Background

To address the increasing mental health problems among young people, health care needs to broaden the spectrum of interventions and increase access to care. One particularly promising first-line intervention is cognitive behavioral therapy (CBT) delivered via the Internet (iCBT). The outbreak of the Coronavirus disease -2019 (COVID -19) has made the need for solid digital mental health care systems clear. This is the first published study exploring the transition among therapists of working with face-to-face treatment to using iCBT for youths suffering from anxiety treated in primary care.

Methods

Fourteen primary care therapists were included in the study. Semi-structured interviews (n = 26) were conducted on two occasions: before starting to use iCBT for youths, and at a subsequent follow-up after gaining treatment experience. Data was summarized into thematic categories.

Results

The overarching themes that were identified were: Attitudes to iCBT before and after implementation; Experiences of treatment delivery; Characteristics of “the right patient;” and The role of the digital therapist.

Conclusion

The participants generally had positive attitudes to iCBT for youths and saw it as a valuable alternative to face-to-face treatments. However, they identified challenges related to patient selection, and to motivating patients and maintaining a therapeutic relationship through mainly written communication. The participants appreciated the increase in variety that iCBT brought to their schedules, and also experienced iCBT as a relief from common challenges of therapeutic work, such as emotional stress and high cognitive demands. The participating therapists' positive experiences support the introduction of iCBT for youths in routine primary care.

中文翻译：

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初级保健青年从面对面治疗过渡到 iCBT——​​治疗师的态度和经验

背景

为了解决年轻人中日益严重的心理健康问题，医疗保健需要扩大干预范围并增加获得医疗保健的机会。一种特别有前途的一线干预措施是通过互联网提供的认知行为疗法 (CBT) (iCBT)。冠状病毒病 -2019 (COVID -19) 的爆发明确了对可靠数字精神卫生保健系统的需求。这是第一项已发表的研究，探讨了治疗师从面对面治疗到使用 iCBT 治疗在初级保健中治疗焦虑症的青少年之间的转变。

方法

该研究包括十四名初级保健治疗师。半结构化访谈 (n = 26) 进行了两次：在开始为青少年使用 iCBT 之前，以及在获得治疗经验后的后续随访中。数据被归纳为主题类别。

结果

确定的首要主题是： 实施前后对 iCBT 的态度；提供治疗的经验；“合适的患者”的特征；数字治疗师的角色。

结论

参与者普遍对青少年 iCBT 持积极态度，并将其视为面对面治疗的一种有价值的替代方案。然而，他们发现了与患者选择相关的挑战，以及主要通过书面交流来激励患者和维持治疗关系的挑战。参与者赞赏 iCBT 为他们的日程安排带来的多样性增加，并且还体验了 iCBT 作为治疗工作中常见挑战的解脱，例如情绪压力和高认知需求。参与治疗师的积极经验支持将 iCBT 引入常规初级保健中的青少年。