Background: Depression is one of the most common mental disorders in older adults. Unfortunately, it often goes unrecognized in the older population.
Objective: The aim of this study was to identify how Web-based apps can recognize and help treat depression in older adults.
Methods: Focus groups were conducted with mental health care experts. A Web-based survey of 56 older adults suffering from depression was conducted. Qualitative interviews were conducted with 2 individuals.
Results: Results of the focus groups highlighted that there is a need for a collaborative care platform for depression in old age. Findings from the Web-based study showed that younger participants (aged 50 to 64 years) used electronic media more often than older participants (aged 65 years and older). The interviews pointed in a comparable direction.
Conclusions: Overall, an e-mental (electronic mental) health treatment for depression in older adults would be well accepted. Web-based care platforms should be developed, evaluated, and in case of evidence for their effectiveness, integrated into the everyday clinic.
Full version: https://aging.jmir.org/2018/2/e10973/
Eichenberg, C., Schott, M., Sawyer, A., Aumayr, G. & Plößnig, M. (2018). Feasibility and Conceptualization of an e-Mental Health Treatment for Depression in Older Adults: Mixed-Methods Study. Journal of Medical Internet Research Aging, 1(2), e10973. DOI: 10.2196/10973.
The development of digital media over the last 20 years has led to seismic changes within many aspects of daily life. This includes numerous facets of family relationships that have not escaped the digital revolution of the last two decades. From the very early stages of initiating relationships to types of post-break-up behaviors, the Internet has the potential to play an influential role in all areas of family and particularly couple relationships. This paper examines how ICTs (“information and communication technology”) can shape such relationships. The impact on the various stages of relationships is systematized (relationship development, couple and family formation, separation) with a special focus on intergenerational opportunities and conflicts associated with modern media usage. Against the background of psychological and media communication theories and psychotherapeutic approaches as well as empirical findings the following topics are considered: 1. Initiation of relationships through ICTs (e.g. meet new partners through online dating); 2. Impact of digital media on relationship development and existing partnerships (e.g. new opportunities and internet-related challenges that have to be faced by couples) 3. Influence of ICTs on separations (e.g. online mediation, getting divorced online). In summary, the role of ICTs in new, existing and separated partnerships and families is multifaceted. An outlook on further developments as well as research desiderata is given.
Eichenberg, C., Huss, J. & Küsel, C. (2017). From online dating to online divorce: An overview of couple and family relationships shaped though digital media. Contemporary Family Therapy, 39, 249–260.
Background: Patient-targeted googling (PTG) describes the searching on the internet by healthcare professionals for information about patients with or without their knowledge.
Introduction: Little research has been conducted into PTG internationally. PTG can have particular ethical implications within the field of mental health. This study was undertaken to identify the extent of PTG by New Zealand mental healthcare professionals and needs for further guidance regarding this issue.
Materials and Methods: All (1850) psychiatrists, clinical psychologists and psychotherapists working in New Zealand were electronically surveyed about their experience of PTG and knowledge about the associated practice of therapist-targeted googling (TTG). Due to ethics and advertising restrictions, only one indirect approach was made to potential participants.
Results: Eighty eight clinicians (5%) responded to the survey invitation. More than half (53.4%, N=47) of respondents reportedly engaged in PTG, but only a minority (10.3%, N=9) had ever received any education about the subject. Reasons for undertaking PTG included facilitating the therapeutic process, information being in the public domain and mitigating risks. Reasons against undertaking PTG included impairment of the therapeutic relationship, unethical invasion of privacy and concerns regarding the accuracy and clinical relevance of online information. Two-thirds of participants reported being the subject of TTG.
Discussion: New Zealand psychiatrists, clinical psychologists and psychotherapists are engaging in PTG with limited education and professional guidance. Further discussion and research are required so PTG is undertaken in a manner that is safe and useful for patients and health practitioners.
Thabrew, H., Sawyer, A. & Eichenberg, C. (2018). Patient-Targeted Googling by New Zealand Mental Health Professionals: A New Field Of Ethical Consideration in the Internet Age. Telemedicine & e-Health, DOI: 10.1089/tmj.2017.0247.
Introduction: In the evolving digital age, media applications are increasingly playing a greater role in the field of psychotherapy. While the Internet is already in the phase of being established when it comes to the care of mental disorders, experimentation is going on with other modern media such as serious games. A serious game is a game in which education and behavior change is the goal, alongside with entertainment.
Objective: The objective of the present article was to provide a first empirical overview of serious games applied to psychotherapy and psychosomatic rehabilitation.
Method: Therefore, a systematic literature search, including the terms “serious game” or “computer game” and “psychotherapy” or “rehabilitation” or “intervention” or “mental disorders” in the databases Medline and PsycINFO, was performed. Subsequently, an Internet search was conducted to identify studies not published in journals. Publications not providing empirical data about effectiveness were excluded.
Results: On the basis of this systematic literature review, the results of N = 15 studies met inclusion criteria. They utilized primarily cognitive behavioral techniques and can be useful for treating a range of mental disorders. Serious games are effective both as a stand-alone intervention or part of psychotherapy and appeal to patients independent of age and sex.
Conclusions: Included serious games proved to be an effective therapeutic component. Nonetheless, findings are not conclusive and more research is needed to further investigate the effectiveness of serious games for psychotherapeutic purposes.
Eichenberg, C. & Schott, M. (2017). Serious Games for Psychotherapy: A Systematic Review. Games for Health, 3, 127–135.
Background: One of the clinically relevant problems of Internet use is the phenomenon of Internet addiction. Considering the fact that there is ample evidence for the relationship between attachment style and substance abuse, it stands to reason that attachment theory can also make an important contribution to the understanding of the pathogenesis of Internet addiction.
Objective:The aim of this study was to examine people’s tendency toward pathological Internet usage in relation to their attachment style.
Methods: An online survey was conducted. Sociodemographic data, attachment style (Bielefeld questionnaire partnership expectations), symptoms of Internet addiction (scale for online addiction for adults), used Web-based services, and online relationship motives (Cyber Relationship Motive Scale, CRMS-D) were assessed. In order to confirm the findings, a study using the Rorschach test was also conducted.
Results: In total, 245 subjects were recruited. Participants with insecure attachment style showed a higher tendency to pathological Internet usage compared with securely attached participants. An ambivalent attachment style was particularly associated with pathological Internet usage. Escapist and social-compensatory motives played an important role for insecurely attached subjects. However, there were no significant effects with respect to Web-based services and apps used. Results of the analysis of the Rorschach protocol with 16 subjects corroborated these results. Users with pathological Internet use frequently showed signs of infantile relationship structures in the context of social groups. This refers to the results of the Web-based survey, in which interpersonal relationships were the result of an insecure attachment style.
Conclusions: Pathological Internet use was a function of insecure attachment and limited interpersonal relationships.
Full version: http://www.jmir.org/2017/5/e170/
Eichenberg, C., Schott, M., Decker, O. & Sindelar, B. (2017). Attachment style and Internet addiction. Journal of Medical Internet Research,m19(5):e170, DOI: 10.2196/jmir.6694.
Much debate surrounds the potential effects of self-harm forum use. Arguments in favor highlight factors such as providing access to a supportive community. However critical voice highlighting potential dangers such as forums serving as a platform to promote self-harm, clearly dominate the debate. Using an online questionnaire, the goal of the current study was to examine sociodemographic characteristics, the psychopathology of forum users, motives for participating, and subjective effects of self-harm forum use. A total of 309 self-harm forum users participated in this study. 3 heterogeneous user types with differing motives for visiting the forum and different usage effects were identified. The results question the assumptions that self-harm forums are a source of harm and point to their predominantly constructive and preventive functions.
Full version: http://www.tandfonline.com/doi/full/10.1080/13811118.2016.1259597
Eichenberg, C. & Schott, M. (2016). An Empirical Analysis of Internet Message Boards for Self-Harming Behavior. Archives of Suicide Research, DOI: http://dx.doi.org/10.1080/13811118.2016.1259597.
Background: The increasing use of the Internet and its array of social networks brings new ways for psychotherapists to find out information about their patients, often referred to as patient-targeted googling (PTG). However, this topic has been subject to little empirical research; there has been hardly any attention given to it in Germany and the rest of Europe and it has not been included in ethical guidelines for psychotherapy despite the complex ethical issues it raises.
Objective: This study explored German psychotherapists’ behavior and experiences related to PTG, investigated how these vary with sociodemographic factors and therapeutic background, and explored the circumstances in which psychotherapists considered PTG to be appropriate or not.
Methods: A total of 207 psychotherapists responded to a newly developed questionnaire that assessed their experience of and views on PTG. The study sample was a nonrepresentative convenience sample recruited online via several German-speaking professional therapy platforms.
Results: Most therapists (84.5%, 174/207) stated that they had not actively considered the topic of PTG. However, 39.6% (82/207) said that they had already looked for patient information online (eg, when they suspected a patient may have been lying) and 39.3% (81/207) knew colleagues or supervisors who had done so. Only 2.4% (5/207) of therapists had come across PTG during their education and training.
Conclusions: It is essential to provide PTG as a part of therapists’ education and training. Furthermore, the complex problems concerning PTG should be introduced into codes of ethics to provide explicit guidance for psychotherapists in practice. This report provides initial suggestions to open up debate on this topic.
Full version: http://www.jmir.org/2016/1/e3/
Eichenberg, C. & Herzberg, P.Y. (2016). Do Therapists Google Their Patients? A Survey Among Psychotherapists. J Med Internet Res, 18 (1):e3. DOI: 10.2196/jmir.4306.