Resources, support, and integration as potential barriers and facilitators to the implementation of blended therapy in the routine care of inpatients: a qualitative study

Nikita Gupta; Sophie Leuba; Erich Seifritz; Thomas Berger; Wolfram Kawohl

doi:10.3389/fpsyt.2024.1417784

Resources, support, and integration as potential barriers and facilitators to the implementation of blended therapy in the routine care of inpatients: a qualitative study

Front Psychiatry. 2024 Dec 17:15:1417784. doi: 10.3389/fpsyt.2024.1417784. eCollection 2024.

Authors

Nikita Gupta^{1

2}, Sophie Leuba³, Erich Seifritz², Thomas Berger³, Wolfram Kawohl^{1

2

4}

Affiliations

¹ Clienia Schlössli AG, Psychiatry and Psychotherapy, Oetwil am See, Switzerland.
² Department of Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich (PUK), University of Zurich, Zurich, Switzerland.
³ Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland.
⁴ Medical School, University of Nicosia, Nicosia, Cyprus.

Abstract

While research on blended therapy (BT), i.e. the combination of face-to-face and digital treatment, has grown rapidly, integrating BT into routine practice remains limited, especially in inpatient settings. This study seeks to investigate the potential barriers healthcare providers and patients are confronted with in implementing BT to inpatients. Here, a retrospective, explorative qualitative research design was employed to gain insights into the experiences of healthcare professionals and inpatients in a real-world clinical setting. Specifically, we utilized semi-structured interviews to explore three key aspects: time resources, organizational support, and integration. A total of 11 therapists and 6 patients were interviewed. To our knowledge, this is one of the first studies to examine the implementation of blended therapy in the routine care of inpatients. We found that therapists emphasized several barriers including overwhelming workloads with insufficient time allocated for the work with the digital tools, inadequate time adjustments, a lack of ongoing training, and the necessity for a well-defined concept and setting of how to implement blended therapy. Interestingly, fewer barriers were reported by patients, who viewed the e-mental health platform as a valuable addition to their standard therapy. They also judged guidance and integration by their therapists as satisfactory and appreciated the adaptability offered in managing their workload in a flexible setting.

Keywords: barrier; blended therapy; implementation; inpatient; integration; qualitative study; resources; support.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. The present project is supported and funded by the private psychiatric hospital Clienia Schlössli AG. This is an internal study with no external funding. The project leader and the main researcher are both affiliated to the Clienia Schlössli AG and the University of Zurich. The entire project is conducted in collaboration with researchers of the University of Bern.