Three self-care versions of guided internet interventions are presented.
•Self-care had shorter duration, fewer words and a narrower focus compared to guided.
•Automated messages and clinical interviews were used to promote adherence.
•Self-care used less clinician time than guided and had promising preliminary effects.
•Randomized studies are needed to compare treatment efficacy.
AbstractIntroductionTherapist-guided internet interventions are often more efficacious than unguided ones. However, the guidance itself requires clinician time, and some research suggests that self-guided interventions could potentially be equally effective. The concept of digital psychological self-care, self-guided internet interventions based on the use of digital tools and provided within a structured clinical process, is presented.
MethodsThree new self-care interventions, a sleep diary-based intervention for insomnia, an alcohol diary-based intervention for problematic alcohol use and an intervention with exposure and mindfulness tools for atopic dermatitis (eczema), were developed. Newly developed digital self-care interventions were compared to the earlier therapist-guided interventions they were based on, using published results from three feasibility trials (n's = 30, 36 and 21) and three randomized trials (n's = 148, 166 and 102). The comparison included type of content, duration, length of written material and within-group effect-sizes.
ResultsIn comparison to the guided interventions, clinician time was greatly reduced and the new interventions involved much less reading for participants. The digital self-care tools also showed within-group effect sizes and response rates on par with the more comprehensive guided internet interventions.
DiscussionPreliminary results suggest that some guided internet interventions can be transformed into self-guided digital tools. These three examples show that digital psychological self-care, if provided with telephone interviews before and after the intervention, can be viable alternatives to more comprehensive guided internet interventions. Although these examples are promising, further studies, including randomized experiments, are needed to compare treatment efficacies, and to identify which groups of patients may need more comprehensive guided internet interventions.
AbbreviationsCBTCognitive Behavioral Therapy
GUIGraphical User Interface
ISIInsomnia Severity Index
ISRIIInternational Society for Research on Internet Interventions
POEMPatient Oriented Eczema Measure
KeywordsISRII
Pittsburgh
Self-guided
Digital self-care
Digital tools
Stepped care
© 2023 The Authors. Published by Elsevier B.V.
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