Internet Interventions-The Application of Information Technology in Mental and Behavioural Health最新文献

{"title":"The role of self-efficacy in internet-based interventions for mental health: A systematic review and meta-analysis","authors":"Solveig Behr ,&nbsp;Laura Martinez Garcia ,&nbsp;Julia Lucas ,&nbsp;Esther Kohlhase ,&nbsp;Marie Puetz ,&nbsp;Johanna Boettcher ,&nbsp;Carmen Schaeuffele ,&nbsp;Christine Knaevelsrud","doi":"10.1016/j.invent.2025.100821","DOIUrl":"10.1016/j.invent.2025.100821","url":null,"abstract":"<div><h3>Introduction</h3><div>Internet-based interventions (IBI) increase access to evidence-based treatments for mental disorders, but knowledge of their mechanisms of change is limited. Self-efficacy, a key factor in psychotherapy, is especially relevant in IBI due to its self-help focus. We investigated self-efficacy and related constructs as outcomes, predictors/moderators, and mediators in randomized controlled trials.</div></div><div><h3>Methods</h3><div>A systematic search was conducted across PsycINFO, PubMed, CINAHL, and Web of Science. Two reviewers selected studies, extracted data, and assessed bias. Effects were quantified using random effect models and supplemented by narrative syntheses and box score visualizations.</div></div><div><h3>Results</h3><div>70 studies (<em>N</em> = 17,407 participants) were included. IBI showed moderate effects on self-efficacy in within (d = 0.47) and between (d = 0.46) comparisons, with guided interventions having the largest effect (d = 0.66). Findings on self-efficacy as a predictor/moderator were mixed, though some studies suggested individuals with lower self-efficacy benefit more. Self-efficacy emerged as a mediator through which IBI affected treatment outcomes.</div></div><div><h3>Conclusion</h3><div>Self-efficacy appears influential in IBI efficacy and may itself be a valuable treatment target. However, mixed results and methodological limitations in mediator studies highlight the need for further research, particularly on long-term effects.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"40 ","pages":"Article 100821"},"PeriodicalIF":3.6,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delivering real-time support for self-injury: A systematic review on ecological momentary interventions","authors":"Anna Julià ,&nbsp;Irene Jaén ,&nbsp;Azucena García-Palacios ,&nbsp;Juan Carlos Pascual ,&nbsp;Anna Sintes ,&nbsp;Anaís Lara ,&nbsp;Iria Méndez ,&nbsp;Soledad Romero ,&nbsp;Joaquim Puntí ,&nbsp;Joaquim Soler ,&nbsp;Marta Banqué ,&nbsp;Marina López-Solà ,&nbsp;Jordi Solé-Casals ,&nbsp;Daniel Vega","doi":"10.1016/j.invent.2025.100826","DOIUrl":"10.1016/j.invent.2025.100826","url":null,"abstract":"<div><h3>Introduction</h3><div>Ecological momentary interventions (EMIs) delivered via smartphone apps have gained attention as a potential tool for addressing self-injurious thoughts and behaviors (SITB), particularly non-suicidal self-injury (NSSI). This systematic review aims to assess the efficacy and feasibility of smartphone-based EMIs in reducing SITB and improving mental health outcomes.</div></div><div><h3>Methods</h3><div>A systematic review was conducted, focusing on smartphone-based EMIs targeting SITB, with particular emphasis on those addressing NSSI. The latest search was made in February 2025.</div></div><div><h3>Results</h3><div>Sixteen studies featuring smartphone-based EMIs were included. Overall, these studies showed promising evidence for the reduction of SITB. Specifically, several studies reported reductions in NSSI frequency and improvements in emotional regulation among participants. Feasibility and acceptability data showed good results.</div></div><div><h3>Limitations</h3><div>Key limitations include small sample sizes, study heterogeneity, lack of follow-up, reliance on self-reports, and absence of standardized tools to distinguish NSSI from other self-injurious behaviors.</div></div><div><h3>Conclusions</h3><div>Results are promising, while the efficacy of smartphone-based EMIs SITB requires further validation through large-scale and well-designed studies. The integration of digital interventions into broader mental health care strategies offers a potential avenue for addressing the treatment gap in at-risk populations, particularly those with limited access to traditional care.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"40 ","pages":"Article 100826"},"PeriodicalIF":3.6,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MyGuide long COVID: An online self-management tool for people with long COVID","authors":"Hiten Naik ,&nbsp;Kyla Pongratz ,&nbsp;Michelle Malbeuf ,&nbsp;Sonya Kung ,&nbsp;Lori Last ,&nbsp;Asuka Sugiyama ,&nbsp;Esther Khor ,&nbsp;Marlee McGuire ,&nbsp;Adeera Levin ,&nbsp;Karen C. Tran","doi":"10.1016/j.invent.2025.100825","DOIUrl":"10.1016/j.invent.2025.100825","url":null,"abstract":"<div><h3>Background</h3><div>Long COVID is a relatively new condition for which patients are asked to employ self-management strategies to manage their symptoms. However, it can be challenging for individuals with long COVID to find reliable and actionable self-management resources. The objective of this project was to develop an online tool for individuals with long COVID that is patient-centered, accessible, and customizable to meet individual needs.</div></div><div><h3>Methods</h3><div><em>MyGuide Long COVID</em> (<span><span>www.longCOVIDguide.ca</span><svg><path></path></svg></span>) was developed in British Columbia (BC), Canada, by a team that included long COVID clinicians and patient partners. Site visitors answer questions about their symptoms, and <em>MyGuide</em> generates a curated set of self-management resources tailored to their needs. Since its launch in August 2023, Google Analytics has been used to monitor website activity.</div></div><div><h3>Results</h3><div>Within the first year, MyGuide had 52,578 total page views and 8570 new users. The most popular method to access <em>MyGuide</em> was by computer (56.3 % of users), and the most represented city was Vancouver, BC (23.5 % of users). The most popular topics were “Post Exertional Malaise” (1339 sessions) and “What is long COVID?” (1257 sessions).</div></div><div><h3>Conclusions</h3><div>An online tool to support chronic disease self-management can be successfully co-developed with patient partners and engagement tracked using web analytics.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"40 ","pages":"Article 100825"},"PeriodicalIF":3.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143799973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital interventions in mental health: An overview and future perspectives","authors":"Johanna Löchner ,&nbsp;Per Carlbring ,&nbsp;Björn Schuller ,&nbsp;John Torous ,&nbsp;Lasse Bosse Sander","doi":"10.1016/j.invent.2025.100824","DOIUrl":"10.1016/j.invent.2025.100824","url":null,"abstract":"<div><div>As e-health offerings rapidly expand, they are transforming and challenging traditional mental health care systems globally, presenting both promising opportunities and significant risks. This article critically examines the potential and pitfalls of integrating digital technologies into mental health care, particularly in the realms of diagnosis, prevention, and treatment. It explores current advancements and evidence-based practices, and provides a vision for how future technologies can evolve responsibly to meet mental health needs. The article concludes with the TEQUILA framework, addressing essential elements and challenges for fostering a beneficial and ethical future. A responsible future for digital mental health requires building <em>Trust</em> by ensuring data privacy, security, and transparency in AI-driven decisions, along with <em>Evidence-based</em> and robust regulatory oversight to maintain <em>Quality</em>. <em>Usability</em>, design, usability tailored to diverse needs, and ethical alignment with users' <em>Interests</em> will all be essential, while <em>Liability</em> and <em>Accreditation</em> standards will safeguard accountability in this evolving landscape.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"40 ","pages":"Article 100824"},"PeriodicalIF":3.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143851527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A mobile-based, single-session intervention to empower parents of adolescents hospitalised for non-suicidal self-injury: A mixed-methods randomised controlled trial","authors":"Juan He ,&nbsp;Yidong Shen ,&nbsp;Zengyu Chen ,&nbsp;Yusheng Tian ,&nbsp;Yanting Hou ,&nbsp;Yamin Li ,&nbsp;Jianjun Ou","doi":"10.1016/j.invent.2025.100822","DOIUrl":"10.1016/j.invent.2025.100822","url":null,"abstract":"<div><h3>Background</h3><div>Adolescents hospitalised for non-suicidal self-injury (NSSI) represent a particularly severe subset within psychiatric care. The NSSI imposes significant challenges on parents, including lack of knowledge, ineffective coping strategies, and negative emotions, exacerbated by stigma. Parental empowerment is crucial for supporting adolescent recovery; however, current interventions often neglect parents. Single-session interventions (SSIs) may offer an accessible and promising approach to address this gap.</div></div><div><h3>Methods</h3><div>This mixed-methods study assessed the short-term effects of project CSH-P: a mobile-based, self-guided SSI aimed at empowering parents of adolescents hospitalised for NSSI. 88 participants were randomly assigned to CSH-P (n = 46) or control group (n = 42). Online assessments measuring knowledge, attitudes, and stigma were administered at baseline, immediately post-intervention, and one week later. Additionally, semi-structured individual interviews were conducted with participants who received CSH-P post-intervention.</div></div><div><h3>Results</h3><div>Compared to the control group, participants who received CSH-P showed significant improvements in NSSI-related knowledge (Cohen’s d = .42, p = .027) and more positive attitudes toward their adolescents (Cohen’s d = - .31, p = .047). Qualitative findings confirmed these results, with parents reporting highly positive engagement and perceived empowerment across cognitive, emotional, and behavioural dimensions. Furthermore, parents provided constructive feedback for further enhancing the intervention’s impact.</div></div><div><h3>Conclusions</h3><div>Project CSH-P demonstrates the potential to enhance parental empowerment in managing adolescent self-injurious behaviours. Its brevity, low cost, and ease of dissemination make it a promising strategy for widely applicable prevention and treatment efforts. Future research should explore the long-term sustainability of these improvements and assess the broader impact on parenting practices and adolescent treatment outcomes.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"40 ","pages":"Article 100822"},"PeriodicalIF":3.6,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility, acceptability, and preliminary efficacy of a blended transdiagnostic group CBT for the treatment of emotional disorders","authors":"Noelia Jiménez-Orenga ,&nbsp;Amanda Díaz-García ,&nbsp;Rosa Lorente-Català ,&nbsp;Alberto González-Robles ,&nbsp;Macarena Paredes-Mealla ,&nbsp;Azucena García-Palacios ,&nbsp;Juana Bretón-López","doi":"10.1016/j.invent.2025.100823","DOIUrl":"10.1016/j.invent.2025.100823","url":null,"abstract":"<div><h3>Introduction</h3><div>The transdiagnostic approach and Internet-based administration can help to implement evidence-based treatments for emotional disorders (ED). However, not all patients benefit from online format and dropout rates are high. Blended format combines the strengths of face-to-face and Internet self-applied interventions to help overcome these barriers. Group format can also help to overcome these difficulties and improve the cost-effectiveness binomial. This study aimed to analyze the feasibility, acceptability, and preliminary efficacy of a blended transdiagnostic group CBT for ED.</div></div><div><h3>Methods</h3><div>A single-group, open-trial design with three measurement points: pre-treatment, post-treatment and 3-month follow-up. A total of 34 adults (mean age = 32.21 years; 79.4 % female) from a community sample with at least one ED diagnosis according to DSM-5-TR criteria participated in the study. The intervention combined 8 group sessions delivered via videoconference with the completion of 16 online modules in a web-platform.</div></div><div><h3>Results</h3><div>Of the total participants, 67.6 % completed the treatment and another 14.7 % completed at least half of the modules and attended at least half of the group sessions. The expectations and satisfaction with the treatment were high (47.39 and 49.39 out of 60, respectively). The system usability was above desirable and around ‘excellent’ (84.02 out of 100 after the first use of the platform and 80.98 out of 100 at post-treatment). Opinions on the online modules and videoconference sessions were good. Participants completed an average of 12.91 online modules out of 16 and attended an average of 5.44 sessions out of 8. There was a significant reduction in anxious and depressive symptomatology at post-treatment and follow-up compared to baseline. There was also a significant change in other secondary clinical measures.</div></div><div><h3>Conclusions</h3><div>A transdiagnostic protocol applied in blended and group formats seems to be feasible, acceptable and preliminary effective in addressing ED. However, more research is needed to test the efficacy of this innovative format.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"40 ","pages":"Article 100823"},"PeriodicalIF":3.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Efficacy of online psychoeducation and relaxation training program (OnPR) on mental health problems in COVID-19 patients: A randomized controlled trial” [J. Internet Interv. vol 35 (2024), 100705]","authors":"Chotiman Chinvararak ,&nbsp;Pantri Kirdchok ,&nbsp;Chayut Wonglertwisawakorn ,&nbsp;Pachara Pumjun ,&nbsp;Orranee Srikhamdokkhae ,&nbsp;Nitchawan Kerdcharoen","doi":"10.1016/j.invent.2025.100820","DOIUrl":"10.1016/j.invent.2025.100820","url":null,"abstract":"","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"40 ","pages":"Article 100820"},"PeriodicalIF":3.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a qualitative and quantitative ambulatory assessment-based feedback system within cognitive behavioural interventions for people with persecutory beliefs","authors":"Laura F. Bringmann ,&nbsp;Eva Tolmeijer ,&nbsp;Maarten Piot ,&nbsp;Merijn Mestdagh ,&nbsp;Stijn Verdonck ,&nbsp;Gert Stulp ,&nbsp;Felicity Waite ,&nbsp;Louise Isham ,&nbsp;Anton P.B. Staring ,&nbsp;Daniel Freeman ,&nbsp;David van den Berg","doi":"10.1016/j.invent.2025.100819","DOIUrl":"10.1016/j.invent.2025.100819","url":null,"abstract":"<div><h3>Background</h3><div>Although the application of self-monitoring (ambulatory assessment) and visual feedback in psychological interventions has yielded promising results, there are currently no reports on using self-monitoring and feedback during a complete therapy. The online m-Path platform provides a tailorable framework for integrating self-monitoring and visual feedback within different psychological interventions.</div></div><div><h3>Methods</h3><div>Therapy-specific questionnaires and visual feedback were developed within the online m-Path platform as part of the Feeling Safe-NL trial (registration number: ISRCTN25766661) for regular CBT for psychosis (CBTp) and the Feeling Safe Programme combined with peer counselling (the Feeling Safe-NL Programme). The design process involved people with lived experience, psychologists, peer counsellors, researchers, and software developers. The design principles included that the system should be 1) easy to use, 2) suitable for use during a six-month therapy, 3) focussed on positive and goal-aligned outcomes, 4) understandable by patients and professionals, and 5) informing, guiding, and promoting therapy. Design principles were evaluated using compliance data and a patient questionnaire.</div></div><div><h3>Results</h3><div>The system was used by 21 patients, of which nine completed the questionnaires for the full therapy period, 168 days on average. Usability data from patients revealed that the system was easy to use, well-explained, and suitable for use over six months of therapy. The patients also reported that the questions overall positively affected their emotions and that the feedback was insightful.</div></div><div><h3>Conclusion</h3><div>The results support the successful application of the design principles to promote the integration of the self-monitoring and visual feedback system within specific CBTp interventions.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"40 ","pages":"Article 100819"},"PeriodicalIF":3.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is one additional phone call enough? - Effectiveness of additional human support to reduce dropout from an internet-based intervention for depressive symptoms: A randomized-controlled trial","authors":"Sophie Christine Eicher,&nbsp;Manuel Heinrich,&nbsp;Pavle Zagorscak,&nbsp;Annette Brose,&nbsp;Christine Knaevelsrud","doi":"10.1016/j.invent.2025.100818","DOIUrl":"10.1016/j.invent.2025.100818","url":null,"abstract":"<div><h3>Background</h3><div>Internet-Based Interventions (IBIs) are effective treatments for mental disorders, but their implementation faces challenges, particularly in addressing high dropout rates. Adding more human support or guidance might reduce treatment dropout rates in IBIs, but it may also limit scalability. Therefore, small, easy-to-implement, guidance-based add-on interventions are warranted to reduce dropout rates. This study tests if offering one additional brief phone contact reduces treatment dropout rates in an IBI for depressive symptoms with written guidance.</div></div><div><h3>Methods</h3><div>We analyze data from <em>N</em> = 394 individuals participating in an IBI for depression. The intervention comprises seven CBT-based modules with module-wise written semi-standardized feedback from psychotherapists (guided IBI). Previous research applying the same IBI in adults with self-reported symptoms of depression found increased dropout rates after the second module. In the study group, therapists offered an additional brief phone call after the second module (<em>n</em> = 206). In the control group, no additional phone calls were offered (<em>n</em> = 188). We present descriptive statistics regarding the intervention course for both groups. We conducted a logistic regression to examine the preventive effect of the additional phone call on treatment dropout.</div></div><div><h3>Results</h3><div>Pooled dropout rates in the study group were 30.5 % (<em>n</em> = 63), and in the control group 36.1 % (<em>n</em> = 68), with a risk difference of about 6 % points favoring the study group. The odds ratios ranged from 1.25 to 1.33, and the relative risks ranged from 1.08 to 1.10. However, all confidence intervals overlap zero, indicating that all effect estimates are statistically non-significant.</div></div><div><h3>Conclusion</h3><div>We tested a strategy of additional human contact to reduce treatment dropout rates in a guided IBI for depressive symptoms. All estimates descriptively favored the study group, but were small and non-significant. Further research is needed to determine how additional contact can be employed to reduce treatment dropout.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"40 ","pages":"Article 100818"},"PeriodicalIF":3.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143620211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study protocol for a triple-blind randomised controlled trial evaluating a machine learning-based predictive clinical decision support tool for internet-delivered cognitive behaviour therapy (ICBT) for depression and anxiety","authors":"Pontus Bjurner ,&nbsp;Nils Hentati Isacsson ,&nbsp;Fehmi Ben Abdesslem ,&nbsp;Magnus Boman ,&nbsp;Erik Forsell ,&nbsp;Viktor Kaldo","doi":"10.1016/j.invent.2025.100816","DOIUrl":"10.1016/j.invent.2025.100816","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Therapist-supported internet-based Cognitive Behavioural Therapy (ICBT) has strong scientific support, but all patients are not helped, and further improvements are needed. Personalized medicine could enhance ICBT. One promising approach uses a Machine learning (ML) based predictive decision support tool (DST) to help therapists identify patients at risk of treatment failure and adjust their treatments accordingly. ICBT is a suitable clinical context for developing and testing such predictive DST's, since its delivery is quite flexible and can quickly be adapted for probable non-responders, for example by increasing the level and nature of therapist support, to avoid treatment failures and improve overall outcomes. This type of strategy has never been tested in a triple-blind randomised controlled trial (RCT) and has rarely been studied in ICBT.&lt;/div&gt;&lt;div&gt;The aim of this protocol is to expand on previous registered protocols with more detailed descriptions of methods and analyses before analyses is being conducted.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods and analysis&lt;/h3&gt;&lt;div&gt;A triple blind RCT comparing ICBT with a DST (DST condition), to ICBT as usual (TAU condition). The primary objective is to evaluate if the DST condition is superior to the TAU condition in decreasing diagnose-specific symptoms among patients identified to be at risk of failure. Secondary objectives are to evaluate if the DST improves functioning, interaction, adherence, patient satisfaction, and therapist time efficiency and decreases the number of failed treatments. Additionally, we will investigate the therapists' experience of using the DST.&lt;/div&gt;&lt;div&gt;Patients and therapists have been recruited nationally. They were randomised and given a sham rationale for the trial to ensure allocation blindness. The total number of patients included was 401, and assessments were administered pre-treatment, weekly during treatment, at post-treatment and at 12-month follow-up. Primary outcome is one of the three diagnosis-specific symptom rating scales for respective treatment and primary analysis is difference in change from pre- to post-treatment for at-risk patients on these scales.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Human ethics and consent to participate&lt;/h3&gt;&lt;div&gt;Informed consent to participate in the study was obtained from all participants. Both therapists and patients are participants in this trial. For patients, informed consent to participate in the study was obtained when they registered interest for the study via the study's secure web platform and carried out initial screening before the diagnostic and fit for treatment assessment, they first received the research subject information and were asked for consent by digitally signing that they had read and understood the information. For therapists who were part of the study, consent was requested after they had registered their interest. Therapists then received an email with a link to the study's secure web platform with","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"40 ","pages":"Article 100816"},"PeriodicalIF":3.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}