Patients’ attitudes and expectations toward a digital inpatient-like psychotherapy concept: a qualitative interview study

Abstract

BACKGROUND: In recent years, digital mental health interventions have become increasingly important due to the rising demand for psychotherapy and the shortage of resources. Digital inpatient-like psychotherapy (DIPT) is a therapeutic concept that allows patients to receive inpatient-like psychotherapy in a digital environment, encompassing multiple dimensions of psychotherapy. It represents a comprehensive and intensive form of psychotherapeutic treatment. OBJECTIVE: This qualitative interview study sheds light on patients' attitudes and expectations toward digital inpatient-like psychotherapy in terms of acceptance, perceived benefits and barriers, as well as suggestions for initial implementation steps. METHODS: Semi-structured interviews were conducted with 20 patients receiving day-patient or inpatient psychotherapy in a university hospital. Iterative thematic analysis and inductive coding were conducted by three independent researchers following Braun and Clarke's approach to thematic analysis. Three overarching themes were identified, along with multiple subsidiary themes and subthemes. RESULTS: Interviewees included individuals with various mental health disorders. The analysis of the interviews revealed three overarching themes: (1) requirements for effective implementation of DIPT, (2) relational dynamics within the interpersonal domain of DIPT, and 3) relief associated with engagement in DIPT. These overarching themes comprised six themes. The overall attitude and acceptance toward digital inpatient-like psychotherapy was predominantly positive, with interviewees recognizing numerous benefits including location independency, time flexibility, and increased openness toward personal mental health issues. However, potential barriers such as lack of personal prioritization, tendencies for social withdrawal or insufficient relationship building must be addressed and considered. CONCLUSION: The findings provide valuable insights into digital mental health interventions and could assist in the development of feasible, patient-centered digital inpatient-like psychotherapy concepts. It is essential to consider patients' appreciation for personal interaction, which could be addressed through the approach of a hybrid treatment.

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