Therapist-related feasibility of blended group therapy (bGT): Mixed methods study of a brief online- and mobile-supported group intervention for major depression

Background: Blended group therapy (bGT) has been investigated a several times for anxiety and depression, but information on patient’s adherence to and therapist’s perception of the novel format is non-existent. Furthermore, many studies investigated mainly female and highly-educated populations, limiting validity of previous findings. Objective: The study aims at reducing those gaps and limitations, by evaluating an integrated Internet- and mobile-supported bGT format. Methods: Twenty-seven patients, diagnosed with major depression (48% male, compulsory education= 29.6%), participated in a seven-week treatment at a university outpatient clinic. Eight novice therapists participated in semi-structured interviews, and a subsequent cross- validation survey. Results: Primary symptom reduction was high (d= 1.31 - 1.51) and lasted for the follow-up period. Therapists identified advantages (e.g. patient engagement, treatment intensification, and improved therapeutic relation) and disadvantages (e.g. increased workload, data issues, and undesired effects) of bGT. Required therapist time was 10.3 minutes per patient and week, including guidance on exercises (67%) and intimate communication (33%). Concerning patients’ adherence to bGT, tracked completion of all online- and mobile tasks was high (67 – 76%), and comparable to group attendance. Conclusion: Results suggest high feasibility of bGT in a gender-balanced, moderately educated sample. bGT provides group therapists with tools for individual care, resulting in an optimization of the therapy process, and high completion rates of the implemented bGT elements. The limited work experience of the involved therapists restricts the study findings, and potential drawbacks need to be regarded in the development of future bGT interventions