Internet interventions may help bridging gaps in the treatment of depression but dissemination is slow in most countries. Attitudes towards these novel treatments options among health care professionals and potential users may be crucial for a successful implementation. We recruited 1004 adults with mild to moderate depression symptoms within a randomized-controlled trial (RCT) on the efficacy of an Internet intervention (EVIDENT trial), and 428 licensed psychotherapists. We used the Attitudes towards Psychological Online Interventions Questionnaire (APOI) and confirmed psychometric validity of an adapted version for health care professionals, in order to test if psychotherapists hold more negative attitudes towards such interventions compared to individuals with depression symptoms, and to explore variables that predict these attitudes. Individuals with depression symptoms reported more positive attitudes towards Internet interventions than psychotherapists (large group difference; η 2p = 0.384). Recruitment in clinical settings was associated with more negative attitudes compared to recruitment via the media. Among therapists, endorsing a psychodynamic rather than another theoretical orientation was associated with more pronounced negative attitudes. Results elucidate possible reasons for the slow dissemination of Internet interventions and suggest pathways for appropriate implementation into healthcare services.
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The authors wish to thank GAIA AG (Hamburg, Germany), which gave technical support and made the Internet intervention (deprexis) available at no cost to the participants in the trial. The full EVIDENT trial team consists of the following: Sandra Nolte, Matthias Rose (local principal investigator), Anna Paulitschek, Leonie Gmöhling, and Leonie Schickedanz (Berlin); Thomas Berger (Bern); Viola Gräfe and Wolfgang Greiner (local principal investigator; Bielefeld); Mirja Behrens, Cecile Hörmann, Anna Katharina Jahns, Thies Lüdtke, Björn Meyer, Steffen Moritz (local principal investigator), Johanna Schröder, Amit Gulati, and Eik Vettorazzi (Hamburg); Carla Gamon, Fritz Hohagen (principal investigator), Philipp Klein (local principal investigator), Antje Roniger, and Christina Späth (Lübeck); Alice Arndt, Liv Glindemann, Wolfgang Lutz (local principal investigator), David Rosenbaum, and Kathinka Wolter (Trier), and Flora Bach, Elisabeth Beck, Kristina Fuhr, Martin Hautzinger (local principal investigator), Katharina Krisch, and Melanie Wahl (Tübingen).
The EVIDENT trial, which underlay this study, was funded by the German Federal Ministry of Health (II A 5-2512 FSB 052).
Conflict of Interest
Björn Meyer reports that he is employed at Gaia AG, the developer and owner of an Internet intervention (deprexis). Johanna Schröder, Thomas Berger, Wolfgang Lutz, Martin Hautzinger, Christina Späth, Christiane Eichenberg, Jan Philipp Klein, and Steffen Moritz declare that they have no conflict of interest related to this work.
This article does not contain any studies with animals performed by any of the authors. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The trial was approved by the ethics committee of the German Psychological Association (Deutsche Gesellschaft für Psychologie; DGPs) and registered at clinicaltrials.gov (NCT01636752).
Informed consent was obtained from all individual participants included in the study.
Jan Philipp Klein and Steffen Moritz have equally contributed to the article and therefore split senior authorship.
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Schröder, J., Berger, T., Meyer, B. et al. Attitudes Towards Internet Interventions Among Psychotherapists and Individuals with Mild to Moderate Depression Symptoms. Cogn Ther Res 41, 745–756 (2017). https://doi.org/10.1007/s10608-017-9850-0
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