Titov Nickolai, Hadjistavropoulos Heather D, Nielssen Olav, Mohr David C, Andersson Gerhard, Dear Blake F
MindSpot Clinic and Department of Psychology, Macquarie University, Sydney, NSW 2109, Australia.
Online Therapy Unit, Department of Psychology, University of Regina, Regina, Saskatchewan, SK S4S 0A2, Canada.
J Clin Med. 2019 Aug 17;8(8):1239. doi: 10.3390/jcm8081239.
There is a large body of research showing that psychological treatment can be effectively delivered via the internet, and Digital Mental Health Services (DMHS) are now delivering those interventions in routine care. However, not all attempts to translate these research outcomes into routine care have been successful. This paper draws on the experience of successful DMHS in Australia and Canada to describe ten lessons learned while establishing and delivering internet-delivered cognitive behavioural therapy (ICBT) and other mental health services as part of routine care. These lessons include learnings at four levels of analysis, including lessons learned working with (1) consumers, (2) therapists, (3) when operating DMHS, and (4) working within healthcare systems. Key themes include recognising that DMHS should provide not only treatment but also information and assessment services, that DMHS require robust systems for training and supervising therapists, that specialist skills are required to operate DMHS, and that the outcome data from DMHS can inform future mental health policy. We also confirm that operating such clinics is particularly challenging in the evolving funding, policy, and regulatory context, as well as increasing expectations from consumers about DMHS. Notwithstanding the difficulties of delivering DMHS, we conclude that the benefits of such services for the broader community significantly outweigh the challenges.
大量研究表明,心理治疗可以通过互联网有效提供,数字心理健康服务(DMHS)目前正在常规护理中提供这些干预措施。然而,并非所有将这些研究成果转化为常规护理的尝试都取得了成功。本文借鉴澳大利亚和加拿大成功的数字心理健康服务经验,描述在建立和提供互联网认知行为疗法(ICBT)及其他心理健康服务作为常规护理一部分的过程中吸取的十条经验教训。这些经验教训包括在四个分析层面学到的内容,即与(1)消费者、(2)治疗师合作时、(3)运营数字心理健康服务时以及(4)在医疗保健系统内工作时学到的经验教训。关键主题包括认识到数字心理健康服务不仅应提供治疗,还应提供信息和评估服务;数字心理健康服务需要强大的治疗师培训和监督系统;运营数字心理健康服务需要专业技能;数字心理健康服务的结果数据可为未来心理健康政策提供参考。我们还确认,在不断变化的资金、政策和监管背景下,以及消费者对数字心理健康服务期望不断提高的情况下,运营此类诊所尤其具有挑战性。尽管提供数字心理健康服务存在困难,但我们得出结论,此类服务对更广泛社区的益处远远超过挑战。