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International Journal of Health Professions

The journal of Verein zur Förderung der Wissenschaft in den Gesundheitsberufen

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Access to Psychotherapy in the Era of Web 2.0 – New Media, Old Inequalities? / Zugang zur Psychotherapie in der Ära des Web 2.0 – Neue Medien, Alte Ungleichheiten?

Jennifer Anette Apolinario-Hagen
  • FernUniversität in Hagen, Institut für Psychologie, LG Gesundheitspsychologie, Universitätsstr. 33, 58084 Hagen, GERMANY
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/ Siegfried Tasseit
  • Psychologischer Psychotherapeut in eigener Praxis, Kurmittelhaus, Hildesheimer Str. 7a, 37581 Bad Gandersheim, GERMANY
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Published Online: 2015-12-04 | DOI: https://doi.org/10.1515/ijhp-2015-0010

Abstract

Background: Currently, the debate on regional and socio-structurally related treatment gaps in psychotherapeutic care increases the interest in e-mental health interventions such as the Internet-based psychotherapy, online self-help and new approaches for self-empowerment. Thus, health professionals could support informed decision-making by knowing the latest developments. However, if the ‘digital revolution’ fails to reach patients not familiar with Web 2.0, access to psychotherapies is unlikely to improve. Therefore, the objective of this review is to clarify whether online therapies should be recommended as an effective alternative to conventional psychotherapy in primary care.

Methods: To investigate the research evidence of online therapies in adults within the last decade (2004-2014), a rapid review of literature was conducted by using electronic databases (i.e. Medline/PubMed, PubMed Central, Cochrane Library) to find systematic reviews, meta-analysis and clinical trials. Furthermore, a hand search in journals and grey literature was undertaken.

Results: A search in PubMed for clinical trials on ‘online psychotherapy’ resulted in a total number of 245 publications. So, eight reviews and several clinical trials were chosen. Overall, mostly positive findings on the effectiveness and acceptance of online psychotherapy, primarily in the treatment of depression and anxiety disorders, were identified.

Discussion: In sum, Internet-based psychotherapies have been effective in reducing symptoms of mood and anxiety disorders in clinical trials. However, due to the limited range of treatable disorders and non-representative samples (young female college graduates), external validity remains insufficient. Thus, further research is needed to determine if online therapies will be capable of improving access to psychotherapy.

Abstract

Hintergrund: Angesichts der Debatte über regionale sowie soziostrukturell bedingte Versorgungslücken in der psychotherapeutischen Versorgung erhöht sich gegenwärtig das Interesse an E-Mental-Health-Interventionen wie der internetbasierten Psychotherapie, Online-Selbsthilfe und an neuen Ansätzen zur Selbstermächtigung. Profitieren könnten Gesundheitsberufe im Hinblick auf eine informierte Entscheidungsfindung, wenn sie die neuesten Entwicklungen kennen. Wenn allerdings diese “digitale Revolution” jene Patienten, die mit dem Web 2.0 nur unzureichend vertraut sind, nicht erreichen kann, wird sich der Zugang zu Psychotherapien kaum verbessern lassen. Daher soll mit dieser Übersichtsarbeit geklärt werden, ob und inwieweit Internettherapien als eine wirksame Alternative zur konventionellen Psychotherapie in der Grundversorgung empfohlen werden können.

Methoden: Zur Untersuchung der Evidenzbasis aus der letzten Dekade (2004 - 2014) zur Internettherapie für erwachsene Patienten wurde ein „Rapid Review“ durchgeführt. Über elektronische Datenbanken (d.h. Medline/PubMed, PubMed Central, Cochrane Library) wurde nach systematischen Reviews, Metaanalysen und klinischen Studien gesucht. Ergänzt wurden sie durch Recherchen in Fachzeitschriften und der grauen Literatur.

Ergebnisse: Die Suche nach klinischen Studien zur “Online-Psychotherapie” in PubMed ergab insgesamt 245 Publikationen, wobei letztlich acht Reviews und klinische Studien ausgewählt wurden. Bezogen auf einen verbesserten Zugang zur Psychotherapie haben vor allem Studien zur Behandlung von Depressionen und Angststörungen überwiegend positive Befunde zur Wirksamkeit und Akzeptanz von Internettherapien erbracht.

Diskussion: Zwar konnten Internettherapien die Symptome von Affektiven Störungen und Angststörungen in klinischen Studien lindern. Jedoch erscheint die externe Validität aufgrund der begrenzten Auswahl an behandelbaren Störungen und nicht-repräsentativen Stichproben (jung, weiblich, Hochschulabsolventen) unzureichend. Somit ist weitere Forschung notwendig, um festzustellen, ob Internettherapien den Zugang zur Psychotherapie verbessern können.

Keywords: e-mental health; psychotherapy; Internet therapy; online self-help; empowerment; treatment gaps; mental disorders; external validity

Keywords: E-Mental-Health; Psychotherapie; Internettherapie; Online-Selbsthilfe; Empowerment; Versorgungslücken; psychische Störungen; externe Validität

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About the article

Received: 2015-06-20

Accepted: 2015-09-14

Published Online: 2015-12-04

Published in Print: 2015-12-01


Citation Information: International Journal of Health Professions, Volume 2, Issue 2, Pages 119–129, ISSN (Online) 2296-990X, DOI: https://doi.org/10.1515/ijhp-2015-0010.

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