Tarp Kristine, Christiansen Regina, Bilberg Randi, Dalsgaard Caroline, Borkner Simone, Folker Marie, Nielsen Anette S
National Research Centre for the Working Environment, Copenhagen, Denmark.
Department of Clinical Research, Research Unit of Digital Psychiatry, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
Front Digit Health. 2025 Jun 17;7:1429582. doi: 10.3389/fdgth.2025.1429582. eCollection 2025.
Though therapists' experiences of offering internet-based treatment for alcohol use disorder have been examined in previous studies, the process of implementing blended internet-based and face-to-face treatment has so far not been studied. This study aims to investigate therapist experiences during implementation of blended face-to-face and internet-based treatment for alcohol use disorder.
The study employed a mixed methods design, more specifically a triangulation design with a convergence model. Quantitative data using NoMAD were collected in two waves, involving 48 therapists at the 1st wave and 18 at the 2nd wave. Qualitative interviews were conducted six months after the 2nd wave. Eleven therapists participated in focus group interviews for qualitative data collection, and an additional three semi-structured interviews were recorded, transcribed, and subsequently analyzed using the Normalization Process Theory.
We found that the therapists generally had a positive experience with implementing blended face-to-face and internet-based treatment for alcohol use disorder and that their motivation to implement increased. The therapists found it challenging to find coherence between digital and face-to-face treatment in the beginning of the implementation process; however, later in the process, they experienced sense-making. Furthermore, the therapists reflected on their own practice regarding the intervention, both in terms of the amount of time spent on the platform and how it was received by the patients. Moreover, the therapists perceived that if they had all been engaged in the intervention to begin with, it would have led to a shared understanding of the platform and collective ownership. Finally, through each of their individual experiences, the therapists had gained adequate knowledge of the digital intervention; thus, had come to each of their individual perceptions of the best way to incorporate the digital technology in their workday.
Familiarity and perceived normalcy of using Blend-A did not change significantly over time, but the cognitive attitude to Blend-A did. The therapists were optimistic about the possible use of a blended treatment format, and that this had a positive effect on the implementation process. Over time, the therapists developed confidence in benefits and disadvantages of a blended format.
尽管先前的研究已经考察了治疗师提供基于互联网的酒精使用障碍治疗的经验，但将基于互联网和面对面治疗相结合的实施过程迄今为止尚未得到研究。本研究旨在调查治疗师在实施酒精使用障碍的面对面与基于互联网相结合的治疗过程中的经验。
本研究采用混合方法设计，更具体地说是具有收敛模型的三角测量设计。使用NoMAD收集定量数据分两波进行，第一波涉及48名治疗师，第二波涉及18名治疗师。在第二波之后六个月进行定性访谈。11名治疗师参加了焦点小组访谈以收集定性数据，另外还记录、转录了3次半结构化访谈，并随后使用归一化过程理论进行分析。
我们发现，治疗师对实施酒精使用障碍的面对面与基于互联网相结合的治疗总体上有积极的体验，并且他们实施的积极性有所提高。治疗师发现在实施过程开始时，要在数字治疗和面对面治疗之间找到连贯性具有挑战性；然而，在过程后期，他们体验到了意义建构。此外，治疗师反思了他们自己在干预方面的实践，包括在平台上花费的时间量以及患者对其的接受程度。而且，治疗师认为如果他们一开始都参与干预，将会带来对平台的共同理解和集体所有权。最后，通过他们各自的个人经历，治疗师获得了关于数字干预的足够知识；因此，他们各自都形成了对在工作日中整合数字技术的最佳方式的看法。
使用混合A的熟悉度和感知常态并没有随时间显著变化，但对混合A的认知态度发生了变化。治疗师对混合治疗形式的可能使用持乐观态度，并且这对实施过程有积极影响。随着时间的推移，治疗师对混合形式的优缺点产生了信心。
