Acceptance of E-Mental Health Services for Different Application Purposes Among Psychotherapists in Clinical Training in Germany and Switzerland: Secondary Analysis of a Cross-Sectional Survey.

Pia Braun,Severin Hennemann,Felix Jan Nitsch,Jennifer Apolinário-Hagen,Robert Staeck,Marie Drüge

doi:10.3389/fdgth.2022.840869

Abstract

BackgroundDespite solid evidence supporting the efficacy of electronic mental health (EMH) services, their acceptance among psychotherapists is limited and uptake rates remain low. However, the acceptance of different EMH services has yet barely been examined in future generations of psychotherapists in a differentiated manner. The aims of this study were (1) to elaborate the intention to use various EMH services for different application purposes and (2) to determine predictors of EMH service acceptance among psychotherapists in clinical training (PiT).Materials and MethodsOur paper is based on a secondary data analysis of a cross-sectional survey. Respondents were recruited via recognized educational institutions for psychotherapy within Germany and the German-speaking part of Switzerland between June and July of 2020. The survey contained items on the intention to use different EMH services (i.e., guided and unguided programs, virtual reality, psychotherapy by telephone and videoconference) for various application purposes (i.e., prevention, treatment addition, treatment substitute, aftercare). Potential predictors of EMH service acceptance (e.g., barriers and advantages) were examined based on an extension of the Unified Theory of Acceptance and Use of Technology (UTAUT).ResultsMost of the n = 216 respondents were female (88.4%) and located in Germany (72.2%). General acceptance of EMH was moderate (M = 3.4, SD = 1.12, range 1–5), while acceptance of psychotherapy via videoconference was highest (M = 3.7, SD = 1.15) and acceptance of unguided programs was lowest (M = 2.55, SD = 1.14). There was an interaction effect of EMH service and application purpose (η2 = 0.21). Barriers and advantages both had a uniform influence on EMH service acceptance (Pr > 0.999), while impersonality, legal concerns, concerns about therapeutic alliance, simplified information provision, simplified contact maintenance, time flexibility, and geographic flexibility were significant predictors (all p < 0.05). Results showed that the extended UTAUT model was the best fitting model to predict EMH service acceptance (Pr > 0.999).ConclusionsThe intention to use different EMH services varied between application purposes among PiT. To increase acceptance of EMH services and reduce misconceptions, we identified predictors that should be addressed in future acceptance-facilitating interventions when educating PiT.

Highlights

During the ongoing COVID-19 pandemic, common mental health disorders (CMDs) such as depression, post-traumatic stress disorder (PTSD) or anxiety disorders increased tremendously across the globe [1–4]
This study is one of few to examine the acceptance of different Electronic mental health (EMH) services across varying application purposes from the perspective of psychotherapists in clinical training (PiT)
We could show that acceptance for several EMH services differed for application purposes among PiT

Summary

Introduction

During the ongoing COVID-19 pandemic, common mental health disorders (CMDs) such as depression, post-traumatic stress disorder (PTSD) or anxiety disorders increased tremendously across the globe [1–4]. Safe and location-independent help, the World Health Organization [8] has recommended to ensure access to psychosocial support services through digital systems. The need for accessible, effective and flexible services as alternatives or additions to traditional mental health treatment to support vulnerable populations became even more evident during the COVID-19 pandemic [9]. Electronic mental health (EMH) services are usually internetdelivered services that have proven to be effective in trials on the prevention and treatment of CMDs [10–13], for instance in reducing symptoms of PTSD [14], anxiety [13, 15], depression [16], panic disorder and social anxiety disorder [17]. Despite solid evidence supporting the efficacy of electronic mental health (EMH) services, their acceptance among psychotherapists is limited and uptake rates remain low. The aims of this study were [1] to elaborate the intention to use various EMH services for different application purposes and [2] to determine predictors of EMH service acceptance among psychotherapists in clinical training (PiT)

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Methods

Results

Discussion

Conclusion