When ‘e’ therapy enters the hospital: Examination of the feasibility and acceptability of SPARX (a cCBT programme) in an adolescent inpatient unit
Abstract
Background: Recently, advances in computer technology have made it possible to deliver evidence-based psychological therapies in a computerised self-help format – a promising approach in the treatment of depression in children and adolescents. We examine the feasibility and acceptability of offering SPARX (smart, positive, active, realistic, X-factor thoughts), a computerised cognitive behavioural therapy tool in an inpatient setting to adolescent patients who typically experience a greater severity of mental illness than in previous trials of computerised therapy. Method: Adolescent patients admitted to hospital for treatment were invited to use SPARX when their mental state had stabilized and they were able to use the computer programme with minimal assistance. We considered uptake and adherence rates and patient-rated satisfaction with the programme and collected demographic descriptive information.Results: Most patients who were offered therapy agreed to trial SPARX, with 60% continuing beyond the fi rst module and 10% completing the programme prior to discharge. Patients who completed only one or two modules cited lack of interest and perceived utility as reasons for discontinuation whereas those who completed three or more modules discontinued because of lack of access to SPARX after discharge from hospital. Conclusion: The study’s small sample limits the generalizability of the fi ndings but the results suggest that it is feasible to offer e-therapy in an inpatient unit and patients are generally interested in trying it. Practical aspects such as timing of delivery and participation in other therapies likely impact on completion rates.
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Digital mental health interventions had the advantage of fitting into the daily routines of users, connecting with current interests, and helping to bring back a sense of normality.
“DMHIs also had the advantage of fitting into the daily routines of users, connecting with current interests (40), and helping “to bring back a sense of normality” (36, p. 290).”
From What Works and What Doesn’t Work? A Systematic Review of Digital Mental Health Interventions for Depression and Anxiety in Young People (2019) · cites this paper as [36]
Two studies that evaluated an interactive CBT-based fantasy game called SPARX both found that some participants preferred face-to-face support from a therapist.
“For example, two studies that evaluated an interactive CBT-based fantasy game called SPARX, both found that some participants preferred face-to-face support from a therapist (36, 56).”
From What Works and What Doesn’t Work? A Systematic Review of Digital Mental Health Interventions for Depression and Anxiety in Young People (2019) · cites this paper as [36]
In many studies, even among those with low study attrition, engagement tended to be low, with participants completing less than half of the intervention components.
“However, this was not always the case and in many studies, even among those with low study attrition, engagement tended to be low, with participants completing less than half of the intervention components (36, 45, 49, 51, 53, 73).”
From What Works and What Doesn’t Work? A Systematic Review of Digital Mental Health Interventions for Depression and Anxiety in Young People (2019) · cites this paper as [36]
Participants stated that digital mental health interventions should be improved to make them comparable to commercially available games.
“Participants stated that DMHIs should be improved to make them “comparable to commercially available games” (36, p. 290).”
From What Works and What Doesn’t Work? A Systematic Review of Digital Mental Health Interventions for Depression and Anxiety in Young People (2019) · cites this paper as [36]
Participants stated that a game-like feel made engaging with the digital mental health interventions fun.
“Participants stated that this made engaging with the DMHIs fun (36, 41).”
From What Works and What Doesn’t Work? A Systematic Review of Digital Mental Health Interventions for Depression and Anxiety in Young People (2019) · cites this paper as [36]
Multiple other studies reported similar comments by participants, particularly non-completers, about educational content.
“Multiple other studies reported similar comments by participants, particularly non-completers (36, 45, 54, 56, 58, 73).”
From What Works and What Doesn’t Work? A Systematic Review of Digital Mental Health Interventions for Depression and Anxiety in Young People (2019) · cites this paper as [36]
Two studies examined adoption and reported low adherence to program sessions.
“Two studies examined adoption and reported low adherence to program sessions [75]”
From eMental Healthcare Technologies for Anxiety and Depression in Childhood and Adolescence: Systematic Review of Studies Reporting Implementation Outcomes (2018) · cites this paper as [75]
Of these, 3 (60%) reported high satisfaction.
“Of these, 3 (60%) reported high satisfaction [73-75]”
From eMental Healthcare Technologies for Anxiety and Depression in Childhood and Adolescence: Systematic Review of Studies Reporting Implementation Outcomes (2018) · cites this paper as [75]
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- Authors
- Bobier, C., Stasiak, K., Mountford, H., Merry, S., & Moor, S.
- Affiliations
- Princess Margaret Hospital (NZ)
- University of Auckland (NZ)
- Venue
- Advances in Mental Health
- Publisher
- Informa UK Limited
- Published
- 2013-06
- Volume
- 11
- Issue
- 3
- Pages
- 286-292
- ISSN
- 1446-7984 (ISSN-L)
- 1838-7357
- 1837-4905
- OpenAlex
- W2082235153
- Cited by
- 18
- References
- 8
- Citations by year
- 2024: 1 · 2023: 1 · 2022: 3 · 2021: 2 · 2020: 2 · 2019: 3 · 2018: 2 · 2017: 1 · 2016: 2 · 2015: 1
- FWCI
- 1.51
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Advances in Mental Health (publishedVersion)
- 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 › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- SPARX, computerized cognitive behavioral therapy, e-therapy, adolescent depression, psychiatric inpatient care, feasibility, acceptability, medication adherence, program completion, patient satisfaction
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