Computer and psychotherapy – do they fit? Review of the state of development of internet-based and blended interventions in psychotherapy

Die Verbreitung moderner Medien wirkt sich zunehmend auf psychologische Behandlungsangebote aus. Während die empirische Basis internetbasierter Interventionen zur Behandlung häufiger psychischer Beeinträchtigungen wächst und ihre Anwendung in der Regelversorgung gegenwärtig international erprobt wird, bestehen zusätzliche Bestrebungen, das gewonnene Knowhow mit konventioneller Psychotherapie zu kombinieren. Die daraus entstehende Behandlungsform der „gemischten Psychotherapie“ („blended therapy“) hat das deklarierte Ziel, das Beste aus beiden Welten zu vereinen. Nach einer einleitenden Begriffsbestimmung gibt die vorliegende Übersichtsarbeit Einblick in die Inhalte und die Bestandteile internetbasierter sowie gemischter Interventionen. Der aktuelle Forschungsstand wird skizziert und vor dem Hintergrund der praktischen Anwendbarkeit durch eine Zusammenschau quantitativer und qualitativer Studien dargelegt. Besonderes Augenmerk gilt der Rolle der therapeutischen Unterstützung und der Beschaffenheit der therapeutischen Allianz bei internetbasierten Interventionen sowie den Stärken und Schwächen beider Behandlungsstrategien. Ziel ist es, sowohl die Entwicklung als auch das Potenzial beider Forschungsrichtungen plausibel und realistisch darzustellen und in eine strategische Versorgungsperspektive zu setzen.Modern media have an increasing impact on psychological health services. While the empirical foundation of internet-based interventions for frequently occurring mental disorders grows and their effectiveness is investigated in routine care trials, efforts also exist to transfer the knowledge gained to classical psychotherapy. The resulting treatment format “blended therapy” aims to combine the best of both worlds. After an introductory definition of both terms this overview describes the contents and components of internet-based and blended interventions. Summarizing the current state of research with an emphasis on feasibility, selected quantitative and qualitative articles are presented. The article depicts the development, application and potential of both interventional strategies and focuses on the role of therapist support as well as on the nature of the therapeutic alliance. Strengths and weaknesses of each intervention are addressed and integrated into a strategic perspective

Digital Interventions for Mental Disorders:Key Features, Efficacy, and Potential for Artificial Intelligence Applications

Mental disorders are highly prevalent and often remain untreated. Many limitations of conventional face-to-face psychological interventions could potentially be overcome through Internet-based and mobile-based interventions (IMIs). This chapter introduces core features of IMIs, describes areas of application, presents evidence on the efficacy of IMIs as well as potential effect mechanisms, and delineates how Artificial Intelligence combined with IMIs may improve current practices in the prevention and treatment of mental disorders in adults. Meta-analyses of randomized controlled trials clearly show that therapist-guided IMIs can be highly effective for a broad range of mental health problems. Whether the effects of unguided IMIs are also clinically relevant, particularly under routine care conditions, is less clear. First studies on IMIs for the prevention of mental disorders have shown promising results. Despite limitations and challenges, IMIs are increasingly implemented into routine care worldwide. IMIs are also well suited for applications of Artificial Intelligence and Machine Learning, which provides ample opportunities to improve the identification and treatment of mental disorders. Together with methodological innovations, these approaches may also deepen our understanding of how psychological interventions work, and why. Ethical and professional restraints as well as potential contraindications of IMIs, however, should also be considered. In sum, IMIs have a high potential for improving the prevention and treatment of mental health disorders across various indications, settings, and populations. Therefore, implementing IMIs into routine care as both adjunct and alternative to face-to-face treatment is highly desirable. Technological advancements may further enhance the variability and flexibility of IMIs, and thus even further increase their impact in people’s lives in the future