Online therapy for the seriously ill
Is it possible to give psychological support via the internet to seriously ill patients and their relatives? Absolutely: it works well, according to research being conducted in U-Care at Uppsala University.
More and more internet-based self-help programmes are in development, and the primary starting point for the research programme U-Care is cognitive behavioural therapy (CBT), a well-proven treatment method with excellent results. Licensed psychologist and Professor of Caring Sciences Louise von Essen and her research team at Uppsala University are developing programmes in close cooperation with system developers and others.
“One programme is completely finished. It offers online support for parents of children with cancer and has been evaluated with great results. Now we have to make sure it’s used in health care, which is the next challenge,” she says.
The researchers are also in the process of developing self-help programmes for young people and adults with cancer, and for patients affected by heart attack; the programmes for the latter two groups are now being evaluated. These physical diseases often lead to emotional problems. Louise von Essen points out that contrary to what one may believe, only a minority of teenagers with cancer are interested in using internet-based self-help programmes.
“We thought the online option would attract teenagers, but a lot of them don’t want any kind of psychological help. A minority of young people want to bother working with emotional problems, in addition to cancer and all it entails.”
Other researchers associated with U-Care are studying the effects of self-help programmes for women with fear of childbirth, women experiencing post-traumatic stress after an abortion or a difficult labour, and people at risk of developing depression.
“When you’re affected by a mental disorder related to disease, the ramifications are often challenging and lasting, both for the individual and society. Options for professional psychological support are limited. But with the help of the internet, we can increase the geographical spread of psychological help and even reach out to socioeconomically disadvantaged groups, who can never afford professional support,” says Louise von Essen.
A functioning business model is required to make the programmes available to both private individuals and medical clinics. Support has therefore been sought from the university’s central support unit, UU Innovation, which has expertise in the area.
The research group also studies how patients and families use the U-Care portal, such as how they log in and work with the programmes, in order to make improvements.
“Many people who conduct psychological treatment online have found that compliance with the programmes is better when our participants have a contact person who follows them through the programme,” says licensed psychologist Martin Cernvall, researcher at the Department of Public Health and Caring Sciences. “Self-help programmes should be seen as a complement to other psychological treatment; it’s not a solution for everyone. But it’s a field that is going to grow sharply.”
Here's how it works:
The self-help programmes are interactive and based largely on cognitive behavioural therapy. The patient or family member begins by describing his or her thoughts and emotions and tracking the situation. Throughout the entire programme, the individual then actively works with various things in order to feel better, for example by practicing taking a structured approach to solving problems. Each patient or family member also has a contact person for support throughout the programme.