Therapist Experience Research Articles

Exploring therapist effectiveness across multiple domains over time.

Despite the common assumption that increased therapist experience correlates with improved client outcomes, studies reveal inconsistent relationships between therapist experience and therapy effectiveness. Some studies have demonstrated a slight worsening of client outcomes as therapists gain more experience. Yet, there are few studies that have examined how therapists change in their client outcomes over time, especially across different outcomes (e.g., depression, life functioning, anxiety). The present study used the Behavioral Health Measure-17 to investigate therapist effectiveness over time on multiple treatment outcomes (e.g., general distress, life functioning, anxiety, alcohol/drug use) using a large naturalistic sample of 613 professional therapists and 42,690 clients over approximately 12 years of psychotherapy data. Our results show a significant decrease in client outcomes over time in three domains: general distress, life functioning, and anxiety, albeit small-sized effects. Our findings also indicate that therapist caseload and baseline severity were not associated with predicting client outcomes and that, unexpectedly, the severity of therapist caseloads decreased over time. These findings underscore the importance of a nuanced understanding of therapist effectiveness, challenging the assumption of universal improvement with experience. Furthermore, we believe that these findings may offer preliminary support for matching therapists with clients based on domain-specific strengths. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Quantifying and Assessing Post-Stroke Patients' Functional Capability Level for Independent Daily Activities: A Review

Every year, over 13.7 million stroke episodes occur worldwide, addressing the pressing need for efficient rehabilitation treatments to restore motor function in stroke patients is paramount. The escalating number of stroke cases emphasises the urgency of developing robust rehabilitation methodologies. Currently, therapists rely on subjective and manual assessments to determine subsequent patient interventions, a method fraught with challenges, including subjectivity and dependence on the therapist's experience. This paper critically reviews the quantification and assessment of post-stroke patients' functional capability for independent daily activities. It delves into the existing standards of clinical assessment, explores the integration of sensors in limb rehabilitation prototypes, and observes the mathematical methods and algorithms employed by previous researchers to assess and quantify stroke patients' functional capability automatically. The discussion covers the advantages and disadvantages encountered in developing these prototypes and evaluating their suitability in addressing the complexities of stroke rehabilitation. In conclusion, this paper provides a perception of existing research and identifies crucial gaps. Based on the current research landscape, it presents proposals for prototype development, paving the way for future advancements in stroke rehabilitation methodologies.

The therapist role in parent-led cognitive behavioral therapy for children after trauma: treating trauma from a distance

ABSTRACT This article examines the therapist experience of their role in providing Stepped Care Cognitive-Behavioral-Therapy for Children after Trauma (SC-CBT-CT), a semi-homebased, parent-led trauma-treatment for children (7–12). Previous research has documented that parent-led, therapist-assisted psychological interventions are an acceptable and effective type of service delivery. Yet, the therapist perspective on their role when providing parent-led treatments has received limited research attention. Attention is therefore directed to the therapist experience of engaging parents, establishing relationships, and working with children’s trauma narratives from a distance—through the engagement of parents. The data material consists of semi-structured interviews with SC-CBT-CT therapists. To identify patterns of experience, thought, and viewpoints in the overall data, a stepwise thematic analysis approach was applied. Two core themes emerged: 1) Perceptions of therapeutic control and therapeutic presence when engaging parents to lead their own children through an exposure-based program; 2) Establishment and maintenance of therapeutic alliances with and between parents and children. Although parents are inherently well-positioned to engage with their own children about trauma, the article highlights that treatment adherence, progression, and perseverance is contingent upon systematic therapist guidance, monitoring, and availability for support and problem-solving.

Treatment Objectives, Memory, and Desire.

This article explores the problems of the frequent loss, in the course of treatment, of the initial goals and motivation for treatment by both patient and therapist, and the connected lack of clarity of the real initial motivation for treatment on the part of both participants. It is strongly proposed that a true coincidence of at least one important initial motivational goal of patient and therapist is essential to assure the success of psychotherapy and that particular care is required to establish such agreement. On this basis, the goals of therapy may be expanded in the course of the therapist's experience, countertransference, and the patient's changing reality during treatment, and the existential and philosophical value systems of the therapist may play an important role in such widening of the therapist's expectations for the patient.

Parent, Physician, and Therapist Experience of In-Person, Hybrid, and All-Virtual Models of Physiatry Care for Children with Special Health Care Needs

ObjectiveThe purpose of this study was to compare three models of pediatric physiatry care (in-person, hybrid, and all-virtual) in terms of parent experience and physician- and therapist-reported quality of care. We hypothesized that the all-virtual model would have lower parent experience scores and lower quality scores compared with the other two models of care. MethodsWe designed a convergent parallel mixed methods study incorporating a cluster-randomized crossover design. Quantitative data included surveys of parents, physicians, and therapists after visits to 13 medical therapy units in Northern California between January 2020 and January 2022. Qualitative data were collected in six focus groups with parents, physicians, and therapists. ResultsA total of 2455 visits were completed for 1281 unique children during the study period, including 507 in-person visits, 246 hybrid visits, and 1702 all-virtual visits. There were no differences in parent experience scores between the three models of care. Physicians and therapists rated all-virtual visits significantly lower in terms of quality of care, parent education, and physical exam, compared with the other two models of care, but qualitative results highlighted specific instances where all-virtual visits could be useful. ConclusionsOur findings suggest that parents, therapists, and physicians find a hybrid virtual model is an acceptable model of care that maintains the quality of care and facilitates parent education. All-virtual models may be appropriate for specific circumstances but are perceived as lower quality. Research exploring implementation of these models would be valuable for providing practical guidance in the future.

Exploring predictors of Treatment Attendance in Patients with PTSD and Comorbid Personality Disorders: Secondary Analysis of a Randomized Controlled Trial

IntroductionPosttraumatic stress disorder (PTSD) and personality disorders (PD) often co-occur and treatment dropout remains a challenging problem for both disorders. The literature on predictors of treatment dropout is highly mixed and few reliable predictors have been identified for both PTSD and PD treatments separately, let alone for concurrent PTSD and PD treatment.ObjectivesThe aim of the present study was to identify predictors of treatment attendance among a wide range of variables in patients with PTSD and comorbid PD who received trauma-focused treatment with and without concurrent PD treatment.MethodsData were used from the prediction and outcome study in comorbid PTSD and personality disorders (PROSPER), a study consisting of two randomized clinical trials (RCT) testing the effectiveness of trauma-focused treatment (eye movement desensitization and reprocessing or imagery rescripting) with versus without concurrent PD treatment (dialectical behavior therapy or group schema therapy). 256 patients with PTSD and comorbid personality disorder participated in the study. The potential predictors included demographic (e.g. work status), patient severity (e.g. PTSD severity), patient-therapist (e.g. working alliance) and therapist (e.g. therapist experience) variables. The ordinal outcome variable was treatment attendance (0, 1-7, 8-11, 12+ trauma-focused treatment sessions). Relevant predictors were identified by a series of ordinal regression analyses (threshold for inclusion p < .10). Relevant predictors were then entered together in a final ordinal regression model. Multiple imputation was used to handle missing data.ResultsThe final model included ten predictor variables and provided a good fit for the data (pooled R2Nagelkerke = .29). Higher education level (OR = 1.22, p = .009), self-rated PTSD severity (OR = 1.04, p = .036) and working alliance (OR = 1.72, p = .047) were associated with a larger number of attended sessions. Higher levels of inadequate social support from a friend (OR = 0.90, p = .042) and being randomized in the concurrent treatment condition (OR = 0.52, p = .022) were associated with a smaller number of attended sessions.ConclusionsIn terms of treatment attendance rates, the results suggest that trauma-focused treatment is preferred over concurrent trauma-focused and personality disorder treatment for patients presenting with PTSD and PD. Clinicians should further be aware of the risk of lower treatment attendance for patients with a lower educational background and those reporting inadequate social support. Enhancing working alliance may protect against early treatment termination. Finally, patients with higher levels of PTSD severity at baseline may need a larger number of treatment sessions.Disclosure of InterestNone Declared

Introducing Mechanically Assisted Cough for Patients With Progressive Neurological Disease: Patient-Physical Therapist Interaction and Physical Therapist Perspective.

The goal of this study was to explore the patient-physical therapist interaction and the physical therapist's experience of the introductory session for mechanical insufflation-exsufflation (MI-E) device treatment for patients with progressive neurological disease. Qualitative content analysis of participant's observation of interaction between patients and physical therapists during 9 MI-E introduction sessions in different clinical care settings and 10 follow-up interviews with 6 physical therapists. The introduction of MI-E emerged as a process of instilling a sense of security in the patient. The process can be described in 4 steps: (1) gain understanding by being responsive to the person's whole life situation; (2) share knowledge and expectations in a respectful and permissive way; (3) introduce the device in a gentle and reciprocal interactivity; and (4) adapt to home use in an inclusive dialog with the patient and their significant others. Physical therapists described a need for assurance to instill a sense of security in the patient, implying a need for confidence, competent peers, guiding yet flexible routines, and emotional support. Physical therapists have a need to foster assurance in employing a person-centered approach to make a patient feel secure in the process of introducing MI-E treatment. Multiple modes of professional knowledge were used together with action-based and relational-based ethics to facilitate a person-centered care approach. This seems to be a promising approach for providing good care when introducing MI-E to patients. Further research is needed to explore this from the patient's perspective. This study added to the body of knowledge regarding MI-E treatment in relation to patients. This has direct implication, particularly for inexperienced physical therapists, for informed care for the patient during introduction. Our study also supports that person-centered care should be implemented at all levels of health care to make it possible for physical therapists to practice person-centered care.

"The early bird catches the worm"-Prediction of early response and its importance for treatment outcome in a naturalistic setting of cognitive behaviour therapy.

Knowledge about predictors of early response (ER) remains limited. This study examined patient, process, and therapist variables to predict ER in a naturalistic setting. Data from 493 psychotherapy outpatients were analysed. ER was defined by a ≥25% reduction in general psychological distress (ER percent) and by the reliable change index (ER RCI) within the first 10 sessions measured by the Brief Symptom Inventory-18. ER prediction was determined using logistic regression. General psychological distress (GSI) throughout treatment in patients with and without ER was modelled using a multilevel linear model. This model aimed to predict GSI over treatment using repeated measurements, considering group affiliation (ER percent vs. no ER percent), controlled for other predictors. The prevalence of ER percent and ER RCI were 63.6% and 47.5%, respectively. GSI and therapeutic relationship significantly predicted ER (ER percent: χ2 (6) 70.32, p < .001, Nagelkerkes R2 = .19; ER RCI: χ2 (6) 134.71, p < .001, Nagelkerkes R2 = .35). Patients who rated the therapeutic relationship more positively were more likely to achieve ER (OR = 1.10). Difference in outcomes between patients with and without ER during treatment was influenced by factors such as therapeutic relationship, GSI, therapist experience, and mental comorbidities. Including these variables improved the predictive model from AIC = 17,042.98 to AIC = 16,730.24. The therapeutic relationship is a crucial predictor of ER. Patients achieving ER tend to have better outcome than those without ER. The early phase of therapy warrants particular attention to enhance psychotherapy outcomes.

Physical activity for patients with chronic low back pain: What are physical therapists prescribing?

Despite the extensive evidence supporting physical activity (PA) for managing chronic low back pain (CLBP), little is known about PA prescription by physical therapists treating patients with CLBP. 1) Explore how PA prescriptions provided by outpatient physical therapists treating patients with CLBP align with PA guidelines. 2) Examine the barriers and facilitators of PA prescription among physical therapists working with patients with CLBP. We conducted a qualitative study with outpatient physical therapists who treat CLBP. Semi-structured interviews provided an understanding of physical therapist experience with PA prescription among patients with CLBP. The interviews were transcribed, coded, and analyzed thematically. The 18 participants had an average of 13.4 (6.4) years of clinical experience in outpatient physical therapy. Thematic analysis revealed: 1) Physical therapists' articulate knowledge of PA guidelines and importance of physical activity; 2) Patient factors take priority over the PA guidelines for people with CLBP; and 3) The importance of building and maintaining a strong patient-therapist relationship influences physical therapist prescription of PA for patients with CLBP. When providing PA recommendations for patients with CLBP, general movement recommendations are emphasized in place of explicit PA prescriptions. Our findings highlight factors for consideration when prescribing movement and PA for patients with CLBP.

Terapeuters tanker om gjenopprettende prosess når barn begår seksuelle overgrep: en kvalitativ studie

Background: Restorative process has been used as a treatment intervention in cases where children sexually abuse other children. However, empirical knowledge of the method is scarce. Aim: This study aims to explore therapists` reflections on how restorative process affects children who participate. Method: We conducted semi-structured interviews with 12 therapists working with sexually abused children and child abusers. Six of the participants had experience in using restorative process. Data were analyzed using thematic analysis. Results: The analysis resulted in three themes: (1) becoming stronger, (2) making matters worse, and (3) restorative conditions. Conclusion: The majority of the therapists point out that restorative process can be helpful if it is well prepared, both children want to participate, and the abuser takes responsibility. Without these factors, restorative process can be harmful, especially for the victim. Keywords: harmful sexual behaviour, child sexual abuse, restorative process, qualitative method, therapist experience

Physiotherapy assessment in people with neurological conditions-Evidence for the most frequently included domains: A mixed-methods systematic review.

There is a lack of consensus in the literature related to what is assessed clinically by physical therapists in people with neurological disorders. This mixed-methods systematic review aimed to identify domains that physiotherapists routinely assess in people with neurological conditions in clinical settings and explored factors influencing assessment domains including country, clinical setting, therapist experience and neurological condition. Five databases were searched from 1946 to 31st January 2023. Studies with any design reporting on domains assessed by a physiotherapist, in people with neurological conditions in any clinical setting, were included. Independent reviewers assessed eligibility and risk of bias using relevant McMaster critical appraisal tools. Data were extracted and synthesised following the Joanna Briggs Institute approach for mixed systematic reviews. A total of 23 (16 quantitative, 7 qualitative) studies involving 3134 participants were included. The studies were rated as high (n = 14) or medium (n = 9) quality. The domains of function (n = 14); postural alignment and symmetry (n = 11); gait (n = 11); balance (n = 9), and muscle strength (n = 8) were most frequently included in assessments. Five key themes were identified from the qualitative studies: the clinical reasoning process, clinical use of standardised measures, utilisation of the senses, clinician experience and information gathering. There was minimal data on how country, clinical setting, therapist experience and neurological condition influence inclusion of assessed domains. Five domains were most frequently included in assessment: function; postural alignment and symmetry; gait; muscle strength; and balance. This limited number of domains is in stark contrast to the full neurological physiotherapy assessment recommended by expert textbooks. Further research is needed to understand the reasons why this might be so.

A stomal therapists experience of a novel chyme reinfusion device for high output enterostomies: A case series instituting a novel chyme reinfusion device in three patients

Background: Reinfusing chyme down the distal limb of an enterostomy is a well-researched technique for helping prevent dehydration and electrolyte loss from a high-output enterostomy. However, it has not gained traction because it is a labour-intensive task that requires nursing management and further in-hospital care. A novel chyme reinfusion device that a patient can manage is now available (The InsidesTM System, The Insides Company, New Zealand). Cases: This paper explores a stomal therapist's experience instituting The InsidesTM System for three patients with high output enterostomies. The reinfusion device is a simple set-up that has been shown to reduce fluid and electrolyte imbalances, reduce and remove the need for parenteral nutrition and is patient managed. Patient experience and learning points gained from the three participants were collected across the themes of patient consent, education of patients and carers, custom tube installation into the distal limb, usability testing and feedback to the device developers. Conclusions: The novel chyme reinfusion device is a simple patient-managed solution that is easy to install and initiate. Clinical benefits include preventing dehydration and electrolyte loss from high-output double enterostomies. By instituting a thorough supportive follow-up management plan for each patient, there were minimal complications with high patient compliance and satisfaction.

Cognitive behavioural anger treatment for adults with intellectual disabilities: effects of therapist experience on outcome.

Anger has been shown to be associated with aggression and violence in adults with intellectual disabilities in both community and secure settings. Emerging evidence has indicated that cognitive behavioural anger treatment can be effective in reducing assessed levels of anger and violent behaviour in these patient populations. However, it has been suggested that the effectiveness of these types of interventions is influenced by the experience and training of the therapists. In this service evaluation study, the pre- and post-treatment and 12-month follow-up assessment scores of 88 detained in-patient adults with intellectual disabilities and forensic histories who received cognitive behavioural anger treatment were examined in order to investigate whether participants' responsiveness to treatment was associated with treatment being delivered by qualified versus unqualified therapists. Overall significant reductions in self-reported measures of anger disposition and anger reactivity were found with no significant time × therapist experience interaction effects. However, the patients treated by qualified therapists improved significantly on measures of anger control compared with those allocated to unqualified therapists. Male and female detained patients with intellectual disabilities and forensic histories can benefit from an individual cognitive behavioural anger treatment intervention delivered by qualified and unqualified therapists, but therapist experience may be important in supporting patients to develop more complex anger control coping skills.

Clinical utility of a decision-making aid for upper limb neurorehabilitation: applying the Hypertonicity Intervention Planning Model across cultures

ABSTRACT Background The Hypertonicity Intervention Planning Model (HIPM) is a decision-making aid which guides clinical reasoning in individualizing upper limb (UL) neurorehabilitation. Aim To examine the HIPM’s clinical utility across cultures, using therapists’ perceptions of its usefulness and challenges when applied in clinical practice. Methods Interpretive description methodology guided qualitative data collection and analysis because it produces clinically practical applications. Forty-four occupational therapists working in Australia or Singapore participated. Three group discussions were conducted using a modified nominal group technique. Results Three themes were: (1) The HIPM guides systematic clinical decision-making for assessment, goal-setting, and intervention; (2) Utility was influenced by systemic or organizational supports and barriers including availability of time, resources, and funding; organizational readiness to change; multidisciplinary and transorganizational collaboration; (3) Therapists’ skills and confidence to apply the HIPM, and openness to changing practice, influenced utility. Conclusions Therapists strongly support HIPM use for structuring and communicating clinical reasoning in UL neurorehabilitation. However, organizational support is key to optimizing clinical utility. Incorporating decision-making aids into documentation and referral processes may strengthen multidisciplinary and transorganizational teamwork, enhancing clinical use. Different training tiers to suit therapist experience levels, refresher courses, and supplementary resources may improve therapists’ skills and confidence, thereby boosting utility.

A randomized, cross-over trial comparing the effect of innovative robotic gait training and functional clinical therapy in children with cerebral palsy; a protocol to test feasibility.

Robotic gait training is relatively new in the world of pediatric rehabilitation. Preliminary feasibility studies and case reports include stationary robot-assisted treadmill training. Mobile robotic gait trainers hold greater promise for intensive practice-based therapy within hospitals, schools, rehabilitation centers, and at-home therapy as they enable participation and social integration while practicing high-quality gait patterns. This paper (clinical trials registry number: NCT05378243) provides a detailed description of a mixed-method cross-over trial design with a broad set of outcome measures. Ultimately the goal is to establish the feasibility of this design which includes the collection of qualitative data regarding patient, family, and therapist experience and quantitative data regarding gait efficiency and quality, impact on tone, individualized goal achievement and bone strength.

Exercise variables and pain threshold reporting for strength training protocols in people with haemophilia: A systematic review of clinical trials.

Although strength exercise is often prescribed for people with haemophilia (PWH), it remains unknown how exercise variables and pain thresholds are used to prescribe strength training in PWH. To analyse how strength exercise variables and pain thresholds have been used to prescribe strength training in PWH. A systematic search was conducted in PubMed, Embase, Web of Science, CENTRAL and CINAHL databases from inception to 7 September 2022. Studies whose intervention included strengthening training in adults with haemophilia were included. Two independent reviewers were involved in study selection, data extraction and risk of bias assessment. Eighteen studies were included. The least reported variables among the studies were: prophylactic factor coverage (11.1%), pain threshold/tolerability (5.6%), intensity (50%), total or partial range of motion (27.8%), time under tension (27.8%), attentional focus modality (0%), therapist experience in haemophilia (33.3%) and adherence assessment (50%). In contrast, weekly frequency (94.4%), duration (weeks) (100%), number of sets/repetitions (88.9%), repetitions to failure/not to failure (77.8%), types of contraction (77.8%), rest duration (55.6%), progression (55.6%), supervision (77.8%), exercise equipment (72.2%) and adverse event record (77.8%) had a higher percentage of reported (>50% of studies). Future research on strength training for PWH should improve information on pain threshold and other important variables such as prophylactic factor coverage, intensity, range of motion, time under tension, attentional focus modality, therapist experience in haemophilia and adherence assessment. This could improve clinical practice and comparison of different protocols.

A Consensus Statement on Clinical Reasoning in Clinical Sexology

This Delphi study was conducted to develop a consensus statement on clinical reasoning in clinical sexology. 10 participants completed the qualitative interviews. The analysis identified 11 principles that provide a framework for sex therapists to better understand clinical reasoning. These principles were grouped into three domains: 1) client empowerment, 2) self-reflection, and 3) evidence-based inquiry. These three domains reflect the factors that shape sexology-informed clinical reasoning: the patient, the therapist's experience, and evidence-based information.

Videoconferencing psychotherapy from a psychodynamic point of view. A qualitative analysis.

There is a growing interest in delivering videoconferencing psychotherapy (VCP) due to the enormous impact of the COVID-19 pandemic on our lives since the beginning of severe restrictions worldwide in March 2020. Scientific literature has provided interesting results about the transition to remote sessions and its implications, considering different psychotherapy orientations. Less is known about whether and how VCP affects psychodynamic psychotherapeutic approaches and reports on remote work with severe and complex mental health problems such as severe personality disorders are still scarce. The aim of the study was to examine the experiences of psychodynamic psychotherapists, mainly delivering Transference-Focused Psychotherapy (TFP), with the transition and delivery of VCP during the first wave of the COVID-19 pandemic. Four hundred seventy-nine licensed psychotherapists completed an online survey during the peak of the pandemic. Survey data were analyzed using qualitative analysis. Results are presented and discussed concerning advantages and disadvantages regarding the access to psychotherapy, the specificity of the online video setting, bodily aspects, the quality of the therapeutic relationship, the therapeutic process including technical aspects and therapist's experience. Furthermore, we analyzed and discussed the statements concerning transference and countertransference reactions differentiating between high-level borderline and neurotic patients and low-level borderline patients. Our results support the importance to identify patients who potentially benefit from VCP. Further research including more prospective randomized controlled trials are needed to investigate the therapeutic implications of the findings.

Two sides of the same coin? Patient and therapist experiences with a transdiagnostic blended intervention focusing on emotion regulation

IntroductionThe combination of internet-based intervention and psychotherapy, commonly termed blended therapy (BT), has gained popularity in recent years. While advantages and disadvantages of BT have been identified from the patient and therapist perspective, the two perspectives have rarely been examined within the same treatment. Moreover, almost all available research on patient and therapist experiences with BT is disorder-specific. This study aimed to investigate patient and therapist experiences within the same transdiagnostic BT. MethodsA qualitative analysis of semi-structured interviews with eight patients and eight therapists taking part in a transdiagnostic blended intervention focusing on the topic of emotion regulation was conducted. A qualitative content analysis approach was used. Category frequencies were calculated and similarities and differences between the patient and therapist experience were explored. ResultsTen main themes and 59 subthemes were identified in the category system for patient interviews and ten main themes and 50 subthemes were identified in the category system for therapist interviews. Similarities and differences between the two perspectives were reported with regard to 1) expectations toward the intervention, 2) the internet-based intervention, 3) symptomatology and emotion regulation, 4) the therapeutic relationship and 5) the blended format. ConclusionThis study provides first insights on the experiences with transdiagnostic BT focusing on emotion regulation. Based on the results, different recommendations for the improvement of transdiagnostic BT are made. Future research on patient and therapist experiences with transdiagnostic BT is necessary, in order to further improve the experience of those involved.

Feasibility of Digital Cognitive Behavioral Therapy for Depressed Older Adults With the Moodbuster Platform: Protocol for 2 Pilot Feasibility Studies.

Internet-based interventions can be effective in the treatment of depression. However, internet-based interventions for older adults with depression are scarce, and little is known about their feasibility and effectiveness. To present the design of 2 studies aiming to assess the feasibility of internet-based cognitive behavioral treatment for older adults with depression. We will assess the feasibility of an online, guided version of the Moodbuster platform among depressed older adults from the general population as well as the feasibility of a blended format (combining integrated face-to-face sessions and internet-based modules) in a specialized mental health care outpatient clinic. A single-group, pretest-posttest design will be applied in both settings. The primary outcome of the studies will be feasibility in terms of (1) acceptance and satisfaction (measured with the Client Satisfaction Questionnaire-8), (2) usability (measured with the System Usability Scale), and (3) engagement (measured with the Twente Engagement with eHealth Technologies Scale). Secondary outcomes include (1) the severity of depressive symptoms (measured with the 8-item Patient Health Questionnaire depression scale), (2) participant and therapist experience with the digital technology (measured with qualitative interviews), (3) the working alliance between patients and practitioners (from both perspectives; measured with the Working Alliance Inventory-Short Revised questionnaire), (4) the technical alliance between patients and the platform (measured with the Working Alliance Inventory for Online Interventions-Short Form questionnaire), and (5) uptake, in terms of attempted and completed modules. A total of 30 older adults with mild to moderate depressive symptoms (Geriatric Depression Scale 15 score between 5 and 11) will be recruited from the general population. A total of 15 older adults with moderate to severe depressive symptoms (Geriatric Depression Scale 15 score between 8 and 15) will be recruited from a specialized mental health care outpatient clinic. A mixed methods approach combining quantitative and qualitative analyses will be adopted. Both the primary and secondary outcomes will be further explored with individual semistructured interviews and synthesized descriptively. Descriptive statistics (reported as means and SDs) will be used to examine the primary and secondary outcome measures. Within-group depression severity will be analyzed using a 2-tailed, paired-sample t test to investigate differences between time points. The interviews will be recorded and analyzed using thematic analysis. The studies were funded in October 2019. Recruitment started in September 2022. The results of these pilot studies will show whether this platform is feasible for use by the older adult population in a blended, guided format in the 2 settings and will represent the first exploration of the size of the effect of Moodbuster in terms of decreased depressive symptoms. PRR1-10.2196/41445.