Influence of acceptance-facilitating interventions on the use of an online self-help: Naturalistic investigation in day clinic and inpatient psychosomatic psychotherapy

Abstract

Background: Despite increasing empirical evidence for the effectiveness in the treatment of mental disorders, internet-based interventions (IBI) are still confronted by low acceptance and high dropout rates. Acceptance-facilitating interventions (AFI) represent a promising measure to improve acceptance of possible users. The effectiveness of AFI on adherence, which has a substantial influence on the effectiveness of IBI, has so far been examined in only a few empirical investigations. Objective: The aim of this study was to examine the influence of an AFI on the acceptance, initial use, and adherence of the transdiagnostic psychodynamic online self-help program that aims to use the power of one’s own emotions and is called “Die Kraft der eigenen Emotionen nutzen, (KEN-Online)”. Material and methods: Routine data from 231 patients were analyzed, who were offered the option of using KEN-Online during a day clinic and inpatient treatment within the framework of an AFI integrated into the routine setting. In the cohort design patients who participated in an AFI were compared with a historical control group of patients who did not receive this offer. Furthermore, the relationship between the attitude and the acceptance of the program was examined in the study group (with AFI). Results: Both acceptance and the initial use of KEN-Online were almost 20% higher (p < 0.01 each) among participants of the AFI group compared to the control group. Concerning the adherence of KEN-Online, a small difference was observed in that participants in the control group completed significantly (p < 0.05) more units than participants in the intervention group; however, the overall percentage of completers of KEN-Online was very low with 13.4%. No evidence was found for an impact of the attitude on acceptance. Conclusion: The present study showed that AFI can help facilitate acceptance and initial use of IBI by supplying patients in routine care with standardized and structured information about the intervention; however, regarding the promotion of adherence, additional measures are required.