scholarly journals The Therapeutic Alliance in Digital Mental Health Interventions for Serious Mental Illnesses: Narrative Review (Preprint)

2019 ◽  
Author(s):  
Hailey Tremain ◽  
Carla McEnery ◽  
Kathryn Fletcher ◽  
Greg Murray
Keyword(s):  
Mental Health ◽  
Therapeutic Alliance ◽  
Narrative Review ◽  
Mental Illnesses ◽  
Health Interventions ◽  
Face To Face ◽  
Digital Interventions ◽  
Mental Health Interventions ◽  
Serious Mental Illnesses

BACKGROUND Digital mental health interventions offer unique advantages, and research indicates that these interventions are effective for a range of mental health concerns. Although these interventions are less established for individuals with serious mental illnesses, they demonstrate significant promise. A central consideration in traditional face-to-face therapies is the therapeutic alliance, whereas the nature of a digital therapeutic alliance and its relationship with outcomes requires further attention, particularly for individuals with serious mental illnesses. OBJECTIVE This narrative review aims to encourage further consideration and critical evaluation of the therapeutic alliance in digital mental health, specifically for individuals with serious mental illnesses. METHODS A narrative review was conducted by combining 3 main areas of the literature: the first examining the evidence for digital mental health interventions for serious mental illnesses, the second illuminating the nature and role of the therapeutic alliance in digital interventions, and the third surrounding practical considerations to enhance a digital therapeutic alliance. RESULTS Results indicated that a therapeutic alliance can be cultivated in digital interventions for those with serious mental illnesses, but that it may have unique, yet-to-be-confirmed characteristics in digital contexts. In addition, a therapeutic alliance appears to be less directly associated with outcomes in digital interventions than with those in face-to-face therapies. One possibility is that the digital therapeutic alliance is associated with increased engagement and adherence to digital interventions, through which it appears to influence outcomes. A number of design and implementation considerations may enhance the digital therapeutic alliance, including human support and technological features. CONCLUSIONS More research is required to further understand the nature and specific role of a therapeutic alliance in digital interventions for serious mental illnesses, particularly in informing their design. This review revealed several key research priorities to advance the therapeutic alliance in digital interventions.

scholarly journals The Therapeutic Alliance in Digital Mental Health Interventions for Serious Mental Illnesses: Narrative Review

10.2196/17204 ◽  
2020 ◽  
Vol 7 (8) ◽  
pp. e17204 ◽  
Author(s):  
Hailey Tremain ◽  
Carla McEnery ◽  
Kathryn Fletcher ◽  
Greg Murray
Keyword(s):  
Mental Health ◽  
Therapeutic Alliance ◽  
Narrative Review ◽  
Mental Illnesses ◽  
Health Interventions ◽  
Face To Face ◽  
Digital Interventions ◽  
Mental Health Interventions ◽  
Serious Mental Illnesses

Background Digital mental health interventions offer unique advantages, and research indicates that these interventions are effective for a range of mental health concerns. Although these interventions are less established for individuals with serious mental illnesses, they demonstrate significant promise. A central consideration in traditional face-to-face therapies is the therapeutic alliance, whereas the nature of a digital therapeutic alliance and its relationship with outcomes requires further attention, particularly for individuals with serious mental illnesses. Objective This narrative review aims to encourage further consideration and critical evaluation of the therapeutic alliance in digital mental health, specifically for individuals with serious mental illnesses. Methods A narrative review was conducted by combining 3 main areas of the literature: the first examining the evidence for digital mental health interventions for serious mental illnesses, the second illuminating the nature and role of the therapeutic alliance in digital interventions, and the third surrounding practical considerations to enhance a digital therapeutic alliance. Results Results indicated that a therapeutic alliance can be cultivated in digital interventions for those with serious mental illnesses, but that it may have unique, yet-to-be-confirmed characteristics in digital contexts. In addition, a therapeutic alliance appears to be less directly associated with outcomes in digital interventions than with those in face-to-face therapies. One possibility is that the digital therapeutic alliance is associated with increased engagement and adherence to digital interventions, through which it appears to influence outcomes. A number of design and implementation considerations may enhance the digital therapeutic alliance, including human support and technological features. Conclusions More research is required to further understand the nature and specific role of a therapeutic alliance in digital interventions for serious mental illnesses, particularly in informing their design. This review revealed several key research priorities to advance the therapeutic alliance in digital interventions.

scholarly journals Digital Interventions for Depression and Anxiety in Older Adults: Protocol for a Systematic Review

10.2196/22738 ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. e22738
Author(s):  
Indira Riadi ◽  
Lucy Kervin ◽  
Kelly Teo ◽  
Ryan Churchill ◽  
Theodore D Cosco
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Older Adults ◽  
Mental Illnesses ◽  
Health Interventions ◽  
Current Evidence ◽  
Depression And Anxiety ◽  
Treatment And Prevention ◽  
Digital Interventions ◽  
Mental Health Interventions

Background There is a high prevalence of older adults experiencing depression and anxiety. In response to heightened demands for mental health interventions that are accessible and affordable, there has been a recent rise in the number of digital mental health interventions (DMHIs) that have been developed and incorporated into mental health treatments. Digital interventions are promising in their ability to provide researchers, medical practitioners, and patients with personalized tools for assessing behavior, consultation, treatment, and care that can be used remotely. Reviews and meta-analyses have shown the benefits of DMHIs for the treatment and prevention of depression, anxiety, and other mental illnesses, but there is still a lack of studies that focus on the benefits and use of DMHIs in the older population. Objective The aim of this systematic review is to investigate the current evidence for the effect of technology-delivered interventions, such as smartphone/tablet applications, remote monitoring and tracking devices, and wearable technology, for the treatment and prevention of depression and anxiety in adults older than 50 years. Methods The academic databases SCOPUS, PsycINFO, AgeLine (EBSCO), and Medline (PubMed) will be searched from January 1, 2010, to the date of search commencement to provide a review of existing randomized controlled trial studies. The search will include 3 key concepts: “older adults,” “digital intervention,” and “depression/anxiety.” A set of inclusion criteria will be followed during screening by two reviewers. Data will be extracted to address aims and objectives of the review. The risk of bias for each study will be determined using appropriate tools. If possible, a random-effects meta-analysis will be performed, and the heterogeneity of effect sizes will be calculated. Results Preliminary searches were conducted in September 2020. The review is anticipated to be completed by April 2021. Conclusions The data accumulated in this systematic review will demonstrate the potential benefits of technology-delivered interventions for the treatment of depression and anxiety disorders in older adults. This review will also identify any gaps in current studies of aging and mental health interventions, thereby navigating a way to move forward and paving the path to more accessible and user-friendly digital health interventions for the diverse population of older adults. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42020192532; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020192532 International Registered Report Identifier (IRRID) PRR1-10.2196/22738

scholarly journals Digital Interventions for Depression and Anxiety in Older Adults: Protocol for a Systematic Review (Preprint)

2020 ◽  
Author(s):  
Indira Riadi ◽  
Lucy Kervin ◽  
Kelly Teo ◽  
Ryan Churchill ◽  
Theodore D Cosco
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Older Adults ◽  
Mental Illnesses ◽  
Health Interventions ◽  
Current Evidence ◽  
Depression And Anxiety ◽  
Treatment And Prevention ◽  
Digital Interventions ◽  
Mental Health Interventions

BACKGROUND There is a high prevalence of older adults experiencing depression and anxiety. In response to heightened demands for mental health interventions that are accessible and affordable, there has been a recent rise in the number of digital mental health interventions (DMHIs) that have been developed and incorporated into mental health treatments. Digital interventions are promising in their ability to provide researchers, medical practitioners, and patients with personalized tools for assessing behavior, consultation, treatment, and care that can be used remotely. Reviews and meta-analyses have shown the benefits of DMHIs for the treatment and prevention of depression, anxiety, and other mental illnesses, but there is still a lack of studies that focus on the benefits and use of DMHIs in the older population. OBJECTIVE The aim of this systematic review is to investigate the current evidence for the effect of technology-delivered interventions, such as smartphone/tablet applications, remote monitoring and tracking devices, and wearable technology, for the treatment and prevention of depression and anxiety in adults older than 50 years. METHODS The academic databases SCOPUS, PsycINFO, AgeLine (EBSCO), and Medline (PubMed) will be searched from January 1, 2010, to the date of search commencement to provide a review of existing randomized controlled trial studies. The search will include 3 key concepts: “older adults,” “digital intervention,” and “depression/anxiety.” A set of inclusion criteria will be followed during screening by two reviewers. Data will be extracted to address aims and objectives of the review. The risk of bias for each study will be determined using appropriate tools. If possible, a random-effects meta-analysis will be performed, and the heterogeneity of effect sizes will be calculated. RESULTS Preliminary searches were conducted in September 2020. The review is anticipated to be completed by April 2021. CONCLUSIONS The data accumulated in this systematic review will demonstrate the potential benefits of technology-delivered interventions for the treatment of depression and anxiety disorders in older adults. This review will also identify any gaps in current studies of aging and mental health interventions, thereby navigating a way to move forward and paving the path to more accessible and user-friendly digital health interventions for the diverse population of older adults. CLINICALTRIAL PROSPERO International Prospective Register of Systematic Reviews CRD42020192532; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020192532 INTERNATIONAL REGISTERED REPORT PRR1-10.2196/22738

scholarly journals Assessing Therapeutic Alliance in the Context of mHealth Interventions for Mental Health Problems: Development of the Mobile Agnew Relationship Measure (mARM) Questionnaire (Preprint)

2017 ◽  
Author(s):  
Katherine Berry ◽  
Amy Salter ◽  
Rohan Morris ◽  
Susannah James ◽  
Sandra Bucci
Keyword(s):  
Mental Health ◽  
Therapeutic Alliance ◽  
Digital Health ◽  
Health Intervention ◽  
Health Interventions ◽  
Health Staff ◽  
Service Users ◽  
Face To Face ◽  
Mental Health Interventions ◽  
Stage 1

BACKGROUND Digital health interventions in the form of smartphone apps aim to improve mental health and enable people access to support as and when needed without having to face the stigma they may experience in accessing services. If we are to evaluate mobile health (mHealth) apps and advance scientific understanding, we also need tools to help us understand in what ways mHealth interventions are effective or not. The concept of therapeutic alliance, a measure of the quality of the relationship between a health care provider and a service user, is a key factor in explaining the effects of mental health interventions. The Agnew Relationship Measure (ARM) is a well-validated measure of therapeutic alliance in face-to-face therapy. OBJECTIVE This study presented the first attempt to (1) explore service users’ views of the concept of relationship within mHealth mental health interventions and (2) adapt a well-validated face-to-face measure of therapeutic alliance, the Agnew Relationship Measure (ARM), for use with mHealth interventions. METHODS In stage 1, we interviewed 9 mental health service users about the concept of therapeutic alliance in the context of a digital health intervention and derived key themes from interview transcripts using thematic analysis. In stage 2, we used rating scales and open-ended questions to elicit views from 14 service users and 10 mental health staff about the content and face validity of the scale, which replaced the word “therapist” with the word “app.” In stage 3, we used the findings from stages 1 and 2 to adapt the measure with the support of a decision-making algorithm about which items to drop, retain, or adapt. RESULTS Findings suggested that service users do identify relationship concepts when thinking about mHealth interventions, including forming a bond with an app and the ability to be open with an app. However, there were key differences between relationships with health professionals and relationships with apps. For example, apps were not as tailored and responsive to each person’s unique needs. Furthermore, apps were not capable of portraying uniquely human-like qualities such as friendliness, collaboration, and agreement. We made a number of changes to the ARM that included revising 16 items; removing 4 items due to lack of suitable alternatives; and adding 1 item to capture a key theme derived from stage 1 of the study (“The app is like having a member of my care team in my pocket”). CONCLUSIONS This study introduces the mHealth version of the ARM, the mARM, that has good face and content validity. We encourage researchers to include this easy-to-use tool in digital health intervention studies to gather further data about its psychometric properties and advance our understanding of how therapeutic alliance influences the efficacy of mHealth interventions. CLINICALTRIAL International Standard Randomized Controlled Trial Number (ISRCTN) 34966555; http://www.isrctn.com/ISRCTN34966555 (Archived by WebCite at http://www.webcitation.org/6ymBVwKif)

Out of tune: Perceptions of, engagement with, and responses to mental health interventions by professional popular musicians—A scoping review

2021 ◽  
pp. 030573562110194
Author(s):  
Amy Visser ◽  
Megan Lee ◽  
Timothy Barringham ◽  
Nasim Salehi
Keyword(s):  
Mental Health ◽  
Scoping Review ◽  
Distinct Group ◽  
Well Being ◽  
Health Interventions ◽  
Therapeutic Approaches ◽  
Increased Risk ◽  
Mental Health Interventions ◽  
Industry Peers

Professional popular musicians are at increased risk of psychological distress, substance use problems, and suicide, yet little evidence is available on effective psychotherapeutic practices to address these issues. This scoping review aims to understand how professional popular musicians perceive, engage with, and respond to mental health interventions. Four databases were searched, garnering a total of 310 articles. Of these, six met inclusion criteria. Four thematic categories were explored: (1) amenability of professional popular musicians to particular therapeutic approaches; (2) attribution of treatment outcomes to tailored approaches; (3) professional popular musicians’ perceived barriers to treatment; and (4) recommendations for treatment approaches. The scoping review supports the importance of considering the characteristics of professional popular musicians as a distinct group with unique well-being needs, challenges, and strengths. There is a clear preference for tailored, affordable, and accessible approaches that consider the uniquities of musicianship and the need to explore the role of nonclinical support, such as friends, family, and industry peers.

Mental Health Screening in General Practices as a Means for Enhancing Uptake of Digital Mental Health Interventions: An Observational Cohort Study (Preprint)

2021 ◽  
Author(s):  
Alexis Estelle Whitton ◽  
Rebecca Hardy ◽  
Kate Cope ◽  
Chilin Gieng ◽  
Leanne Gow ◽  
...  
Keyword(s):  
Mental Health ◽  
Critical Role ◽  
Health Screening ◽  
Mental Health Screening ◽  
Health Interventions ◽  
Treatment Recommendation ◽  
Digital Interventions ◽  
Digital Intervention ◽  
Mental Health Interventions ◽  
General Practices

BACKGROUND Digital mental health interventions will play a critical role in managing the mental health impacts of the COVID-19 pandemic. Thus, enhancing their uptake is a key priority. General Practitioners (GPs) are well-positioned to facilitate access to digital interventions, but tools that assist GPs in identifying suitable patients are lacking. OBJECTIVE This study evaluated the effectiveness of a web-based mental health screening and treatment-recommendation tool (‘StepCare’) for improving the detection of anxiety and depression in general practice, and subsequently, uptake of digital mental health interventions. METHODS StepCare screens patients for symptoms of depression (PHQ-9) and anxiety (GAD-7) in the GP waiting room. It provides GPs with stepped treatment recommendations that include digital mental health interventions for mild-to-moderate symptoms. Patients (n=5,138) from 85 general practices across Australia were invited to take part in screening. RESULTS Depression and/or anxiety was detected in 43.1% of patients screened (one quarter were previously undiagnosed/untreated). The majority (89.5%) of previously undiagnosed/untreated patients had mild-to-moderate symptoms and were candidates for digital mental health interventions. Although less than half were prescribed a digital intervention by their GP, when a digital intervention was prescribed, over two thirds of patients used it. CONCLUSIONS Implementing mental health screening in general practices can increase patient access to digital mental health interventions. Although GPs prescribed digital interventions less frequently than in-person psychotherapy or medication, the promising rates of uptake by GP-referred patients suggests that GPs can play a critical role in championing digital interventions and maximising the associated benefits.

Mental health interventions in the mining industry: a narrative review

2020 ◽  
Vol 25 (2) ◽  
pp. 153-167
Author(s):  
Winifred Asare-Doku ◽  
Jane Rich ◽  
Brian Kelly ◽  
Carole James
Keyword(s):  
Mental Health ◽  
Mining Industry ◽  
Narrative Review ◽  
Health Interventions ◽  
Health Needs ◽  
Mental Health Needs ◽  
Content Type ◽  
Workplace Mental Health ◽  
Mental Health Interventions ◽  
Male Dominated

Purpose Previous research has suggested high levels of unaddressed mental health needs among male-dominated work settings. The mining industry has been a recent focus internationally. This paper aims to critically examine research regarding organizational mental health interventions for people working in mining industries. Design/methodology/approach The narrative review used a systematic standardized search strategy in six databases and grey literature from 1990 to 2019. Findings Of the 418 studies identified, seven studies (five quantitative and two qualitative studies) met the inclusion criteria. Analysis of these studies revealed the organisational interventions available to address mental health needs of miners. Interventions were categorised into organisational and individual-focused approaches. Evidence shows there is great potential in conducting workplace mental health programs, yet further research is required to create a strong evidence base for substantiated policy and practice implications. Practical implications Mental health interventions and programs should be available in mining industry to enhance mental health. Organisations can also improve mental health by implementing significant changes in the work environment and identifying workplace factors that induce strain and contribute to psychological distress in employees. Attempt can be made at restructuring safety policies and practices to include mental health, addressing organisational structures such as work schedules and providing training for managers and supervisors. Originality/value This review focuses on the unique characteristics pertaining to male-dominated mining industries and workplace mental health interventions which are aimed at supporting employee mental health.

A Systematic Mapping Review of Family Perspectives About Received Mental Health Interventions

2021 ◽  
pp. 104973152110109
Author(s):  
Caroline Walters ◽  
Melissa Petrakis
Keyword(s):  
Mental Health ◽  
Health Interventions ◽  
Inclusion Criteria ◽  
Systematic Mapping ◽  
Evidence Mapping ◽  
Carer Support ◽  
Mapping Review ◽  
Mental Health Interventions ◽  
Systematic Mapping Review

Purpose: Families experience their own journey in adjusting to the role of carer. The purpose of this review was to understand from the perspective of families and carers which practices, and health system responses meet their needs in supporting people who experience mental health challenges. Methods: A systematic evidence mapping review was conducted, through searching five electronic databases to identify peer-reviewed studies, written in English and published between the years 2010 and 2020, that prioritized the perspectives of families. Results: Fifty-five studies met the inclusion criteria and were mapped according to the country of author, year, methodology, who delivered, and intervention mode and format. Discussion: The review demonstrated a diversity of interventions with growing numbers of studies considering the view and experiences of carers. There is evidence of increasingly active participation of carers in designing, leading, or facilitating interventions, recognizing the importance of coproduction in tailoring family and carer support.

Understanding Adolescent Narratives About “Bullying” Through an Intersectional Lens: Implications for Youth Mental Health Interventions

2016 ◽  
Vol 50 (5) ◽  
pp. 636-658 ◽  
Author(s):  
Rebecca J. Haines-Saah ◽  
Carla T. Hilario ◽  
Emily K. Jenkins ◽  
Cara K. Y. Ng ◽  
Joy L. Johnson
Keyword(s):  
Mental Health ◽  
Qualitative Study ◽  
Youth Mental Health ◽  
Health Interventions ◽  
Contextual Approach ◽  
Social Inequities ◽  
The Social ◽  
Mental Health Interventions ◽  
A Site

This article is based on findings from a qualitative study with 27 adolescents in northern British Columbia, Canada. Our aim was to explore youths’ perspectives on the sources of emotional distress in their lives and how these are connected to peer-based aggression and victimization within their community. Our analysis of narrative findings suggests that youths’ narratives about bullying reflect intersecting and socially embedded configurations of “race,” neocolonialism, and place. We argue that mainstream approaches to addressing bullying as a relationship-based problem must be re-oriented to account for the role of the social or structural contexts of youths’ lives. By applying an intersectional lens, we make the case for a widening of the focus of interventions away from individual victims and perpetrators, toward a contextual approach that addresses how adolescents experience bullying as a site of health and social inequities in their community.

scholarly journals Use of the Principles of Design Thinking to Address Limitations of Digital Mental Health Interventions for Youth: Viewpoint (Preprint)

2018 ◽  
Author(s):  
Hanneke Scholten ◽  
Isabela Granic
Keyword(s):  
Mental Health ◽  
Design Thinking ◽  
Health Interventions ◽  
New Wave ◽  
Digital Interventions ◽  
Wide Range ◽  
Mental Health Interventions ◽  
Principles Of Design ◽  
Meta Analyses ◽  
Scientific Standards

UNSTRUCTURED Numerous reviews and meta-analyses have indicated the enormous potential of technology to improve the appeal, effectiveness, cost, and reach of mental health interventions. However, the promise of digital mental health interventions for youth has not yet been realized. Significant challenges have been repeatedly identified, including engagement, fidelity, and the lack of personalization. We introduce the main tenets of design thinking and explain how they can specifically address these challenges, with an entirely new toolbox of mindsets and practices. In addition, we provide examples of a new wave of digital interventions to demonstrate the applicability of design thinking to a wide range of intervention goals. In the future, it will be critical for scientists and clinicians to implement their scientific standards, methods, and review outlets to evaluate the contribution of design thinking to the next iteration of digital mental health interventions for youth.

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