Psychotherapeutic Competencies in Blended Care Psychotherapy: Development of a Competence Framework

Blended care psychotherapy (BCP) combines face-to-face psychotherapy with digital interventions, such as videoconferencing, apps, or virtual reality, which can be incorporated in various ways and at different stages of the therapeutic process. Despite its increasing implementation, conceptual and terminological inconsistencies continue to impede a shared understanding of the competencies required for its effective delivery.

This theoretical paper introduces a framework of psychotherapeutic competencies in BCP, designed to provide conceptual clarity.

The framework was developed in four steps. (1) An exploratory literature search was conducted to identify existing competence and educational frameworks relevant to psychotherapy, digitalization, and educational psychology. (2) These models informed a preliminary theoretical framework. (3) This preliminary framework was critically reviewed and refined in an expert workshop with 5 licensed psychotherapists and researchers experienced in BCP. (4) Lastly, findings from a systematic review of 35 studies on BCP competencies were integrated, resulting in the final 8-domain framework.

The resulting framework comprises Modalities of BCP (eg, face-to-face, videoconferencing, and apps), Competence Facets (knowledge, skills, and attitudes), as well as 8 Competence Domains (Creation of Setting and Infrastructure; Transfer of Communication and Methods; Therapeutic Relationship; Self-Regulation, Self-Confidence, and Self-Care; Data Security, Legal Issues, Ethics, and Safety; Technological Aspects; Scientific Knowledge and Methods; and Individual and Cultural Diversity).

This conceptual contribution aims to strengthen the theoretical foundation of BCP, support competence-based education for psychotherapists, and guide future research toward the empirical validation and refinement of BCP-specific competencies.