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      The impact of digital technology on psychological treatments and their dissemination

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          Abstract

          The psychological treatment of mental health problems is beginning to undergo a sea-change driven by the widespread availability of digital technology. In this paper we provide an overview of the developments to date and those in the pipeline. We describe the various uses of digital interventions and consider their likely impact on clinical practice, clinical services and the global dissemination of psychological treatments. We note the importance of online clinics, blended treatment, digital assessment and digital training.

          Highlights

          • Psychological treatments are undergoing a sea-change driven by digital technology.

          • New forms of treatment are being developed.

          • Existing treatments are being converted into digital interventions.

          • Blended treatment is gaining in popularity and it can take a variety of forms.

          • Autonomous digital treatments have potential as public health interventions.

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          Most cited references36

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          Advantages and limitations of Internet-based interventions for common mental disorders.

          Several Internet interventions have been developed and tested for common mental disorders, and the evidence to date shows that these treatments often result in similar outcomes as in face-to-face psychotherapy and that they are cost-effective. In this paper, we first review the pros and cons of how participants in Internet treatment trials have been recruited. We then comment on the assessment procedures often involved in Internet interventions and conclude that, while online questionnaires yield robust results, diagnoses cannot be determined without any contact with the patient. We then review the role of the therapist and conclude that, although treatments including guidance seem to lead to better outcomes than unguided treatments, this guidance can be mainly practical and supportive rather than explicitly therapeutic in orientation. Then we briefly describe the advantages and disadvantages of treatments for mood and anxiety disorders and comment on ways to handle comorbidity often associated with these disorders. Finally we discuss challenges when disseminating Internet interventions. In conclusion, there is now a large body of evidence suggesting that Internet interventions work. Several research questions remain open, including how Internet interventions can be blended with traditional forms of care. Copyright © 2014 World Psychiatric Association.
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            Effectiveness of online mindfulness-based interventions in improving mental health: A review and meta-analysis of randomised controlled trials.

            Mindfulness-based interventions (MBIs) are increasingly being delivered through the Internet. Whereas numerous meta-analyses have investigated the effectiveness of face-to-face MBIs in the context of mental health and well-being, thus far a quantitative synthesis of the effectiveness of online MBIs is lacking. The aim of this meta-analysis was to estimate the overall effects of online MBIs on mental health. Fifteen randomised controlled trials were included in this study. A random effects model was used to compute pre-post between-group effect sizes, and the study quality of each of the included trials was rated. Results showed that online MBIs have a small but significant beneficial impact on depression (g=0.29), anxiety (g=0.22), well-being (g=0.23) and mindfulness (g=0.32). The largest effect was found for stress, with a moderate effect size (g=0.51). For stress and mindfulness, exploratory subgroup analyses demonstrated significantly higher effect sizes for guided online MBIs than for unguided online MBIs. In addition, meta-regression analysis showed that effect sizes for stress were significantly moderated by the number of intervention sessions. Effect sizes, however, were not significantly related to study quality. The findings indicate that online MBIs have potential to contribute to improving mental health outcomes, particularly stress. Limitations, directions for future research and practical implications are discussed.
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              The impact of guidance on Internet-based mental health interventions — A systematic review

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                Author and article information

                Contributors
                Journal
                Behav Res Ther
                Behav Res Ther
                Behaviour Research and Therapy
                Elsevier Science
                0005-7967
                1873-622X
                1 January 2017
                January 2017
                : 88
                : 19-25
                Affiliations
                [a ]Oxford University, Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX, UK
                [b ]London School of Hygiene and Tropical Medicine, UK
                Author notes
                []Corresponding author. credo@ 123456medsci.ox.ac.uk
                Article
                S0005-7967(16)30137-1
                10.1016/j.brat.2016.08.012
                5214969
                28110672
                f76b61d9-f1cb-4ef9-9a77-edb53fa0000e
                © 2016 The Authors

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 5 August 2016
                : 14 August 2016
                Categories
                Article

                Clinical Psychology & Psychiatry
                digital health,digital technology,psychological treatment,internet,blended treatment,training,dissemination

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