Blended Digital and Face-to-Face Care for First-Episode Psychosis Treatment in Young People: Qualitative Study

Abstract

Background A small number of studies have found that digital mental health interventions can be feasible and acceptable for young people experiencing first-episode psychosis; however, little research has examined how they might be blended with face-to-face approaches in order to enhance care. Blended treatment refers to the integration of digital and face-to-face mental health care. It has the potential to capitalize on the evidence-based features of both individual modalities, while also exceeding the sum of its parts. This integration could bridge the online–offline treatment divide and better reflect the interconnected, and often complementary, ways young people navigate their everyday digital and physical lives. Objective This study aimed to gain young people’s perspectives on the design and implementation of a blended model of care in first-episode psychosis treatment. Methods This qualitative study was underpinned by an end-user development framework and was based on semistructured interviews with 10 participants aged 19 to 28 (mean 23.4, SD 2.62). A thematic analysis was used to analyze the data. Results Three superordinate themes emerged relating to young people’s perspectives on the design and implementation of a blended model of care in first-episode psychosis treatment: (1) blended features, (2) cautions, and (3) therapeutic alliance. Conclusions We found that young people were very enthusiastic about the prospect of blended models of mental health care, in so far as it was used to enhance their experience of traditional face-to-face treatment but not to replace it overall. Aspects of blended treatment that could enhance clinical care were readily identified by young people as increasing accessibility, continuity, and consolidation; accessing posttherapy support; strengthening the relationship between young person and clinician; and tracking personal data that could be used to better inform clinical decision making. Future research is needed to investigate the efficacy of blended models of care by evaluating its impact on the therapeutic alliance, clinical and social outcomes, cost-effectiveness, and engagement.

Gaming My Way to Recovery: A Systematic Scoping Review of Digital Game Interventions for Young People's Mental Health Treatment and Promotion

“…Moreover, research needs to focus more on participation by young users to improve engagement with the games, and, crucially, on eliciting participation by service providers and family to promote the transformation of stand-alone digital game interventions into standard tools for mental health treatment in clinical and community settings (schools and home) for youth. Opportunities for blending digital and face-to-face treatment should also be explored ( 140 ). Potential harms in the therapeutic use of digital games need to be better understood and more research is needed to unpack the complexity of gaming disorder, deeply rooted in the relationship between the user and the digital technology, and to find a proper framework that promotes safety in the use of digital interventions, particularly videogame interventions ( 51 ).…”

Research to Clinical Practice—Youth seeking mental health information online and its impact on the first steps in the patient journey

“…For instance, the current literature on the influence of ICT on patient‐clinician relationships rarely addresses either MH or YMH. This is important as young people with MH concerns are consistently express a preference for ‘blended’ service models (ie digital support plus face‐to‐face interactions) 88 . As well as obvious lines of investigation, future research might consider, for example whether the impact of engagement in online MHI seeking differs if youth are then offered face‐to‐face or online consultations only.…”

Psychological Screening and Tracking of Athletes and Digital Mental Health Solutions in a Hybrid Model of Care: Mini Review

“…The mixed linear model of smartphone mobile sensing and self-reported mental health questions [19] was applied in this study. In synthesis, the main theoretical basis informing these studies is the hybrid model of care that identifies patients receiving both in-person and online interventions for diagnosis, therapy, and monitoring [10,[20][21][22].…”

“…The MHQ is an epidemiological mental health assessment tool that provides personalized insight into an individual's mental health partnered with feedback that is generated based on the individual scoring profile. The delivery of solutions for influencing positive mental health is recommended to consider the mixed linear model of smartphone mobile sensing and self-reported mental health questions [19], and a hybrid model of care [10,[20][21][22] as part of a general guide.…”