In recent years, advancements in technology have led to the development and cost-effective delivery of sophisticated digital mental-health programs, with burgeoning resources for common mental-health problems.
Today, a Google search for ‘digital therapies for anxiety’ yields more than 67 million results, while ‘digital therapies for depression’ brings up more than 80 million results, said Dr. Jennifer Wild, consultant clinical psychologist and associate professor at the University of Oxford, during a session at Benefits Canada’s 2019 Toronto Mental Health Summit on Nov. 29.
“With one in five Canadians suffering a mental-health problem, the sheer abundance of these results might seem reassuring. But they’re also incredibly daunting. How do you know which digital mental-health platform is going to be best suited for your employees?”
Read: An in-depth look at digital cognitive behavioural therapy
According to Dr. Wild, there are two categories of digital mental-health platforms: standalone or supported packages. The former is completed online without support, while the latter includes online material and regular support from a well-being coach, a clinical psychologist or other mental-health professional.
When it comes to ensuring that a digital therapy will be successful, she highlighted 10 key factors. For starters, the first week of a program is crucial, because what people do during this time determines whether they’ll achieve reliable change.
“Clients have to get active in the first week. Not just about reading psycho-education or normalizing symptoms or identifying treatment goals. There has to be something active happening in the first week — learning a tool, spotting triggers or going out for a walk to test the idea that getting active won’t improve mood. The program and clients have to be very active.”
As well, the user must complete at least 50 per cent of the program, noted Dr. Wild. The more engaging a program, the more likely clients are going to stick to and engage with it. The three features of a compelling digital therapy program are that it’s interactive, tailored to the user’s needs and includes support, she added.
Read: Assessing the impact of online therapy as digital health tools proliferate
It’s also vital that program supporters monitor and support adherence to treatment, she said. “Supporters need to be on-the-ball in terms of helping people adhere to the treatment, which ultimately comes back to that first week.”
It’s also important for people to achieve exposure activities to ensure digital therapy success, said Dr. Wild. Further, it’s important that supporters refer to cognitive behavioural therapy techniques in their communication.
She also highlighted that those who do well with digital treatments are typically older — the mean age is 35. In addition, these users are well-educated, physically healthier and have a better quality of life at the outset. These users also tend to log on to their digital therapy platforms more frequently, she added.
People are more likely to do well if they log in a lot and there’s little to no wait for initial treatment assessment, added Dr. Wild. “The shorter that time, the better someone will do in treatment.”
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The research is divided when it comes to the ninth factor, noted Dr. Wild, which say those who are likely to do well with digital therapy are either more or less severe than other groups. “When people are more severe, they have more room for improvement, so the change we see in therapy is much larger than people who are milder.”
Lastly, the programs that are likely to lead to success target behavioural change and go beyond improving insight.
When plan sponsors are looking at a digital therapy for their workforce, they should consider a number of questions and areas to help them decide whether a certain treatment plan or package is best for employees.
“We know digital therapy has to be attractive, engaging and support adherence. I would be looking at programs that are CBT-based and follow evidence-based CBT protocols — does the content include engaging methods for challenging thoughts and for modifying behaviours?”
Read more coverage of the 2019 Toronto Mental Health Summit.