Consensus statement on the problem of terminology in psychological interventions using the internet or digital components

Ewelina Smoktunowicz,Lee M Ritterband,Mark B Powers,Per Carlbring,Nickolai Titov,Viktor Kaldo,Cristina Botella,Heleen Riper,Blake F Dear,Alexander Rozental,Cornelia Weise,David C Hodgins,Stephen M Schueller,Gerhard Andersson,Tara Donker,Tine Nordgreen,Thomas Berger,Azy Barak,David C Mohr,Heather D Hadjistavropoulos ,David Daniel Ebert ,Rosa M Baños

doi:10.1016/j.invent.2020.100331

Abstract

Since the emergence of psychological interventions delivered via the Internet they have differed in numerous ways. The wealth of formats, methods, and technological solutions has led to increased availability and cost-effectiveness of clinical care, however, it has simultaneously generated a multitude of terms. With this paper, we first aim to establish whether a terminology issue exists in the field of Internet-delivered psychological interventions. If so, we aim to determine its implications for research, education, and practice. Furthermore, we intend to discuss solutions to mitigate the problem; in particular, we propose the concept of a common glossary. We invited 23 experts in the field of Internet-delivered interventions to respond to four questions, and employed the Delphi method to facilitate a discussion. We found that experts overwhelmingly agreed that there were terminological challenges, and that it had significant consequences for conducting research, treating patients, educating students, and informing the general public about Internet-delivered interventions. A cautious agreement has been reached that formulating a common glossary would be beneficial for the field to address the terminology issue. We end with recommendations for the possible formats of the glossary and means to disseminate it in a way that maximizes the probability of broad acceptance for a variety of stakeholders.

Highlights

The emergence of Internet-delivered interventions in the mid-1990s has led to the continuous introduction of an abundance of approaches, methods, and techniques into the area of psychological and behavioral therapeutic and self-help interventions (Andersson et al, 2019b)
Due to the lack of shared and accepted definitions, Internet-delivered psychological interventions cover the spectrum from unguided self-help interventions to treatments in which patients receive ongoing feedback from a clinician
Finding proper and—where possible—distinguishable terms for different forms of intervention would allow researchers to adequately assess the efficacy of Internet-delivered psychological interventions

Summary

Introduction

The emergence of Internet-delivered interventions in the mid-1990s has led to the continuous introduction of an abundance of approaches, methods, and techniques into the area of psychological and behavioral therapeutic and self-help interventions (Andersson et al, 2019b). As is typical of the richness and multifaceted structure of the Internet, these interventions are heterogeneous (Barak et al, 2009), and they differ from each other in numerous ways, including the technological platforms, use of technical features, level of textuality, degree of inclusion of online and offline factors, extent of human versus automatic involvement, professional qualifications of therapists, and other important aspects. To demonstrate the scope of the heterogeneity in wording, we present the results of our review of terms in PubMed. Table 1 contains a list of terms used in scientific publications to designate Internet-delivered intervention procedures. A review of the literature shows that there is no consistency in use of these terms over time and across publication outlets (Andersson et al, 2019a, 2019b). Adding to the complexity are the differences in journal preferences and explicit instructions to change terms during the review process

Objectives

Methods

Results

Discussion

Conclusion