The University of Southampton
University of Southampton Institutional Repository

Developing an unguided internet intervention for emotional distress in primary care patients: applying common factor and person-based approaches

Developing an unguided internet intervention for emotional distress in primary care patients: applying common factor and person-based approaches
Developing an unguided internet intervention for emotional distress in primary care patients: applying common factor and person-based approaches
Background: Developing effective, unguided internet interventions for mental health represents a challenge. Without structured human guidance engagement with these interventions is often limited and effectiveness reduced. If their effectiveness can be increased, they have great potential for broad, low-cost dissemination. Improving unguided e-mental health interventions requires a renewed focus on the proposed underlying mechanisms of symptom improvement and the involvement of target users from the outset.

Objective: To develop an unguided e-mental health intervention for distress in primary care patients, drawing on meta-theory of psychotherapeutic change and utilising the person-based approach to guide iterative qualitative piloting with patients.

Method: Common factors meta-theory informed the selection and structure of therapeutic content, enabling flexibility whilst retaining proposed necessary ingredients for effectiveness. A logic model was designed outlining intervention components and proposed mechanisms underlying improvement. The person-based approach provided a framework for systematically incorporating target-user perspective into the intervention development. Twenty primary care patients who had consulted with emotional distress in the last 12 months took part in exploratory qualitative interviews, and a subsample (n = 13) undertook think-aloud interviews with a prototype of the intervention.

Results: A flexible intervention was developed, to be used as and when patients need, diverting from a more traditional, linear approach. Based on the in-depth qualitative findings, disorder terms such as depression were avoided, and discussion of psychological symptoms was placed in the context of stressful life events. Think-aloud interviews showed that patients were positive about the design and structure of the intervention. On the basis of patient feedback, modifications were made to increase immediate access to all therapeutic techniques.

Conclusions: Detailing theoretical assumptions underlying e-mental health interventions, and integrating this approach with systematic in-depth qualitative research with target patients is important. These strategies may provide novel ways forward for addressing challenges of unguided delivery. The resulting intervention, ‘Healthy Paths’ will be evaluated in primary care-based randomised controlled trials, as well being deployed as a Massive Open Online Intervention (MOOI).
Geraghty, Adam
2c6549fe-9868-4806-b65a-21881c1930af
Muñoz, Ricardo
8b189945-458c-4f09-9e9f-16b781d577d3
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Mc Sharry, Jennifer
1f4c96b4-ef96-494a-8911-40f52349ee70
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Geraghty, Adam
2c6549fe-9868-4806-b65a-21881c1930af
Muñoz, Ricardo
8b189945-458c-4f09-9e9f-16b781d577d3
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Mc Sharry, Jennifer
1f4c96b4-ef96-494a-8911-40f52349ee70
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99

Geraghty, Adam, Muñoz, Ricardo, Yardley, Lucy, Mc Sharry, Jennifer, Little, Paul and Moore, Michael (2016) Developing an unguided internet intervention for emotional distress in primary care patients: applying common factor and person-based approaches. JMIR Mental Health, 3 (4), [e53]. (doi:10.2196/mental.5845).

Record type: Article

Abstract

Background: Developing effective, unguided internet interventions for mental health represents a challenge. Without structured human guidance engagement with these interventions is often limited and effectiveness reduced. If their effectiveness can be increased, they have great potential for broad, low-cost dissemination. Improving unguided e-mental health interventions requires a renewed focus on the proposed underlying mechanisms of symptom improvement and the involvement of target users from the outset.

Objective: To develop an unguided e-mental health intervention for distress in primary care patients, drawing on meta-theory of psychotherapeutic change and utilising the person-based approach to guide iterative qualitative piloting with patients.

Method: Common factors meta-theory informed the selection and structure of therapeutic content, enabling flexibility whilst retaining proposed necessary ingredients for effectiveness. A logic model was designed outlining intervention components and proposed mechanisms underlying improvement. The person-based approach provided a framework for systematically incorporating target-user perspective into the intervention development. Twenty primary care patients who had consulted with emotional distress in the last 12 months took part in exploratory qualitative interviews, and a subsample (n = 13) undertook think-aloud interviews with a prototype of the intervention.

Results: A flexible intervention was developed, to be used as and when patients need, diverting from a more traditional, linear approach. Based on the in-depth qualitative findings, disorder terms such as depression were avoided, and discussion of psychological symptoms was placed in the context of stressful life events. Think-aloud interviews showed that patients were positive about the design and structure of the intervention. On the basis of patient feedback, modifications were made to increase immediate access to all therapeutic techniques.

Conclusions: Detailing theoretical assumptions underlying e-mental health interventions, and integrating this approach with systematic in-depth qualitative research with target patients is important. These strategies may provide novel ways forward for addressing challenges of unguided delivery. The resulting intervention, ‘Healthy Paths’ will be evaluated in primary care-based randomised controlled trials, as well being deployed as a Massive Open Online Intervention (MOOI).

Text
Geraghty et al Final post acceptance manuscript.doc - Accepted Manuscript
Available under License Creative Commons Attribution.
Download (790kB)

More information

Accepted/In Press date: 30 October 2016
e-pub ahead of print date: 20 December 2016
Published date: 20 December 2016
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 405781
URI: http://eprints.soton.ac.uk/id/eprint/405781
PURE UUID: ce116f24-2154-49d5-a9b7-52a05eceb089
ORCID for Adam Geraghty: ORCID iD orcid.org/0000-0001-7984-8351
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X
ORCID for Michael Moore: ORCID iD orcid.org/0000-0002-5127-4509

Catalogue record

Date deposited: 18 Feb 2017 00:20
Last modified: 18 Feb 2021 17:14

Export record

Altmetrics

Contributors

Author: Adam Geraghty ORCID iD
Author: Ricardo Muñoz
Author: Lucy Yardley ORCID iD
Author: Jennifer Mc Sharry
Author: Paul Little
Author: Michael Moore ORCID iD

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×