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Blended care – the future of therapy?

Psychologists and their clients are perceiving online therapy in a new light since the pandemic. Although face-to-face therapy is once again possible, psychologists are opting for a mix of in-person and online therapy as the demand for care grows. Moving forward, how can digital programs be best integrated into routine care?

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Most of us are now used to being online – whether it’s for meetings, virtual events, or social catchups. With the introduction of the Government’s MBS telehealth items in March 2021, many of us are now increasingly introducing virtual options to patients, as a way to access their healthcare, including mental health services. This digital shift has led to a welcome increase in people’s ability to access affordable mental health care, however we are only beginning to understand the challenges of integrating digital services, into a mental health system, that was built on a foundation of in-person treatment. Overcoming the challenges of this integration requires a collective effort to shift how we define and deliver ‘care’.

Digital programs have transformed therapy

The increasing availability and application of digital and telehealth interventions for mental health, has substantially increased the flexibility with which practitioners deliver care. Receiving therapy has also become easier for people who have narrow windows of time, such as for parents juggling home-schooling and work and for people from regional and rural areas who may have to travel long distances to access in-person care. For the younger generation – the digital natives – having telehealth as an option has also meant that they can use their preferred method of communication to access and receive care.

In addition to the immense benefits of telehealth in ensuring Australians’ access to therapy, digital mental health interventions (such as web-based CBT), have been highlighted as critical tools for addressing unmet mental health needs. For example, online treatments like MindSpot and THISWAYUP have been shown to be effective in treating symptoms of anxiety and depression and improving accessibility of care. However, how best to integrate this suite of treatment options into existing models of care remains an important question.

What is blended care?

Blended care’ is a model of care that combines routine therapy with online treatments, and has been highlighted as a promising approach to treating mental health disorders[1]. Blended care tends to be preferred by practitioners over online-only treatment[2] and studies also show that it is more efficient and cost-effective than traditional in-person therapy. For example, studies have shown that blended care can reduce the frequency, duration and cost of treatment, while producing the same therapeutic benefits as traditional face-to-face care from a psychologist.

Have digital programs improved the experience and effectiveness of therapy?

So how does this compare with how psychologists are currently conducting therapy? With the easing of physical distancing requirements, psychologists and clients are now able to have face-to-face therapy again, but many psychologists report that rather than reverting back to past methods, they use a mixture of face-to-face and online appointments. Psychologists also report that certain features of their telehealth sessions, like the ability to share the screen and write on a collaborative whiteboard, are critical to the success of their therapy. This suggests that many psychologists are already beginning to shift their practice towards blended forms of care.

What we still need to learn about blended care and how you can help

With telehealth looking like it’s here to stay, there are many questions that need to be answered to ensure we can succeed in this new way of working. What kind of training do psychologists need to feel confident using blended care? How might integrating digital tools into therapy impact psychologists’ existing practices? Is blended care better for some clients than others?

Answers to these questions will provide important insights into how we can capitalise on technological advances applied? in service delivery, to reach more Australians in need of mental health care.

Dr. Samantha Spanos is a Research Officer at the Black Dog Institute and is seeking psychologists to share their experiences of digital mental health programs and contribute their perspectives on the best ways to implement digital interventions into routine clinical practice. To take part in this study and be a voice into the future of blended care, contact Samantha at samantha.spanos@blackdog.org.au.

[1] Erbe, D., Eichert, H., Riper, H., & Ebert, D. D. (2017). Blending face-to-face and internet-based interventions for the treatment of mental disorders in adults: Systematic review. J Med Internet Res, 19(9): e306. doi: 10.2196/jmir.6588

[2] Davies, F., Shepherd, H. L., Beatty, L., Clark, L., Butow, P., & Shaw, J. (2020). Implementing web-based theraoy in routine mental health care: Systematic review of health professionals’ perspectives. J Med Internet Res, 22(7): e17362. doi: 10.2196/17362

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Dr Samantha Spanos

Dr Samantha Spanos

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