JMIR Publications

ABSTRACT

Background:

Therapy protocols help therapists to apply the ingredients that are intended to evoke predicted therapeutic effects. Although psychosocial therapies are effective in treating adolescents with mental disorders, there is still room for improvement. Including eHealth in therapeutic practice is a promising mean to improve patient engagement and therapeutic effectiveness. The therapy protocols that form the basis for the face-to-face therapies are typically used as a basis for the design of eHealth. However, not all parts of such protocols are always applied in therapeutic practice. If eHealth designers do not take this into account, the designed eHealth might not optimally fit the therapeutic practice and impede implementation.

Objective:

The aim of this study was to gain insight into the potential effect of personalization as a design mean for optimizing eHealth implementation in mental healthcare. To achieve this, we studied the proportion, type and reasons for personalization of a given therapy protocol by therapists and patients.

Methods:

A set of focus group sessions were organized, involving therapists and patients. The commonly applied protocol for Cognitive Behavioral Therapy was used as a case protocol. The first part of focus groups aimed to research the amount and type of protocol personalization. The discussions were conducted with either therapists (N = 6) or patients (N = 5). The second part of focus groups evaluated the results of the first part and aimed to gain insight into the reasons for personalization. These discussions were conducted with groups of therapists and patients together (N = 7: 3 therapists, 4 patients).

Results:

Results showed that therapists strictly followed 48% of the protocol and adapted 30%. Therapists added 22% of other non-protocol therapeutic parts. Patients strictly followed 29% of the provided therapy by the therapist, adapted 48%, and added 23%.

Conclusions:

Based on these results the following recommendations for eHealth designers are presented to enhance alignment of eHealth to the therapeutic practice and implementation: a) study and copy at least the applied parts of a therapy protocol, b) co-design eHealth so both therapists and patients can personalize specific parts, and c) investigate if parts of the therapy protocol that are not applied should be part of the eHealth application.