Cloncluded INTROMAT with good results

The partners of INTROMAT gathered on Mondag 6 December for a closing seminar. The research project started in 2016 and has been funded by the Research Council of Norway as an IKTPLUSS Lighthouse project.

All the research partners and three industrial partners spent the day presenting results from the research and innovation activities at the center, and thanked one another for an educational and exciting year together.

See some pictures from the event below:

There were several specific presentations on what came out of the project. Some of the presentation:

Smiti Kahlon presented findings from the study on the use of VR technology in the treatment of performance anxiety in adolescents. The programme is called Youth Spotlight (Ung Spotlight) and is available now online (Helsenorge.no).

Emilie Sektnan Nordby presented findings from the study on digital treatment programmes for adults with ADHD. This programme is now scheduled to be used in eMeistring.

Sunniva Brurok Myklebust presented findings from the digital treatment programme for those struggling with residual symptoms after depression. They are starting a new study and have begun lookin for participants.

Ragnhild Sekse and Sigrund Breistig presented their Gynea programme, which is designed for women who have had gynaecological cancer. Part of this treatment programme can be found online, in the the health library website (Helsebiblioteket).

Petter Jakobsen and Andrea Stautland presented the study on the use of digital tools to monitor symptoms of bipolar disorder in adult patients.

Many skilled people were responsible for INTROMAT’s success. Here is a list of the others not already mentioned above:

  • Eirik Hansen
  • Jan Rasmus Sulebakk
  • Yngve Lamo
  • Andreas Rimala
  • Jim Tørresen
  • Eivind Flobak
  • Youwell
  • Robin Kenter
  • Suresh Mukhiya
  • Ulysse Côté-Allard
  • Jo Wake
  • Yngvar Sigmund Skaar
  • Minh H. Pham
  • Amin Aminfar
  • Ketil J. Ødegaard

Experience from using asynchronous treatment for mental health issues

Kjersti Skare and Tine Nordgreen presented their experience in the use of text-based treatment at the webinar entitled “Textual Therapists”.

Tine Nordgreen led the development of e-mastery program (eMeistring) for the Bergen Health Trust. She currently heads the ForHelse health centre. Kjersti Skare is a psychiatric nurse and head of section at eMeistring.

The National Centre for e-Health Research offered several webinars this fall on the topic of digital home-based care. On Friday 19 November, Tine Nordgreen and Kjersti Skare presented their experiences in the use of guided web-based treatment.

The webinar revolved around eMeistring and what the program has to offer. The program offers web-based treatment on various issues like anxiety and depression

The treatments were initially based on studies initiated in Sweden which offered similar programs. The studies that looked at eMeistring indicate that this form of treatment appears to have good effects.

They also presented research on the role of the therapist and how the treatment program should be used.

Collaboration with patients 

-The patient-therapist relationship must be taken seriously and maintained in web-based treatment as well, Skare said.

Some of the challenges associated with the use of internet therapy are e.g. that therapist are unable to talk things through thoroughly with the patient, body language is unavailable as an indicator of the patient’s situation and it is not as easy to express commitment in the same way as face-to-face therapy.

-This distance is challenging for the patient and the therapist, Skare said.

For example, it can be difficult for the therapist to remember the face and individual, and the therapist will not be able to observe the patient’s non-verbal language in the same way.

According to Skare, her colleagues who work face-to-face with patients have expressed some concerns that the therapist is not always able to form an emotional bond with the patient when treatment occurs over a computer screen.

-But emotional bonds are not the ultimate factor in successful treatment, Skare said.

She said they do get positive feedback from patients who say they feel seen and heard, and it is important to remember that these patients specifically asked for online treatment.

Asynchronous messages  

The patients receive treatment via eMeistring based on the content of the program itself. The form communication used between the therapist and patient is known as asynchronous messages. That means it can take up to seven days between sending and receiving a message from the therapist/patient.

-It is therefore important to consider how one formulates one’s messages to patients, Skare said.

Among other things, they utilise open questions or respond to their own questions to prevent patients from experiencing that it takes too long to get an reply.

They also try to link the questions and answers to the topics that the patient is working on in treatment.

A lot of people don’t ask the therapist for help  

At the end of the treatment, all patients are given the opportunity to answer questions about whether the treatment has worked for them or not.

-When asked whether they feel they receive help from their therapist after asking for help, 20 percent of the patients respond that they do not feel they get the help they need, Nordgreen said.

In the evaluation form, they are also asked questions about how it was to read the text and how they experienced contact with the therapist.

Feedback from patients so far:

  • I would like more face-to-face meetings.
  • I would have liked more frequent responses
  • The treatment sound good, but it wasn’t suitable for me.
  • Too little time to do the assignments

Many patients also told us the would have liked the therapists to ask how they were doing, not just talking about the program’s modules, and occasionally they were unsure about what they could ask the therapist.

Further development of the service 

eMeistring is working constantly to find good ways of communicating with patients and finding the right manner of communication for each patient.

– It is important to adapt to the patient’s needs and respect their way of communicating, Skare said.

eMeistring is currently offered via the regional health authorities in Western Norway, Southern Norway and Central Norway

– We have compiled teams of professionals at the various health regions to maintain professional development, contact and experience sharing, Nordgreen said in conclusion.

Would you like to learn more about eMeistring and learn what a textual therapist can offer, check out the webinar here 

A lot of interest for digital ADHD courses for adults

The MinADHD digital training program was made with adults in mind (age +18). After two rounds of admissions to the study, more than 300 applicants had asked to join. 

ADHD is a diagnosis with a prevalence of 2-4% among the Norwegian population. Those diagnosed with ADHD may experience symptoms such as lack of concentration and impulsiveness, but they also tend to be very creative, energetic and have many other positive qualities.

Many people think ADHD is a common diagnosis among children, but ADHD can also cause problems for adults. Many adults with ADHD face challenges in their daily lives, but very few of them are offered the help they need, said Robin Kenter, a postdoctoral fellow and the author of the study 

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Robin Kenter, post doc

She explained that treatment for adults with ADHD consists mainly of drug treatment. According to Kenter, many people benefit from medication, but there is also a large group that cannot or will not use such medication.

We created a self-help program called MinADHD for adults who want non-medicamental treatment, Kenter said.  

Used real stories and videos as a tool 

The study and the program were co-authored between the University of Bergen and Haukeland Hospital.

The team consisted of psychologists, clinical researchers, IT researchers and experienced experts. They placed a lot of emphasis on talking to adults who have been diagnosed with ADHD.

To develop the content and themes for the program, we placed particular emphasis on input from adults who live with ADHD. They were our experts, Kenter said.  

The content of MinADHD is based on general principles from cognitive behavioural therapy, dialectical behavioural therapy and goal management training. In total, MinADHD has seven modules that cover seven different themes.

Each module involves listening to stories and experiences from people who live with ADHD. This was visualised through video clips where the actors told their stories and shared their experiences.

The purpose of MinADHD is to allow adults diagnosed with ADHD to reduce symptoms and manage their daily lives in better ways, Kenter said.  

Had to shut down admission to study after 48 hours  

The first intake for the study started in 2020, and despite the fact that no one had heard of the program before, 120 participants had shown an interest within one week.

In 2021, 198 people signed up after 48 hours when a new call for participants was sent out.

I was surprised by the number of people who completed the program and answered the questionnaire. Our participants made a tremendous effort, Kenter said.  

Kenter explained that they have been running several studies in recent years to improve MinADHD. The results from the RCT study show that the participants are experiencing significantly improved concentration and better quality of life. They received the same response when they monitored the participants three moons later.

The RCT study also indicated that most people are satisfied with what the program offers; 90% would recommend MinADHD to a friend, and 87% said they would use what they learned through MinADHD in the future.

We usually see much bigger numbers of those who abandon such self-help programs, Kenter said.  

Kenter explained that it can be difficult for everyone to commit to a program and try to make changes to their lives. It can be extra challenging for people with ADHD who have trouble concentrating and/or are more impulsive.

Still, they managed to change how they deal with their difficulties and problems, and made changes to their daily lives, Kenter said.  

We hope to offer our program to more people in the future 

During the development phase of the program, we always had our end users in mind. It is our great hope that this program can be made readily available and easily accessible to anyone who needs it, Kenter said.  

According to Kenter, many people are looking for change and help that is not based on medication.

– We hope our program can provide evidence-based non-medicamental help for people with ADHD, she added.  

Kenter and Tine Nordgreen, who heads the Forhelse Centre, are working on getting the program approved for use at the Bergen Health Trust in collaboration with Bjørgvin district psychiatric center and eMeistring.

New team ready to devolve digital health interventions

The research department at the Division of Mental Health Services wants to make it easier to develop and use digital health services within somatics and psychiatry. The new DigiHub team aims to make that happen.  

Form the left: Terje Sandkjær-Hanssen, Runa Kongsvik, Toyha Vengsholt og Ingeborg Kløve-Graue

Our daily lives are constantly becoming more digitised and digitalised, also within the health and care services. The IKTPLUSS project INTROMAT has been working for several years to develop digital patient intervention platforms within the field of mental health. This work will now carry on at the Research Centre for Digital Mental Health Services.

Specialist in psychology Tine Nordgreen is the research director supervising research being done in collaboration with end users, state health services, the business sector and other researchers.

The goal of these research environments is to increase the use of digital health services for people with somatic and mental health problems.

This team has been compiled to make this goal a little easier to reach.

This is DigiHub – Digitisation of health services, development and user testing. 

Runa Kongsvik

Runa is the team’s psychologist. She collaborates with the team half of the week and works the rest of the week at the Crisis Psychology Clinic. Runa previously worked as a municipal psychologist in interdisciplinary rehabilitation and in the specialist health services helping young people deal with issues of harmful sexual behaviour.

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Toyha Vengsholt  

Toyha comes from the field of psychology with a master’s in behavioural science, specialising in behavioural analysis. She works half the week with the team, and is otherwise employed by the Oslo Metropolitan University. She is tasked with content production, guidance and courses in the use of Teams/SharePoint for faculty employees.

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Terje Hanssen  

Terje has a master’s degree in media studies, as well as an education and experience within various creative subjects like illustration, animation and video.

I look forward to working with the e-health services to help people living with a wide range of diagnoses,” he said.  

Terje, Runa and Toyha all work 50 % on the team and will be available 2-3 days a week.

Ingeborg Kløve-Graue  

Ingeborg is an educated nurse and has experience working with various patient groups in somatics and psychiatry. Over the past year she has worked as a journalist at the Norwegian National Broadcasting Agency and produces content for TV, radio and web. She is attending Kristiania University College taking classes in creative writing, copywriting and journalism.

Ingeborg has been hired in a full-time position as team leader.

Work is well underway  

The team will collaborate with various stakeholders to develop and produce content for digital intervention, which also involves testing digital content with users. So far, they have begun developing an online treatment program for depression.

In the months ahead, they aim to start work on online treatment programs for people with gaming and gambling addiction, insomnia, ADHD and adolescents who struggle with issues of anxiety.

The content of digital treatment is being developed in close cooperation with the users and professional experts. The work is based on existing research being developed for patient use via visual tools and texts.

Feel free to contact Ingeborg by e-mail (ingeborg.klove-graue@helse-bergen.no) if you have any questions about the new team!