Reference: Leung, C., Pei, J., Hudec, K., Shams, F., Munthali, R., & Vigo, D. (2022). The effects of nonclinician guidance on effectiveness and process outcomes in digital mental health interventions: systematic review and meta-analysis. Journal of Medical Internet Research, 24(6), e36004.
Summarized By: Jordan Cherry
About the Study
Digital mental health interventions (DMHIs) are becoming more popular and have shown to be as effective as in-person treatment options. Using guidance within these programs has been shown to increase adherence to interventions; however, using professionals (i.e. psychologists and physicians) in this role may undermine the broader applicability of the intervention. To address this, paraprofessionals (such as peer supporters, technicians, and other non clinicians) can be utilized instead to provide guidance that can reduce costs and improve accessibility of interventions. This systematic review and meta-analysis examined nonclinician-guided DMHIs by analyzing randomized controlled trials published between 2010 and 2020. The study assessed their effectiveness, adherence, and other process outcomes, comparing them to treatment as usual, clinician-guided interventions, and unguided interventions.
- Nonclinician-guided DMHIs were found to be more effective in improving mental health outcomes when compared to control programs or wait-list controls
- Nonclinical-guided interventions were also more effective than unguided interventions, indicating that having a nonclinician guide improves effectiveness outcomes
- There was no significant difference in effectiveness between nonclinician-guided and clinician-guided interventions, suggesting that nonclinicians can achieve outcomes comparable to professionals in digital mental health interventions
- Adherence outcomes did not significantly differ between nonclinician-guided and unguided interventions, although there was a general trend toward improved adherence in the nonclinician-guided group
- Participant satisfaction with DMHIs, regardless of guidance type, were generally high, and the presence of a guide, whether clinician or nonclinician, was beneficial for evoking positive changes
Implications for Mentoring
There is a potential for DMHIs to be enhanced by the inclusion of nonclinician mentors, who can offer relatable and approachable support to mentees using these interventions. This can be particularly beneficial for mentoring programs aiming to reach a wider audience, as nonclinicians are often more accessible than clinicians. The scalability and cost-efficiency of mentoring initiatives can be improved by using their mentors as guides for DMHIs, making it easier to meet the growing demand for mental health support for their mentees. These results underscore the importance of exploring the qualifications and roles of mentors in virtual mentoring programs, and understanding how different levels of support can impact effectiveness and outcomes of these programs. This study represents a promising avenue for expanding access to effective mentoring while minimizing resource demands, and further research in this area can help refine and optimize a partnership between mentoring organizations and DMHIs.
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