Needs and expectations for the myNewWay blended digital and face-to-face psychotherapy model of care for depression and anxiety (part 2): participatory design study including mental health professionals

Background:
In blended care, digital mental health interventions (DMHIs) integrate with face-to-face psychotherapy provided in person or via telehealth. To incorporate DMHIs into routine care for depression and anxiety, it is important to understand the needs and expectations of mental health professionals for blended DMHIs.

Objective:
The study objective was to partner with Australian mental health professionals in the design of a transdiagnostic, cognitive behavioral therapy–based blended model of care for adults experiencing depression and anxiety.

Methods:
Participants were Australian health professionals who treat adults with depression and anxiety. The participatory design process included a web-based survey (N=258), one-on-one interviews (N=14), and a 2-part focus group (N=6). Quantitative and qualitative data were collected through the web-based survey. In-depth qualitative feedback from interviews and the 2-part focus group was subjected to reflexive thematic analysis.

Results:
Mental health professionals found blended care with face-to-face therapy more acceptable than telehealth and blended care with telehealth, with standalone DMHIs being the least preferred option. The most common ways in which mental health professionals thought a DMHI could integrate with face-to-face psychotherapy included homework completion (129/178, 72.5%), skills practice to support in-session therapy (128/178, 71.9%), and psychoeducation (127/178, 71.3%). Mental health professionals expect the blended DMHI to be easy to use, flexible, protective of client data, and to include evidence-based content from several therapeutic modalities (eg, cognitive behavioral therapy and mindfulness). Other preferences included mental health professionals being able to prescribe specific program modules to their clients, track the treatment progress of clients, and receive alerts if their clients’ symptoms worsened. In terms of implementation, mental health professionals were concerned about the time and effort needed to use blended care. They suggested that ongoing training and support would help mental health professionals implement blended care with their clients. Monitoring client risk and progress via a web-based dashboard and downloadable summaries was also important.

Conclusions:
Designing DMHIs that support psychotherapy for adults with depression and anxiety has the potential to increase access to evidence-based treatment. Involving mental health professionals in DMHI design is expected to increase their acceptance of DMHIs and facilitate the integration of these digital products into routine care.