BackgroundMany studies have provided evidence for the effectiveness of Internet-based stand-alone interventions for mental disorders. A newer form of intervention combines the strengths of face-to-face (f2f) and Internet approaches (blended interventions).ObjectiveThe aim of this review was to provide an overview of (1) the different formats of blended treatments for adults, (2) the stage of treatment in which these are applied, (3) their objective in combining face-to-face and Internet-based approaches, and (4) their effectiveness.MethodsStudies on blended concepts were identified through systematic searches in the MEDLINE, PsycINFO, Cochrane, and PubMed databases. Keywords included terms indicating face-to-face interventions (“inpatient,” “outpatient,” “face-to-face,” or “residential treatment”), which were combined with terms indicating Internet treatment (“internet,” “online,” or “web”) and terms indicating mental disorders (“mental health,” “depression,” “anxiety,” or “substance abuse”). We focused on three of the most common mental disorders (depression, anxiety, and substance abuse).ResultsWe identified 64 publications describing 44 studies, 27 of which were randomized controlled trials (RCTs). Results suggest that, compared with stand-alone face-to-face therapy, blended therapy may save clinician time, lead to lower dropout rates and greater abstinence rates of patients with substance abuse, or help maintain initially achieved changes within psychotherapy in the long-term effects of inpatient therapy. However, there is a lack of comparative outcome studies investigating the superiority of the outcomes of blended treatments in comparison with classic face-to-face or Internet-based treatments, as well as of studies identifying the optimal ratio of face-to-face and Internet sessions.ConclusionsSeveral studies have shown that, for common mental health disorders, blended interventions are feasible and can be more effective compared with no treatment controls. However, more RCTs on effectiveness and cost-effectiveness of blended treatments, especially compared with nonblended treatments are necessary.

The composition of participants and the success of rehabilitation of an ambulant vocational rehabilitation programme for persons with mental illness was examined (Integration Seminar; 1994-2009; n=703). The programme applies an individualized concept of rehabilitation. The findings show that average age and share of participants with psychotic illness had increased over the years. The share of long-term unemployed persons in all was very high and had increased strongly in the 2002-2005 period. Depending on the year of programme completion, the share of successful participants ranged between 50% and 60% a year. The success of rehabilitation turned out relatively stable over all measurement times (r (s)=0.52-0.83) and correlates with resilience, age and duration of unemployment. This implies the necessity of an early beginning of vocational rehabilitation, as the probability of success decreases with increasing duration of prior unemployment. Overall, the concept of individualized ambulant vocational rehabilitation turns out very successful.