Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Dec 10, 2019
Date Accepted: Jun 11, 2020
Implementing online therapy in routine mental health care: A systematic review of health professionals’ perspectives.
ABSTRACT
Background:
Online therapies hold great promise to increase accessibility and reduce costs of delivering mental health care, however, uptake in routine settings has been low.
Objective:
This review summarizes what is known about the barriers and facilitators perceived by health professionals (HPs) to the implementation of online psychological treatments in routine care of adults in health settings.
Methods:
Five major databases were searched, identifying 34 eligible papers: 18 qualitative, 11 quantitative and 5 mixed methods.
Results:
The following themes were identified: consumer factors, HP factors, the therapeutic relationship, therapy factors, organisational and system factors, and models of care. HPs only supported online therapies for consumers with relatively straightforward, low risk diagnoses, strong motivation and engagement, high computer literacy and access, and low need for tailored content. They perceived flexibility with timing and location as advantages of online therapy, but preferred blended therapy to facilitate rapport, and allow active monitoring and follow-up of consumers. They emphasised the need for targeted training and organisational support to manage changed workflows. HPs were concerned about the confidentiality and security of client data for online programs, suggesting that clear and transparent protocols need to be in place to reassure HPs before they will be willing to refer.
Conclusions:
In order to increase uptake of online therapies it is worth considering targeting a subset of consumers, using a blended approach, reconsidering the content and structure of online programs, educating HPs about their use, and designing a system that supports HPs in this new way of working with consumers and addresses their concerns.
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Copyright
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