Proposed Method

Protocol template

Protocol Template: Literature Review

1. Background

I. Important characteristics

What are the important population and/or characteristics (diagnostic criteria, minors -age/stage of development, adults on the Autism spectrum, etc.)?

It is necessary to examine several population characteristics to evaluate the impact of

Internet therapy on mental health. The first step towards this understanding should be the

diagnostic criteria for patients who seek Internet therapy. Different mental illnesses may respond

differently to online treatment. Online therapies treat anxiety and depression, while this

intervention may not help in schizophrenia and bipolar disorder cases. To assess the effectiveness

of internet therapy across different mental disorders, it is essential to stipulate the diagnostic

criteria of the study population.

Secondly, age and development affect online therapy. People’s reliance on virtual

communication, technological skills, and comfort change with age. Teens love digital connection;

hence, such treatment may sometimes be helpful. It can be less enjoyable for aged people due to

their levels of technology adoption and digital literacy; therefore, they tend to find online therapy

boring or irrelevant to them. This study carefully examines participants’ age and developmental

stages to determine how demographic issues affect online treatment throughout the life course.

Additionally, the autism spectrum is another key population characteristic. There are

peculiarities in autism which limit its applicability to internet-based therapies. Autism spectrum

influences how comfortable one may feel being around other people, sensory sensitivities and

communication. For that reason, it becomes essential to question whether it fits with people with

autism or not, given that it has been designed to focus on verbal and non-verbal communication

through a computer-mediated environment. Understanding how individuals within this community

experience online care can enhance the inclusive delivery of mental health services and allow for

targeted interventions.

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II. Relevance

Does the review topic have important implications (individual and/or public), e. g. can be applied for education, health, business, etc.?

This analysis has important implications for public health and individual well-being when

comparing mental health services provided over the Internet versus face-to-face encounters. The

availability and use of e-therapy services will depend on their effectiveness concerning existing

conventional methods, including in–person therapy. This may be effective for mental health

patients if it is as effective as face-to-face therapy. However, in areas with inadequate mental

health infrastructure, long waiting times, transportation problems and social stigma can make in-

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Protocol template

person treatment difficult (Stewart et al., 2006). Understanding the benefits and challenges of

online therapies can make mental health treatment more personalized and accessible to patients.

From a broader perspective, Public health and policy are affected. If it works, policymakers

may consist of and encourage internet treatment as part of a comprehensive mental health care

strategy. To assure online therapy quality and accessibility, standards, legislation, and

reimbursement mechanisms may be created. This analysis may also inform resource allocation for

technological infrastructure, digital literacy programs, and mental health awareness campaigns

promoting online therapy interventions' advantages and responsible use. Integrating mental

health into public health policy could improve mental health by addressing neglected populations.

III. Rationale

Does the evidence (including existing systematic reviews) fail to answer the review question, and why?

The data, including systematic reviews, fails to answer the review question of how online therapy

influences mental health outcomes, particularly compared to in-person therapy. Numerous studies

have examined online therapy's efficacy in isolation, but systematic reviews generally have

drawbacks that limit comparisons. Many reviews focus on specific diagnostic categories, groups, or

outcome measures, fragmenting evidence. Some periodic evaluations may have been completed

early in the spread of online therapy platforms, missing contemporary technological advances and

demographic changes. The dynamic digital mental health ecosystem requires a more current

synthesis that includes online therapy's changing methodologies and modalities. This review

examines the research, considering technological advances, varied demographic groupings, and

direct comparison with in-person therapy to fill these gaps. The study intends to improve

systematic reviews and provide significant insights into mental health research and practice by

providing a more complete and nuanced understanding of internet therapy's efficacy.

IV. Justification

Is the need for the review justified in the light of the potential health or other implications and current limitations of the evidence base? What are the inclusion / exclusion criteria?

The considerable health consequences of mental health outcomes and the limitations of the

online therapy evidence base justify this extensive analysis. Individual, family, and societal well-

being depend on mental health. Understanding the best and most efficient therapeutic techniques

to address mental health issues is crucial due to their rising prevalence worldwide. Online

treatment should be compared with in-person therapy as it impacts on mental health care

accessibility, patient outcomes and resource allocation. Since the evidence base comprises many

studies with different methods and focuses, a comprehensive review is needed to synthesize and

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Protocol template

critically evaluate the existing knowledge to provide a more coherent and insightful perspective on

the comparative effectiveness of these therapeutic approaches.

To thoroughly review the relevant literature, this study's inclusion criteria have been

carefully designed. Online therapy outcomes will be compared to in-person therapy first. This

criterion confirms the review's relevance to the study subject and compares the efficacy of these

two therapy modalities. Additionally, including studies on a variety of mental health disorders and

diagnostic criteria allows a holistic grasp of online therapy's applicability and efficacy. The review

includes studies on children, adolescents, adults, and older individuals to account for

developmental differences in therapy results.

However, strict exclusion criteria are necessary to ensure review quality and relevance. To

ensure the synthesis evidence's robustness, studies with small sample sizes, no comparison group,

or low statistical power will be removed. Studies concentrating on specific subpopulations without

more significant implications for mental health care will be omitted to make the review applicable

to various therapy seekers. To ensure the evaluation includes the latest data, research published

before a specific timeframe is excluded due to rapid technological improvements and the changing

environment of digital mental health therapies.

Will you impose any additional limits, e.g. language, publication type, study design?

Further constraints will be added to the primary inclusion and exclusion criteria to narrow

the evaluation. Only English-language research will be included to ensure the review panel can

evaluate their quality and relevance. This decision is pragmatic since non-English papers may be

challenging to comprehend and synthesize, compromising review rigour. Peer-reviewed articles will

be prioritized to maintain study rigor. Grey literature, conference abstracts, and non-peer-reviewed

sources will be rejected for evidence quality. The evaluation will prioritize RCTs and systematic

reviews to ensure methodological rigour in the included papers. This additional constraint improves

the synthesis evidence's quality and reliability, following mental health research systematic review

criteria.

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Protocol template

How will study selection be performed (will you search and get a maximum number or

articles and then pare them down, or will you search for specifics and add on? For the

purposes of this project, you should use the former unless you have a god reason -talk

to your instructor!)?

I will search and get a maximum number of articles and then pare them down during the

study selection process. The initial search will include a systematic and comprehensive search of

PubMed, PsycINFO, and Google Scholar. This wide-ranging search method seeks as many relevant

studies as possible within the scope. Search terms include online therapy variations, mental health

outcomes, and in-person treatment comparisons. After gathering the articles, a rigorous screening

will follow predetermined inclusion and exclusion criteria. A thorough review of full-text articles

follows an initial evaluation of titles and abstracts to confirm alignment with the research topic and

quality requirements. The inclusion criteria will choose research directly comparing online versus

in-person therapy for diverse mental health disorders and age groups. This methodologically

rigorous assessment includes multiple viewpoints and synthesizes the information thoroughly and

nuancedly.

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Topic: Examining how online therapy affects people's mental health outcomes, specifically

emphasizing how effective it is compared to traditional in-person therapy.

Important Variables:

 Diagnostic Criteria

 Age and Developmental Stage

 Autism Spectrum

Search Terms:

 Online therapy mental health outcomes

 Telepsychiatry effectiveness

 Internet-based interventions for mental health 4

Protocol template

 Comparative analysis virtual therapy and in-person therapy

Links

https://doi.org/10.1136/bmjopen-2019-036034

https://doi.org/10.4018/IJHISI.295820

https://doi.org/10.4018/IJHISI.295820

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