Increasing the Effectiveness of Psychotherapy in Routine Care through Transdiagnostic Online Modules? Randomized Controlled Trial Investigating Blended Care

Objective: Blended Care (BC), the integration of Internet-based interventions into psychotherapy (PT), is thought of as a promising approach to enhance PT’s effectiveness and efficiency. This randomized controlled trial aimed to investigate the usage, implementation, and effectiveness of BC with transdiagnostic online modules compared to PT in routine care. Method: Psychotherapists in routine care recruited 1159 patients who were randomized to BC or PT. Outcomes included self-reported anxiety, depression, satisfaction with life and level of functioning, as well as therapist-rated severity and changes. Outcomes were measured at baseline, 6 weeks, 12 weeks, and 6 months. We examined whether BC and PT groups changed differently over time using linear mixed models. We also investigated differences in sessions and terminations and report usage metrics of the BC platform. Results: Contrary to our hypotheses, we did not find differences between BC and PT in outcomes, including anxiety, depression, satisfaction with life, level of functioning, therapist-rated severity / changes, and satisfaction with treatment at 6-months post-randomization (all p > 0.05). BC and PT did not differ in the number of sessions or terminations. Regarding usage of the BC platform, 534 patients (91.6%) received at least one online chapter, with M = 7.26 (SD = 7.01) online chapters assigned on average. Conclusions: In real-world applications of BC, therapists have considerable flexibility in integrating IBIs with sessions. Our findings suggest that the benefits observed in more controlled BC settings may not fully translate to routine care, possibly due to variations in implementation and adherence to BC.