Evaluation of Two Web-Based Interventions (Res-Up! and REMOTION) in Routine Outpatient Psychotherapy (Therapy Online Plus-TOP): Protocol for a Randomized Controlled Trial.

BACKGROUND Only 11%-40% of those with a mental disorder in Germany receive treatment. In many cases, face-to-face psychotherapy is not available because of limited resources, such as an insufficient number of therapists in the area. New approaches to improve the German health care system are needed to counter chronification. Web-based interventions have been shown to be effective as stand-alone and add-on treatments to routine practice. Interventions designed for a wide range of mental disorders such as transdiagnostic interventions are needed to make treatment for mental disorders more accessible and thus shorten waiting times and mitigate the chronification of mental health problems. In general, interventions can be differentiated as having either a capitalization (CAP) focus-thus drawing on already existing strengths-or a compensation (COMP) focus-trying to compensate for deficits. Up to now, the effectiveness of transdiagnostic web-based interventions with either a CAP or a COMP focus has not yet been evaluated. OBJECTIVE This study is the first to examine the effectiveness of two transdiagnostic web-based interventions: (1) the activation of resilience and drawing on existing strengths (CAP: Res-Up!) and (2) the improvement of emotion regulation (COMP: REMOTION), compared with care as usual (CAU) in routine outpatient psychotherapy. METHODS Adults with at least 1 mental health disorder will be recruited at 4 outpatient centers in Germany. Participants will then be randomized equally into 1 of the 2 intervention groups Res-Up! (CAP) and REMOTION (COMP) or into the control group (CAU). Assessments will be made at baseline (T0), at 6 weeks after treatment start (T1), and at 12 weeks after treatment start (T2). A primary outcome will be symptom severity (Brief Symptom Inventory-18). Secondary outcomes will focus on emotion regulation and resilience. RESULTS Participant recruitment and data collection started in April 2020 and were ongoing as of July 2022. We expect participants to benefit more from the interventions than from the CAU control on the dimensions of symptom severity, resilience, and emotion regulation. Furthermore, we expect to find possible differences between CAP and COMP. The results of the study are expected in 2023. CONCLUSIONS This randomized controlled trial will compare CAU with the transdiagnostic web-based interventions Res-Up! and REMOTION, and will thus inform future studies concerning the effectiveness of transdiagnostic web-based interventions in routine outpatient psychotherapy. TRIAL REGISTRATION ClinicalTrials.gov NCT04352010; https://clinicaltrials.gov/ct2/show/NCT04352010. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/41413

Die Mischung macht’s eben? Blended-Psychotherapie als Ansatz der Digitalisierung in der Psychotherapie

Hintergrund: Über die letzten Jahrzehnte wurden verschiedene Ansätze zur Digitalisierung der Psychotherapie (PT) entwickelt. Eine Behandlungsform stellt die Kombination von „Face-to-face“-PT und Online-Interventionen, die „Blended-PT“, dar. Während das Forschungsinteresse zu Blended-PT in den letzten Jahren zugenommen hat, wurde die praktische Anwendung von Blended-PT im deutschsprachigen Raum bisher weniger stark umgesetzt. Auch bedingt durch die globale, durch die „coronavirus disease 2019“ (COVID-19) ausgelöste Pandemie gewinnen Blended-PT und andere Online-Ansätze zunehmend an Bedeutung. Ziel der Arbeit: Ein Überblick zum Thema und zu verschiedenen Formen von Blended- PT wird gegeben. Im Weiteren wird auf die Wirksamkeit, die Sicht der Patient:innen und Therapeut:innen sowie auf das Thema der Implementierung eingegangen. Material und Methoden: Narrative Übersicht der Literatur zum Thema Blended-PT; auf Basis einer umfassenden Suche werden wichtige Überlegungen und Befunde eingeordnet und beschrieben. Ergebnisse: Der Begriff der Blended-PT wird bisher uneinheitlich verwendet. In Anlehnung an Blended-Learning-Ansätze können „blends“ auf verschiedenen Ebenen stattfinden. Es kann zwischen ergänzenden und transformierenden Blends unterschieden werden. In transformierenden Blends verändert das Format die Face-to-face-PT grundlegend. Zu einigen Blended-PT-Formen gibt es bereits Wirksamkeitsbelege, zu anderen besteht dringender Forschungsbedarf. Im Vergleich zu Face-to-face-PT und reiner Online-Therapie könnte die Blended-PT verschiedene Vorteile bieten. Schlussfolgerung: Das Interesse an Blended-PT wächst aufseiten von Patient:innen und Therapeut:innen. Um evidenzbasierte Blended-PT erfolgreich anbieten zu können, bedarf es der engen Zusammenarbeit zwischen Wissenschaft, Institutionen, Therapeut:innen und Kostenträgern im Gesundheitssystem

REMOTION Blended Transdiagnostic Intervention for Symptom Reduction and Improvement of Emotion Regulation in an Outpatient Psychotherapeutic Setting: Protocol for a Pilot Randomized Controlled Trial.

BACKGROUND Emotion regulation has been identified as an important transdiagnostic factor relevant to the treatment of mental health disorders. Many empirically validated psychotherapeutic treatments incorporate elements targeting emotion regulation. Most of these treatment approaches are conceptualized as standard face-to-face treatments not as blended treatments, which include an internet-based intervention. OBJECTIVE The aim of this study is to examine, for the first time, a new internet-based intervention-REMOTION-that will be provided transdiagnostically, as an add-on to psychotherapy, to provide a blended treatment format. METHODS A total of 70 participants will be assigned (1:1 allocation ratio) to either the intervention group (REMOTION + psychotherapy) or the treatment-as-usual group that receives psychotherapy alone. To maximize external validity, a typical outpatient treatment sample of patients diagnosed with a range of disorders such as depression, anxiety disorders, and adjustment disorder will be recruited from a university outpatient clinic. Patients with bipolar disorder, psychotic disorders, or acute suicidality will be excluded from the study. The feasibility and potential effectiveness of the intervention will be examined by assessing data at baseline, 6 weeks (post), and 12 weeks (follow-up). The primary outcome is general symptom severity, assessed with the Brief Symptom Inventory. Secondary outcomes are emotion regulation, depressive symptoms, anxiety symptoms, health related quality of life, well-being, and a variety of feasibility parameters. Quantitative data will be analyzed on an intention-to-treat basis. RESULTS Participant recruitment and data collection started in February 2020, and as of November 2020, are ongoing. Results for the study are expected in 2022. CONCLUSIONS This pilot randomized controlled trial will inform future studies using transdiagnostic blended treatment. TRIAL REGISTRATION ClinicalTrials.gov NCT04262726; http://clinicaltrials.gov/ct2/show/NCT04262726. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/20936