professional help than those in Russia. Conclusions: Trust can predict the endorsement of help-seeking from mental health professionals cross culturally. Barriers to help-seeking such as stigma continue to negatively affect mental health outcomes, particularly in Russia.


2018 ◽  
Vol 214 (2) ◽  
pp. 90-95 ◽  
Author(s):  
Pallab K. Maulik ◽  
Siddhardha Devarapalli ◽  
Sudha Kallakuri ◽  
Anadya Prakash Tripathi ◽  
Mirja Koschorke ◽  
...  

BackgroundStigma related to mental health and lack of trained mental health professionals is a major cause for an increased treatment gap, particularly in rural India. The Systematic Medical Appraisal, Referral and Treatment (SMART) Mental Health project delivered a complex intervention involving task sharing, an anti-stigma campaign and use of technology-based, decision-support tools to empower primary care workers to identify and manage depression, anxiety, stress and suicide risk.AimsThe aim of this article is to report changes in stigma perceptions over three time points in the rural communities where the anti-stigma campaign was conducted.MethodA multimedia-based anti-stigma campaign was conducted over a 3-month period in the West Godavari district of Andhra Pradesh, India. Following that, the primary care-based mental health service was delivered for 1 year. The anti-stigma campaign was evaluated in two villages and data were captured at three time points over a 24-month period (N = 1417): before and after delivery of the campaign and after completion of the health services delivery intervention. Standardised tools captured data on knowledge, attitude and behaviour towards mental health as well as perceptions related to help seeking for mental illnesses.ResultsMost knowledge, attitude and behaviour scores improved over the three time points. Overall mean scores on stigma perceptions related to help seeking improved by −0.375 (minimum/maximum of −2.7/2.4, s.d. 0.519, P < 0.001) during this time. Loss to follow-up was 10%.ConclusionsThe data highlight the positive effects of an anti-stigma campaign over a 2-year period.Declaration of interestNone.


The internal migration in countries around the globe as a result of rapid urbanization and related to industrialization as a consequence of globalization has been truly remarkable. The past 50 years have seen a massive rise in the numbers of people moving and creating megapolis in many parts of the world. It is inevitable that with such massive internal migration come stressors such as pollution, lack of space, overcrowding, unemployment, and increased likelihood of infectious diseases, all of which contribute to an increase in psychiatric disorders. Furthermore, such migration can also lead to the splintering of social support and the fraying of social networks, which can further contribute to poor help-seeking and poor therapeutic adherence and poor prognosis. This book highlights challenges in managing mental health and psychiatric disorders in urban areas. The contributors include researchers, clinicians, urban planners, urban designers, and others who are interested in the field. The book will appeal to all mental health professionals, whether they are working in urban areas or rural areas.


BJPsych Open ◽  
2019 ◽  
Vol 5 (5) ◽  
Author(s):  
Kamelia Harris ◽  
Patricia Gooding ◽  
Gillian Haddock ◽  
Sarah Peters

Background Suicide is a leading cause of premature death in people with a diagnosis of schizophrenia. Although exposure to stressors can play a part in the pathways to death by suicide, there is evidence that some people with a diagnosis of schizophrenia can be resilient to the impact of suicide triggers. Aims To investigate factors that contribute to psychological resilience to suicidal thoughts and behaviours from the perspectives of people with a diagnosis of schizophrenia. Method A qualitative design was used, involving semi-structured, face-to-face interviews. Twenty individuals with non-affective psychosis or schizophrenia diagnoses who had experience of suicide thoughts and behaviours participated in the study. The interviews were audio-recorded, transcribed verbatim and examined using inductive thematic analysis. Results Participants reported that psychological resilience to suicidal thoughts and behaviours involved ongoing effort. This ongoing effort encompassed: (a) understanding experiences (including reconciliation to mental health experiences and seeking reasons to live), (b) active behaviours (including talking to people and keeping occupied), and (c) relationship dynamics (including feeling supported by significant others and mental health professionals). Conclusions Psychological resilience was described as a dynamic process that developed over time through the experiences of psychosis and the concomitant suicidal experiences. Psychological resilience can be understood using a multicomponential, dynamic approach that integrates buffering, recovery and maintenance resilience models. In order to nurture psychological resilience, interventions should focus on supporting the understanding and management of psychosis symptoms and concomitant suicidal experiences. Declaration of interest None.


2014 ◽  
Vol 20 (1) ◽  
pp. 62 ◽  
Author(s):  
Bridget Bassilios ◽  
Jane Pirkis ◽  
Kylie King ◽  
Justine Fletcher ◽  
Grant Blashki ◽  
...  

A telephone-based cognitive behavioural therapy pilot project was trialled from July 2008 to June 2010, via an Australian Government-funded primary mental health care program. A web-based minimum dataset was used to examine level of uptake, sociodemographic and clinical profile of consumers, precise nature of services delivered, and consumer outcomes. Key informant interviews with 22 project officers and 10 mental health professionals elicited lessons learnt from the implementation of the pilot. Overall, 548 general practitioners referred 908 consumers, who received 6607 sessions (33% via telephone). The sessions were delivered by 180 mental health professionals. Consumers were mainly females with an average age of 37 years and had a diagnosis of depressive and/or anxiety disorders. A combination of telephone and face-to-face sessions of 1 h in duration were conducted, delivering behavioural and cognitive interventions, usually with no cost to consumers. Several implementation issues were identified by project officers and mental health professionals. Although face-to-face treatment is preferred by providers and consumers, the option of the telephone modality is valued, particularly for consumers who would not otherwise access psychological services. Evidence in the form of positive consumer outcomes supports the practice of multimodal service delivery.


2014 ◽  
Vol 9 (2) ◽  
pp. 109-122 ◽  
Author(s):  
Kimberley Wriedt ◽  
Daryl Oehm ◽  
Brendon Moss ◽  
Prem Chopra

Purpose – Women from culturally and linguistically diverse communities face barriers to accessing perinatal mental health care. Victorian Transcultural Mental Health (VTMH) is a state-wide service in Victoria, Australia, that supports specialist mental health service providers to improve cultural responsiveness. VTMH provided training for perinatal health professionals in cultural responsiveness. The paper aims to discuss these issues. Design/methodology/approach – A curriculum was specifically developed based on a literature review, consultation forum, and input from members of an industry-based reference group. An Evaluation Tool was designed to collect participants’ feedback regarding the perceived relevance of the training content and its impact on practice. Responses were analysed using quantitative techniques and thematic analysis. Findings – Nine face-to-face training sessions were provided, in metropolitan and rural regions. In all, 174 professionals of various backgrounds (including midwives, mental health professionals, and maternal child health nurses) attended. In all, 161 completed evaluations were received and responses indicated that the training was of high relevance to the target workforce, that the training would have implications for their practice, and support was given for further training to be delivered using online methods. Research limitations/implications – First, an assessment of the cultural competence of participants prior to enrolment in the course was not conducted, and no matched control group was available for comparison with the participants. Second, generalisability of these findings to other settings requires further investigation. Third, the sustainability of the project is an area for further study in the future. Fourth, other methods including direct interviews of focus groups with participants may have yielded more detailed qualitative feedback regarding the effectiveness of the programme. Practical implications – To facilitate the sustainability of the project, following the face-to-face training, an online training module and a resource portal were developed, offering links to relevant web sites and resources for health professionals working in this field. Originality/value – The training addressed a significant unmet need for cultural responsiveness training for a diverse range of practitioners in the field of perinatal mental health. Online training can be adapted from face-to-face training and it is anticipated that online training will facilitate the sustainability of this initiative.


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