An Integrative Engagement Model of Digital Psychotherapy: Exploratory Focus Group Findings

Area of Science:

• Digital mental health
• Psychotherapy process-outcome research
• Human-computer interaction

Background:

• Digital mental health interventions are increasingly common, but user engagement patterns remain understudied.
• Understanding user engagement is crucial for improving the effectiveness of digital psychotherapy.
• Integrating theories from health science and human-computer interaction can illuminate engagement determinants.

Purpose of the Study:

• To qualitatively analyze user engagement patterns in digital therapy.
• To synthesize intrapersonal and relational factors influencing engagement.
• To develop an integrative framework for digital therapy engagement.

Main Methods:

• Qualitative analysis of 24 participants across 5 focus groups.
• Thematic analysis of participant responses by two researchers.
• Focus groups conducted between October and November 2021.

Main Results:

• Identified 10 constructs and 24 subconstructs influencing user engagement trajectories.
• Engagement is primarily informed by self-efficacy, outcome expectancy, therapeutic alliance, treatment costs, and social support.
• Therapist connection was the most critical factor for treatment continuation or termination.

Conclusions:

• An interdisciplinary approach is valuable for understanding messaging therapy engagement.
• Users perceive digital therapy as a means to access a provider, emphasizing the healing relationship over the platform.
• Further research into engagement factors is vital for enhancing digital mental health interventions.