Author:
Jackson Hayley M.,Batterham Philip J.,Ohan Jeneva L.,Calear Alison L.,Farrer Louise M.
Abstract
Abstract
Background
The acquisition of knowledge and use of skills from digital mental health interventions (DMHIs) are considered important for effectiveness. However, our understanding of user experiences implementing skills learned from these interventions is limited, particularly outside of research trials. This qualitative study aimed to investigate how community users learn and apply knowledge and skills from DMHIs based on cognitive behavioural therapy (CBT) in daily life. The study also examined factors influencing the selection and use of skills and explored perceived changes in mental health resulting from the intervention.
Methods
Thirteen adults aged 26 to 66 years (10 females) were recruited using social media advertising and participated in semi-structured interviews by telephone or videoconference. All participants were living in Australia and had used a digital CBT program within the past 3 months. Interviews lasted on average 45 min. Transcripts were analysed using theoretical thematic analysis.
Results
Participants demonstrated high levels of program engagement. Findings were organised into three topics with six major themes. Participants reported that their chosen intervention reinforced existing knowledge and fostered new skills and insights (Topic 1, Theme 1: knowledge consolidation). Most described actively applying skills (Topic 1, Theme 2: active approach to skill enactment), although the extent of learning and range of skills enacted varied across participants. Influences on skill selection included the perceived relevance of intervention strategies to the user’s needs and personal characteristics (Topic 2, Theme 1: relevance of intervention strategies), as well as the perceived or experienced effectiveness of those strategies (Topic 2, Theme 2: perceived and experienced benefit). Challenges to ongoing skill enactment included time scarcity, prioritisation difficulties, and lack of motivation (Topic 2, Theme 3: navigating time constraints and low motivation). Improvements in mental health were generally modest and attributed mainly to participants’ proactive efforts (Topic 3, Theme 1: perceived changes).
Conclusions
DMHIs may reinforce existing understanding of psychotherapeutic strategies, offer new knowledge, and encourage the application of skills in everyday life among community users who actively engage with these interventions. Future research should prioritise personalising DMHIs and investigating methods to optimise the acquisition, retention, and sustained application of knowledge and skills.
Funder
Australian Government Research Training Program Scholarship
Grace Groom Memorial Scholarship
National Health and Medical Research Council
Australian Research Council
Publisher
Springer Science and Business Media LLC
Reference60 articles.
1. Steel Z, Marnane C, Iranpour C, Chey T, Jackson JW, Patel V, Silove D. The global prevalence of common mental disorders: a systematic review and meta-analysis 1980–2013. Int J Epidemiol. 2014;432:476–93. https://doi.org/10.1093/ije/dyu038.
2. Wang PS, Angermeyer M, Borges G, Bruffaerts R, Tat Chiu W, De Girolamo G, Fayyad J, Gureje O, Haro JM, Huang Y et al. Delay and failure in treatment seeking after first onset of mental disorders in the world health organization’s world mental health survey initiative. World Psychiatry. 2007; 6;3:177–185.
3. Kazdin AE. Addressing the treatment gap: a key challenge for extending evidence-based psychosocial interventions. Behav Res Ther. 2017;88:7–18. https://doi.org/10.1016/j.brat.2016.06.004.
4. Mohr DC, Azocar F, Bertagnolli A, Choudhury T, Chrisp P, Frank R, Harbin H, Histon T, Kaysen D, Nebeker C, et al. Banbury Forum Consensus Statement on the path forward for digital mental health treatment. Psychiatr Serv. 2021;72:677–83. https://doi.org/10.1176/appi.ps.202000561.
5. Pauley D, Cuijpers P, Papola D, Miguel C, Karyotaki E. Two decades of digital interventions for anxiety disorders: a systematic review and meta-analysis of treatment effectiveness. Psychol Med. 2021;1–13. https://doi.org/10.1017/S0033291721001999.