Cited by 166Digital Mental Health InterventionsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Treatment and Access

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Impact of guidance on intervention adherence in computerised interventions for mental health problems: a meta-analysis

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Musiat, Peter, Johnson, Catherine, Atkinson, Melissa, Wilksch, Simon, Wade, Tracey·2022·Psychological Medicine

DOI 10.1017/s0033291721004621

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Abstract

Web-based interventions are increasingly used for the prevention, treatment and aftercare of mental disorders. A crucial factor to the efficacy of such online programmes is adherence to the intervention content and procedure. It has been frequently suggested that adherence in web-based interventions is low and little is known about which factors influence adherence. To increase intervention uptake and completion, studies increasingly include interventions with some form of guidance. Guided interventions have been shown to have higher efficacy, however, evidence for the impact on adherence is limited and mixed. This meta-analysis explored the impact of human guidance on intervention completion in web-based mental health interventions. A total of 22 studies were included with interventions primarily targeting symptoms of depression and anxiety disorders. Results showed that guidance significantly increases the average amount of intervention completion [ g = 0.29, 95% confidence interval (CI) 0.18–0.40] and the proportion of intervention completers [ log odds ratio (OR) = 0.50, 95% CI 0.34–0.66] with small effects. On average, full completion rates were 12% higher in guided intervention groups. This meta-analysis demonstrated that guidance in web-based mental health interventions does increase adherence, but more research is required to better understand the specific mechanisms between guidance, adherence and outcomes.

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“Additionally, findings are mixed regarding the impact of these human-supports on adherence and treatment efficacy (Musiat et al., 2021; Shim et al., 2017).”
Background
Digital Mental Health Interventions for University Students With Mental Health Difficulties: A Systematic Review and Meta‐Analysis
Madrid‐Cagigal, A., Kealy, C., Potts, C., Mulvenna, M. D., Byrne, M., Barry, M. M., & Donohoe, G. (2025) · Early Intervention in Psychiatry · doi:10.1111/eip.70017 · Cited by 78

See all 166

Authors: Musiat, P., Johnson, C., Atkinson, M., Wilksch, S., & Wade, T.
Affiliations: Flinders University (AU)
University of Bath (GB)
Corresponding author: Musiat, Peter
ORCID: Musiat, Peter
Johnson, Catherine
Atkinson, Melissa
Wilksch, Simon
Wade, Tracey
Venue: Psychological Medicine
Publisher: Cambridge University Press (CUP)
Published: 2021-11-22
Volume: 52
Issue: 2
Pages: 229-240
ISSN: 0033-2917 (ISSN-L)
1469-8978
DOI: 10.1017/s0033291721004621
OpenAlex: W3215127018
Cited by: 166
References: 70
Citations by year: 2026: 34 · 2025: 55 · 2024: 37 · 2023: 26 · 2022: 14
FWCI: 3.09
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.cambridge.org/core/terms (unspecified)
Locations: Psychological Medicine (publishedVersion)
PubMed (publishedVersion)
Pure (University of Bath) (publishedVersion, other-oa)
Funders: Australian Research Council (DP170100237)
Topics: Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Keywords: intervention adherence, online intervention, guided intervention, human guidance, intervention completion, mental health, depression, anxiety disorders
MeSH terms: Internet-Based Intervention, Humans, Mental Health, Internet

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Impact of guidance on intervention adherence in computerised interventions for mental health problems: a meta-analysis

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