Vol. 5 No. 2 (2023): July - Decembre 2023
Integrated therapy

Blended psychotherapy: integrated intervention

pdf (Italiano)
  • Antonio Iannazzo,
  • Stefano Stefano,
  • Luana Zaira Ruggero,
  • Caterina Santonicola,
  • Olimpia Armenante,
  • Vincenzo Motta,
  • Anna Degano,
  • Veronica Rosa
DOI: https://doi.org/10.32069/PJ.2021.2.203

Published 2023-12-07

Keywords

  • Online Psychotherapy,
  • Remote Psychotherapy,
  • Blended Therapy,
  • Online Resources,
  • Blended Setting

How to Cite

Iannazzo, A., Stefano, S., Ruggero, L. Z., Santonicola, C., Armenante, O., Motta, V., Degano, A., & Rosa, V. (2023). Blended psychotherapy: integrated intervention. Phenomena Journal - International Journal of Psychopathology, Neuroscience and Psychotherapy, 5(2), 124–142. https://doi.org/10.32069/PJ.2021.2.203

Copyright (c) 2023 Antonio Iannazzo, Stefano Zorgno, Luana Ruggero, Caterina Santonicola, Olimpia Armenante, Vincenzo Motta, Anna Degano, Veronica Rosa

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Abstract

This article constitutes the first part of an in-depth work on blended therapeutic intervention on trauma. The objective is starting from the various meanings of the terms blended, online, presence, describing their genesis and evolution, to delve into the possibilities that presence/distance integration can offer to the treatment of trauma.

This first article will more focus on the meanings of the term blended, as the possibility of building an intervention through the use of various tools, which can be video chats, e-mails, text chats, the telephone, presence, the metaverse.

Furthermore, some international experiences and some tools/platforms/software for remote working will be reported.

An in-depth analysis of the term trauma and how to use it for trauma intervention will be explored in depth in the second article (in press).

pdf (Italiano)

References

  1. Fornari S., & Terranova, C. (2020). La psicoterapia on line in videochiamata. Rivista Costruttivismi, 7, 3-21.
  2. Amichai-Hamburger, Y., Brunstein-Klomek A., Friedman D., Zuckerman O., & Shani-Sherman T. (2014). The future of online therapy. Computer in Human Behavior, 41, 288-294.
  3. Barak, A., Hen, L., Boniel-Nissim, M., & Shapira, N. (2008). A comprehensive review and meta-analysis of the effectiveness of internet-based psychotherapeutic interventions. Journal of Technology in Human Services, 26, 109-160.
  4. Mancuso, F. (2019). La terapia online: Innovazione e integrazione tecnologica nella pratica clinica. Cognitivismo Clinico, 16, 193-207.
  5. Venturo-Conerly, K. E., Fitzpatrick, O. M., Horn, R. L., Ugueto, A. M., Weisz, J. R. (2022). Effectiveness of youth psychotherapy delivered remotely: A meta-analysis. American Psychologist, 77(1). doi: 10.1037/amp0000816
  6. Iannazzo, A., Leoni, F., & Ciufo, P. (2022). Psicoterapia online. Come realizzare interventi efficaci a distanza. Carocci, Roma.
  7. Carroll, M. K., Ball, S. A, Martino, S., Nich, C., Babuscio, T. A., & Rounsaville, B.,J. (2009). Enduring effects of a computer-assisted training program for cognitive behavioral therapy: A 6-month follow-up of CBT4CBT. Drug Alcohol Depend, 100(1-2):178-81. doi: 10.1016/j.drugalcdep.2008.09.015
  8. Fitzpatrick, M., Nedeljkovic, M., Abbott, J-A., Kyrios, M., & Moulding, R. (2018). Blended” therapy: The development and pilot evaluation of an internet-facilitated cognitive behavioral intervention to supplement face-to-face therapy for hoarding disorder. Internet Interventions, 12, 16 -25. doi.org/10.1016/j.invent.2018.02.006
  9. Månsson, K. N. T, Skagius Ruiz, E., Gervind, E., Dahlin, M., & Andersson, G. (2013). Development and initial evaluation of an internet-based support system for face-to-face cognitive behavior therapy: A proof of concept study. Journal of Medicine Internet Resources, 15(12): e280. Published online 2013 Dec 10. doi: 10.2196/jmir.3031
  10. Olmstead, T. A., Ostrow, C. D., & Carroll, K. M. (2010). Cost-effectiveness of computer-assisted training in cognitive-behavioral therapy as an adjunct to standard care for addiction. Drug Alcohol Depend, 110(3):200-7.
  11. doi: 10.1016/j.drugalcdep.2010.02.022
  12. Erbe, D., Eichert, H. C., Riper, H., & Ebert, D. D. (2017). Blending Face-to-Face and Internet-Based Interventions for the Treatment of Mental Disorders in Adults: Systematic Review. Journal of Medical Internet Research 19(9).
  13. doi: 10.2196/jmir.6588. PMID: 28916506; PMCID: PMC5622288
  14. Racing, S. P. A., Stikkelbroek, Y. A. J., den Hollander, W., Riper, H., Deković, M., Nauta, M. H., Creemers, D. H. M., Immink, M. C. P., Spuij, M., &Bodden, D. H. M. (2021). Pragmatic Quasi-Experimental Controlled Trial Evaluating the Outcomes of Blended CBT Compared to Face-to-Face CBT and Treatment as Usual for Adolescents with Depressive Disorders. International Journal of Environmental Research and Public Health, 18(6):3102.
  15. doi.org/10.3390/ijerph18063102
  16. Massoudi, B., Blanker, M. H., Valen van, E., Wouters ,H., Bockting, C. L. H., & Burger, H. (2017). Blended care vs. usual care in the treatment of depressive symptoms and disorders in general practice [BLENDING]: Study protocol of a non-inferiority randomized trial. BMC Psychiatry, 13;17(1):218. doi: 10.1186/s12888-017-1376-1
  17. Wentzel, J., van der Vaart, R., Bohlmeijer, E. T., & van Gemert-Pijnen, J. E. (2016). Mixing online and face-to-face therapy: how to benefit from blended care in mental health care. JMIR mental health, 3(1), e4534.
  18. Ebert, D., Tarnowski, T., Gollwitzer, M., Sieland, B., & Berking, M. (2013). A transdiagnostic internet-based maintenance treatment enhances the stability of outcome after inpatient cognitive behavioral therapy: a randomized controlled trial. Psychotherapy and psychosomatics, 82(4), 246-256.
  19. Romijn, G., Riper, H., Kok, R., Donker, T., Goorden, M., van Roijen, L. H., ... & Koning, J. (2015). Cost-effectiveness of blended vs. face-to-face cognitive behavioural therapy for severe anxiety disorders: study protocol of a randomized controlled trial. BMC psychiatry, 15(1), 1-10. doi: 10.1186/s12888-015-0697-1.
  20. Romijn, G., Batelaan, N., Koning, J., Van Balkom, A., De Leeuw, A., Benning, F., ... & Riper, H. (2021). Acceptability, effectiveness and cost-effectiveness of blended cognitive-behavioural therapy (bCBT) versus face-to-face CBT (ftfCBT) for anxiety disorders in specialised mental health care: A 15-week randomised controlled trial with 1-year follow-up. PLoS One, 16(11), e0259493.
  21. doi:10.1371/journal.pone.0259493.
  22. Schlicker, S., Ebert, D. D., Middendorf, T., Titzler, I., & Berking, M. (2018). Evaluation of a text-message-based maintenance intervention for Major Depressive Disorder after inpatient cognitive behavioral therapy. Journal of Affective Disorders, 227, 305-312.
  23. https://doi.org/10.1016/j.jad.2017.10.047
  24. Eisenberg, E., & Manfrida, G. (2007). Scripta... volant: uso e utilità dei messaggi sms in psicoterapia. Scripta... volant, 1000-1024.
  25. Manfrida, G. (2009). Gli sms in psicoterapia. Antigone Edizioni, Torino.
  26. Watzlavick, P., Beavin, J. H., & Jackson, D. D. (1971). Pragmatica della comunicazione umana. Astrolabio, Roma.
  27. Kim, S., & Lee, K. (2023). Development and evaluation of an online mental health program for traumatized female college students: A randomized controlled trial. Archives of Psychiatric Nursing, 43, 118-126. doi.org/10.1016/j.apnu.2023.01.003
  28. Knaevelsrud, C., Brand, J., Lange, A., Ruwaard, J., & Wagner, B. (2015). Web-based psychotherapy for posttraumatic stress disorder in war-traumatized Arab patients: randomized controlled trial. Journal of medical Internet research, 17(3), e3582. doi :https://www.jmir.org/2015/3/e71
  29. Lewis, C., Roberts, N. P., Bethell, A., Robertson, L., & Bisson, J. I. (2018). Internet‐based cognitive and behavioural therapies for post‐traumatic stress disorder (PTSD) in adults. Cochrane Database of Systematic Reviews, (12).
  30. doi: www.10.1002/14651858.CD011710.pub2.
  31. Weiner, L., Berna, F., Nourry, N., Severac, F., Vidailhet, P., & Mengin, A. C. (2020). Efficacy of an online cognitive behavioral therapy program developed for healthcare workers during the COVID-19 pandemic: the REduction of STress (REST) study protocol for a randomized controlled trial. Trials, 21, 1-10.
  32. https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-020-04772-7
  33. Zalta, A. K., Tirone, V., Siedjak, J., Boley, R. A., Vechiu, C., Pollack, M. H., & Hobfoll, S. E. (2016). A pilot study of tailored cognitive–behavioral resilience training for trauma survivors with subthreshold distress. Journal of traumatic stress, 29(3), 268-272.
  34. Knaevelsrud, C., & Maercker, A. (2006). Does the quality of the working alliance predict treatment outcome in online psychotherapy for traumatized patients?. Journal of medical internet research, 8(4), e31.
  35. https://www.jmir.org/2006/4/e31
  36. Ruwaard, J., Lange, A., Schrieken, B., Dolan, C. V., & Emmelkamp, P. (2012). The effectiveness of online cognitive behavioral treatment in routine clinical practice. PloS one, 7(7), e40089.
  37. doi.org/10.1371/journal.pone.0040089
  38. Ruwaard, J., & Lange, A. (2016). Online structured writing therapy for post-traumatic stress disorder and complicated grief. Guided Internet-Based Treatments in Psychiatry, 121-141.
  39. doi.org/10.1007/978-3-319-06083-5_7, consultabile anche alla pagina
  40. https://www.researchgate.net/publication/299506204_Online_Structured_Writing_Therapy_for_Post-traumatic_Stress_Disorder_and_Complicated_Grief.
  41. Békés, V., Grondin, F., & Bouchard, S. (2020). Barriers and facilitators to the integration of web‐based interventions into routine care. Clinical Psychology: Science and Practice, 27(2). doi.org/10.1111/cpsp.12335
  42. Békés, V., Belleville, G., Lebel, J., Ouellet, M. C., Chen, Z., Morin, C. M., ... & MacMaster, F. P. (2022). Trainee Therapists’ Perceptions of a Blended Intervention to Promote Resilience after a Natural Disaster: A Qualitative Case Study. Journal of Clinical Medicine, 11(15), 4361. doi.org/10.3390/jcm11154361 parzialmente consultabile alle pagine https://www.mdpi.com/journal/jcm. Rimando anche alla sezione “Special Issue Clinical Applications of Cyberpsychology and Virtual Reality for Mental Disorders” al link
  43. https://www.mdpi.com/journal/jcm/special_issues/cyberpsychology.
  44. Belleville, G., Ouellet, M. C., Békés, V., Lebel, J., Morin, C. M., Bouchard, S., ... & Macmaster, F. P. (2023). Efficacy of a therapist-assisted self-help internet-based intervention targeting PTSD, depression, and insomnia symptoms after a disaster: a randomized controlled trial. Behavior therapy, 54(2), 230-246.
  45. doi.org/10.1016/j.beth.2022.08.004
  46. Belleville, G., Ouellet, M. C., Békés, V., Lebel, J., Morin, C. M., Bouchard, S., ... & Macmaster, F. P. (2023). Efficacy of a therapist-assisted self-help internet-based intervention targeting PTSD, depression, and insomnia symptoms after a disaster: a randomized controlled trial. Behavior therapy, 54(2), 230-246. doi.org/10.1016/j.beth.2022.08.004
  47. Weathers, F. W., Litz, B. T., Keane, T. M., Palmieri, P. A., Marx, B. P., & Schnurr, P. P. (2013). The ptsd checklist for dsm-5 (pcl-5). Scale available from the National Center for PTSD at www. ptsd. va. gov, 10(4), 206. Versione aggiornata illustrata al link del National Center for PTSD:
  48. https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.PDF.
  49. Spitzer, R. L., Kroenke, K., Williams, J. B., Patient Health Questionnaire Primary Care Study Group, & Patient Health Questionnaire Primary Care Study Group. (1999). Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Jama, 282(18), 1737-1744.
  50. https://jamanetwork.com/journals/jama/fullarticle/192080.
  51. Morin, C. M. (1993). Insomnia, psychological assessment and management. Guilford Press, New York.
  52. Grondin, F., Lomanowska, A. M., & Jackson, P. L. (2019). Empathy in computer-mediated interactions: A conceptual framework for research and clinical practice. Clinical Psychology: Science and Practice, 26(4), e12298.
  53. doi.org/10.1111/cpsp.12298
  54. Grondin, F., Lomanowska, A. M., Békés, V., & Jackson, P. L. (2021). A methodology to improve eye contact in telepsychotherapy via videoconferencing with considerations for psychological distance. Counselling Psychology Quarterly, 34(3-4), 586-599.
  55. doi.org/10.1080/09515070.2020.1781596
  56. Simpson, S. (2009). Psychotherapy via videoconferencing: A review. British Journal of Guidance & Counselling, 37(3), 271-286.
  57. doi.org/10.1080/03069880902957007
  58. Lebel, J., Flores-Tremblay, T., Binet, É., Ouellet, M. C., & Belleville, G. (2021). Données d’utilisation d’un autotraitement guidé en ligne pour promouvoir la résilience après une catastrophe naturelle. Santé mentale au Québec, 46(1), 203-227.
  59. doi.org/10.7202/1081516ar
  60. Frenette, É., Ouellet, M. C., Guay, S., Lebel, J., Békés, V., & Belleville, G. (2023). The effect of an Internet‐based cognitive behavioral therapy intervention on social support in disaster evacuees. Journal of Clinical Psychology, 79, 1713–1725. doi.org/10.1002/jclp.23497
  61. Cloitre, M., Amspoker, A. B., Fletcher, T. L., Hogan, J. B., Jackson, C., Jacobs, A., ... & Lindsay, J. (2022). Comparing the ratio of therapist support to internet sessions in a blended therapy delivered to trauma-exposed veterans: Quasi-experimental comparison study. JMIR mental health, 9(4), e33080.
  62. Sintesi al link: https://pubmed.ncbi.nlm.nih.gov/35475777/. Articolo intero
  63. consultabile ai link: https://mental.jmir.org/2022/4/e33080/ o
  64. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9096630/
  65. Amarti, K., Schulte, M. H., Kleiboer, A., Van Genugten, C. R., Oudega, M., Sonnenberg, C., ... & Riper, H. (2022). Feasibility of Digital Cognitive Behavioral Therapy for Depressed Older Adults With the Moodbuster Platform: Protocol for 2 Pilot Feasibility Studies. JMIR Research Protocols, 11(10), e41445. https://www.researchprotocols.org
  66. Connolly, S. L., Miller, C. J., Lindsay, J. A., & Bauer, M. S. (2020). A systematic review of providers’ attitudes toward telemental health via videoconferencing. Clinical Psychology: Science and Practice, 27(2), e12311.
  67. doi.org/10.1111/cpsp.12311
  68. Nakao, S., Nakagawa, A., Oguchi, Y., Mitsuda, D., Kato, N., Nakagawa, Y., ... & Mimura, M. (2018). Web-based cognitive behavioral therapy blended with face-to-face sessions for major depression: randomized controlled trial. Journal of medical Internet research, 20(9), e10743.
  69. https://www.jmir.org/2018/9/e10743.
  70. Netter, A. L., Beintner, I., & Brakemeier, E. L. (2022). Adding an App-Based Intervention to the Cognitive Behavioral Analysis System of Psychotherapy in Routine Outpatient Psychotherapy Treatment: Proof-of-Concept Study. JMIR Formative Research, 6(8), e35482.
  71. https://formative.jmir.org/2022/8/e35482
  72. Pearson, R., Carl, E., & Creech, S. K. (2022). Computerized Psychological Interventions in Veterans and Service Members: Systematic Review of Randomized Controlled Trials. Journal of Medical Internet Research, 24(6). e30065.https://www.jmir.org/2022/6/e30065
  73. Horvath, A. O., & Greenberg, L. S. (1989). Development and validation of the Working Alliance Inventory. Journal of counseling psychology, 36(2), 223.
  74. doi.org/10.1037/0022-0167.36.2.223
  75. Ehlers, A., Wild, J., Warnock-Parkes, E., Grey, N., Murray, H., Kerr, A., ... & Clark, D. M. (2023). Therapist-assisted online psychological therapies differing in trauma focus for post-traumatic stress disorder (STOP-PTSD): a UK-based, single-blind, randomised controlled trial. The Lancet Psychiatry, 10(8), 608-622. Consultabile alla pagina:
  76. https://www.thelancet.com/action/showPdf?pii=S2215-0366%2823%2900181-5
  77. Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour research and therapy, 38(4), 319-345. https://www.researchgate.net/publication/292004334_A_cognitive_model_of_posttraumatic_stress_disorder.
  78. Van der Kolk, B. (2015). Il corpo accusa il colpo. Cortina, Milano. [ed. or., 2014, The body keeps the score: brain, mind and body in the healing of trauma. Viking Press. NY, 3].
  79. Sitografia
  80. https://www.guidapsicologi.it/pro/psicologos_it/own/osservatorio-psicologia-online2021.pdf
  81. https://www.blendedtherapy.com.au/about
  82. https://www.facebook.com/blendedtherapy