Therapists hold a key role for the uptake of digital mental health interventions (DMHI) within regular care services but have demonstrated cautious attitudes towards such interventions. It is relevant to explore in detail what factors may positively influence therapists' perception when considering DMHI implementation within routine care. We recently assessed therapist views towards Internet-based and blended treatment in Austria (low implementation level). The present study aims at testing the reliability of previous findings, and moreover, it compares therapists' appraisals to a country with advanced DMHI implementation (Sweden).

An online survey was conducted February through June of 2019. Respondents were recruited via email and social media. The survey assessed first-hand experience with Internet-based treatment (IT) and blended treatment (BT). To start, the survey presented a short informational video to half of the respondents, then assessed therapists' views on 17 advantages and 13 disadvantages of IT and BT on 6-point Likert scales.

In total N = 300 therapists responded to the invitation, of which N = 165 provided full survey data (Germany 114/220, 52%; Sweden 51/80, 64%). German therapists rated the advantages of IT and BT as neutral (IT, M = 3.6; BT, M = 3.8) and to some extent agreed with disadvantages of IT (IT, M = 4.5; BT, M = 3.5). In comparison, Swedish therapists rated significantly greater advantages (IT, M = 4.6; BT, M = 4.5) and less disadvantages (IT, M = 3.2; BT, M = 2.8). Effect sizes ranged from d = 0.89 to d = 1.83; all P's < .001. Those with first-hand experience with DMHI reported more positive appraisals in both countries. No significant effect was found for exposure to the short informational video. The German sample represented essential characteristics of current German therapists; in comparison Swedish respondents skewed towards younger less experienced therapists (P's < .001). Those confounders accounted for a small non-significant proportion of variance (0.1–4.7%).

We found that therapists considered blended treatment to have less disadvantages than Internet treatment, and that first-hand experience with DMHI, but not exposure to an acceptance facilitating video clip, predicted greater acceptability on individual level. The responses among German therapists closely resembled findings from our preceding study in Austria, indicating that reliable results can be achieved in small survey studies if sample and population parameters correspond. Swedish therapists held significantly more favorable attitudes towards both interventions. The comparison between countries, however, is limited by a number of potential confounding variables.

治疗师在常规护理服务中采用数字心理健康干预措施 (DMHI) 方面发挥着关键作用，但他们对此类干预措施表现出谨慎的态度。当考虑在常规护理中实施 DMHI 时，详细探讨哪些因素可能会对治疗师的看法产生积极影响是相关的。我们最近评估了奥地利治疗师对基于互联网和混合治疗的看法（实施水平较低）。本研究旨在测试先前研究结果的可靠性，此外，还将治疗师的评估与 DMHI 实施先进的国家（瑞典）进行比较。

2019 年 2 月至 6 月进行了一项在线调查。受访者是通过电子邮件和社交媒体招募的。该调查评估了基于互联网的治疗（IT）和混合治疗（BT）的第一手经验。首先，该调查向一半受访者播放了一段简短的信息视频，然后根据 6 点李克特量表评估了治疗师对 IT 和 BT 的 17 个优点和 13 个缺点的看法。

总共有N  = 300 名治疗师响应了邀请，其中N  = 165 名治疗师提供了完整的调查数据（德国 114/220，52%；瑞典 51/80，64%）。德国治疗师将 IT 和 BT 的优点评为中性（IT，M = 3.6；BT，M = 3.8），并在某种程度上同意 IT 的缺点（IT，M = 4.5；BT，M = 3.5）。相比之下，瑞典治疗师认为其优点明显更大（IT，M = 4.6；BT，M = 4.5），缺点也较少（IT，M = 3.2；BT，M = 2.8）。效应大小范围为 d = 0.89 至 d = 1.83；所有 P < .001。那些对 DMHI 有第一手经验的人在这两个国家都报告了更积极的评价。没有发现观看短信息视频有显着影响。德国样本代表了当前德国治疗师的基本特征；相比之下，瑞典受访者倾向于年轻、经验不足的治疗师（P < .001）。这些混杂因素只占很小的非显着比例的方差（0.1-4.7%）。

我们发现，治疗师认为混合治疗比互联网治疗有更少的缺点，并且 DMHI 的第一手经验，而不是接触促进接受的视频剪辑，预示着个人层面上的可接受性更高。德国治疗师的反应与我们之前在奥地利的研究结果非常相似，这表明如果样本和总体参数相对应，小型调查研究可以取得可靠的结果。瑞典治疗师对这两种干预措施持明显更有利的态度。然而，国家之间的比较受到一些潜在的混杂变量的限制。