Harnessing the Potential of Social Media to Develop the Next Generation of Digital Health Treatments in Youth Mental Health

Valentine, Lee; McEnery, Carla; D’Alfonso, Simon; Phillips, Jessica; Bailey, Eleanor; Álvarez‐Jiménez, Mario

doi:10.1007/s40501-019-00184-w

Cited by 26 publications

(18 citation statements)

References 42 publications

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“…An example of how digital interventions can include technological features to facilitate social support include incorporating newsfeeds and/or social forums. There is some support to suggest that the inclusion of social networking facilities in digital interventions for individuals with serious mental illnesses can assist in fostering a sense of social connectedness [ 35 , 140 , 141 ], a sense of cooperation (shared goals), and increased accountability toward treatment [ 137 ].…”

Section: Resultsmentioning

confidence: 99%

The Therapeutic Alliance in Digital Mental Health Interventions for Serious Mental Illnesses: Narrative Review

Tremain¹,

McEnery²,

Fletcher³

et al. 2020

JMIR Ment Health

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120

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Background Digital mental health interventions offer unique advantages, and research indicates that these interventions are effective for a range of mental health concerns. Although these interventions are less established for individuals with serious mental illnesses, they demonstrate significant promise. A central consideration in traditional face-to-face therapies is the therapeutic alliance, whereas the nature of a digital therapeutic alliance and its relationship with outcomes requires further attention, particularly for individuals with serious mental illnesses. Objective This narrative review aims to encourage further consideration and critical evaluation of the therapeutic alliance in digital mental health, specifically for individuals with serious mental illnesses. Methods A narrative review was conducted by combining 3 main areas of the literature: the first examining the evidence for digital mental health interventions for serious mental illnesses, the second illuminating the nature and role of the therapeutic alliance in digital interventions, and the third surrounding practical considerations to enhance a digital therapeutic alliance. Results Results indicated that a therapeutic alliance can be cultivated in digital interventions for those with serious mental illnesses, but that it may have unique, yet-to-be-confirmed characteristics in digital contexts. In addition, a therapeutic alliance appears to be less directly associated with outcomes in digital interventions than with those in face-to-face therapies. One possibility is that the digital therapeutic alliance is associated with increased engagement and adherence to digital interventions, through which it appears to influence outcomes. A number of design and implementation considerations may enhance the digital therapeutic alliance, including human support and technological features. Conclusions More research is required to further understand the nature and specific role of a therapeutic alliance in digital interventions for serious mental illnesses, particularly in informing their design. This review revealed several key research priorities to advance the therapeutic alliance in digital interventions.

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Section: Resultsmentioning

confidence: 99%

The Therapeutic Alliance in Digital Mental Health Interventions for Serious Mental Illnesses: Narrative Review

Tremain¹,

McEnery²,

Fletcher³

et al. 2020

JMIR Ment Health

Self Cite

120

View full text Add to dashboard Cite

show abstract

“…For many young people who are native users of digital technology within their everyday lives [ 15 ] and are interested in receiving care via blended modalities, there is an important opportunity to assist them in strengthening connections with their therapist and offering ways to improve engagement with therapies. As the therapeutic alliance is considered one of the most important predictors of treatment efficacy regardless of the therapeutic approach [ 39 ], there is great potential in capitalizing on the ways to enhance this alliance through digital technologies or with digital technologies themselves [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

“…Digital interventions have the potential to provide efficient avenues to extend treatment for young people experiencing first-episode psychosis [ 3 , 13 , 14 ]. It is estimated that up to 89% of people aged 16 to 25 years access social media daily [ 15 ], which makes digital intervention particularly relevant to adolescent and young adult populations. Importantly, young people experiencing first-episode psychosis also endorse digital pathways as a valuable mode through which to access mental health support and information [ 13 , 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

“…It is estimated that up to 89% of people aged 16 to 25 years access social media daily [ 15 ], which makes digital intervention particularly relevant to adolescent and young adult populations. Importantly, young people experiencing first-episode psychosis also endorse digital pathways as a valuable mode through which to access mental health support and information [ 13 , 15 , 16 ]. To date, however, uptake of and engagement with digital mental health interventions are low, and attrition rates for mental health interventions, in general, are high [ 13 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Valentine¹,

McEnery²,

Bell³

et al. 2020

JMIR Ment Health

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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.

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“…Social media presents an opportunity to target this issue. A new generation of digital interventions has harnessed the popularity of social media to both promote engagement and foster social connectedness [ 8 , 9 , 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Young People’s Experience of a Long-Term Social Media–Based Intervention for First-Episode Psychosis: Qualitative Analysis

Valentine¹,

McEnery²,

O’Sullivan³

et al. 2020

J Med Internet Res

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Background Digital mental health interventions present a unique opportunity to address the lack of social connection and loneliness experienced by young people with first-episode psychosis (FEP). The first generation of digital interventions, however, is associated with high attrition rates. Social media presents an opportunity to target this issue. A new generation of digital intervention has harnessed the popularity of social media to both promote engagement and foster social connectedness in youth mental health interventions. Despite their potential, little is known about how young people engage with, and experience, social media–based interventions as well as the optimal design, implementation, and management needed to ensure young people with psychosis receive benefit. Objective This study aimed to explore how young people engage with, and experience, a long-term social media–based mental health intervention designed to address social functioning in individuals with FEP. Methods This qualitative study was based on 12 interviews with young people who used Horyzons, a long-term social media–based mental health intervention, as part of a previous randomized controlled trial. A semistructured phenomenological interview guide with open-ended questions was used to explore young people’s subjective experience of the intervention. All interviews were recorded and transcribed verbatim. Data were analyzed using interpretative phenomenological analysis. Results A total of 4 superordinate themes emerged during the analysis including (1) shared experience as the catalyst for a cocreated social space, (2) the power of peer support, (3) an upbeat environment, and (4) experiences that interrupt being in Horyzons. Conclusions We found that Horyzon’s therapeutic social network fostered a connection and an understanding among young people. It also aided in the creation of an embodied experience that afforded young people with FEP a sense of self-recognition and belonging over the long term. However, although we found that most young people had strong positive experiences of a social connection on Horyzons, we also found that they experienced significant barriers that could substantively interrupt their ability to use the platform. We found that social anxiety, paranoia, internalized stigma, lack of autonomy, and social protocol confusion interfered with young people’s usage of the platform. From a design perspective, digital interventions are flexible and thus equipped to begin addressing these implications by providing customizable and personalized treatment options that account for varying levels of social connection and psychological need that could otherwise interrupt young people’s usage of social media–based interventions.

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Harnessing the Potential of Social Media to Develop the Next Generation of Digital Health Treatments in Youth Mental Health

Cited by 26 publications

References 42 publications

The Therapeutic Alliance in Digital Mental Health Interventions for Serious Mental Illnesses: Narrative Review

The Therapeutic Alliance in Digital Mental Health Interventions for Serious Mental Illnesses: Narrative Review

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

Young People’s Experience of a Long-Term Social Media–Based Intervention for First-Episode Psychosis: Qualitative Analysis

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