Young people's experience of online therapy for first-episode psychosis: a qualitative study
Abstract
Objectives This study aimed to understand how young people with first-episode psychosis experienced online therapy on a Moderated Online Social Therapy (MOST) platform known as Horyzons. Methods Semi-structured in-depth qualitative interviews were conducted with 12 young people who had previously participated in Horyzons, a randomized controlled trial (RCT) of a long-term digital intervention for first-episode psychosis. Interviews were analysed using a phenomenological approach. Results This study found that the online therapy experience for first-episode psychosis was idiosyncratic, taking on different meaning for different users. The relatively fixed therapeutic content led to experiences that included on-demand help-seeking, positive distraction, revision, generalization and translation, and normalization. We also found that although the experience of online therapy was motivating to some, it was overwhelming for others. Conclusions The self-directed and flexible nature of the Horyzons online therapy gave some young people a sense of welcomed control over their mental health journey, and others felt overwhelmed by the high level of choice. Feeling overwhelmed by the level of choice appeared to interrupt their engagement with the platform, and thus their overall ability to use the intervention meaningfully. We also found that on-demand help-seeking and positive distraction were two functions unique to young people through online therapy and may have been related to the sig…
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Results from several pilot studies and a clinical trial showed that MOST was engaging over prolonged periods of time, safe, non-stigmatising, endorsed and valued by young people, clinicians, and services, effective in improving vocational recovery and reducing use of hospital services in youth psychosis, cost-saving, and cost-effective.
“Results from several pilot studies and a clinical trial showed that MOST was engaging over prolonged periods of time; safe; nonstigmatising; endorsed and valued by young people, clinicians, and services; effective in improving vocational recovery and reducing use of hospital services in youth psychosis; cost-saving; and cost-effective, with four clinical trials underway.”
From The Lancet Psychiatry Commission on youth mental health (2024) · cites this paper as [372]
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The Lancet Psychiatry Commission on youth mental health
McGorry, P. D., Mei, C., Dalal, N., Alvarez-Jimenez, M., Blakemore, S.-J., Browne, V., Dooley, B., Hickie, I. B., Jones, P. B., McDaid, D., et al. (2024) · The Lancet Psychiatry · doi:10.1016/s2215-0366(24)00163-9 · Cited by 663 · see citing works
Self-citation
- Authors
- Valentine, L., McEnery, C., O’Sullivan, S., D’Alfonso, S., Gleeson, J., Bendall, S., & Alvarez‐Jimenez, M.
- Affiliations
- The University of Melbourne (AU)
- Australian Catholic University (AU)
- Orygen Parkville VIC Australia
- Corresponding author
- Valentine, Lee
- Venue
- Psychology and Psychotherapy: Theory, Research and Practice
- Publisher
- Wiley
- Published
- 2021-07-12
- Volume
- 95
- Issue
- 1
- Pages
- 155-172
- ISSN
- 1476-0835 (ISSN-L)
- 2044-8341
- OpenAlex
- W3179041527
- Cited by
- 19
- References
- 14
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 5 · 2023: 4 · 2022: 2
- FWCI
- 2.44
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychology and Psychotherapy Theory Research and Practice (publishedVersion)
- PubMed (publishedVersion)
- Minerva Access (University of Melbourne) (submittedVersion)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- first-episode psychosis, online therapy, digital mental health interventions, youth, user experience, self-guided intervention, help-seeking, positive distraction, choice overload, engagement, normalization, emergency department presentation, hospitalization
- MeSH terms
- Adolescent, Counseling, Humans, Mental Health, Psychotic Disorders, Qualitative Research
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