9th Sep 2016 Anne Etzelmueller

Feelings after more than one year of operation

When we started the MasterMind project, we were talking about all those concepts, indicators and goals we wanted to reach. We had to find pragmatic ways in integrating the different services into already existing systems and also about the comparison we could make while we were operating in a dozen different health care systems. We were set out to learn while ready to face the barriers ahead.

And then they hit us. Technical solutions not being ready in time, programs that were translated with regard to language but not cultures, stakeholders not willing to engage and therapists skeptical about our innovations. In some moments, it was as if the wind had been taken out off our sails. And progress went slow.

But for me, that was only devastating as long as I thought I was alone with my thousands of problems. During the first meetings it actually became clear, that we were all facing the same issues in one way or another: Engaging providers, setting up a technical solution in a new environment, reservations against the innovation, patient information, data collection and other organizational issues. It really helped to know I was not alone and everyone could provide little bits and pieces to help overcome those barriers.

Also, in the beginning we thought, that we all were very different. Sure, we were all doing Cognitive Behavioral Therapy in a functionally equivalent way, but how could we – Germany, doing video-conference – be learning from partners offering blended care treatments or guided self-help. Well, after about one year of operation, I realized that there are way more communalities than differences. And while we adapted our services to the patients’ and therapists’ needs in routine practice, we even grew closer. The video-conference service now comprises more asynchronous tools (as in Blended Therapy programs) and some guided self-help programs became more guided than self-help. Not only we, but also our services grew together.

And then it happened, not even that slowly anymore, each partner started offering a functioning service in routine care. And way faster than we expected we exceeded the number of patients we set out to treat. Up to today, we have treated more than 6000 patients with our services across Europe. And as we start getting to know our data we can see, that we can actually help the majority of the patients with regard to their depressive symptom severity. Overall, patients are happy with our services and we are in the process of understanding the therapists’ perspective better by conducting interviews with them. In Germany, therapists have been very doubtful about the services we implemented, mostly about possible flaws in the program they were using. And they thought, if there is these technical downsides, we will not be able to actually help patients and they will also not really like it. Therefore, we conducted interviews with patients using our service in order to find out what we could do better. What we found was, that the patients were very happy with our service. They would say “Yes, some days the videoconference does not work. But then I just talk to my therapist on the phone. I know what she looks like, so that is fine with me.” The patients of course had some remarks on the treatment, but overall they were very satisfied. More than the therapists would have thought in the beginning. So learning about this was a nice surprise for them and they felt rewarded for their work.

Talking to the patients was also a great experience for me. I met people who were really grateful for what we had done for them. And then I play with the thought by multiplying that many many times in order to imagine what the implementation of our service actually means.

Of course, these are only first steps, but in my opinion very valuable ones, for here we and others can build on. Still many barriers exist but we also overcame quiet a lot and now it is our work to help others overcoming the barriers of implementing internet-based Cognitive Behavioral Therapy into routine care as well.

 

So, what is your feeling after more than one year of operation within the MasterMind project?

 

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