Assessing psychotherapy patients' social context through personal networks and experience sampling: A mixed methods...

This study explored the feasibility and perceived clinical utility of a novel psychotherapy intervention consisting of two components (1) assessment of patients' social context using the experience sampling methodology (ESM) and personal social network data collection (PSN) and (2) a feedback report summarizing the collected data. Four qualitatively driven concurrent embedded mixed-methods case studies were conducted in a large mental health care facility in the Netherlands and included nine young adults receiving either individual or group psychotherapy: six in part-time treatment and three transitioning from inpatient to outpatient care. Feasibility and utility were evaluated using codebook thematic analysis of semi-structured patient and therapist interviews, patient compliance with the intervention components and researchers' reflexive field notes. Overall, the intervention appeared most feasible in individual therapy, in which patient and therapist engaged with it collaboratively. Engagement was more difficult among avoidant patients and when the intervention was experienced as too confronting by patients, highlighting the importance of establishing rapport before its use. The intervention yielded varying degrees of insight for patients, depending on their ability to engage with the assessments and feedback-based therapeutic dialogue. The feedback report specifically improved therapists' understanding of patients' social context. Future implementation will require automation, integration into digital clinical infrastructure, and therapist training to support appropriate interpretation of feedback and follow-up action.