Increasing the Effectiveness of Psychotherapy through Transdiagnostic Online Modules? Randomized Controlled Trial comparing Blended Care to Psychotherapy in Routine Care

Background: Blended Care (BC) is thought of as a promising approach to enhance psychotherapy (PT) effects by increasing its effectiveness and decreasing therapy sessions.Method: This randomized controlled trial aimed to investigate the usage, implementation, and effectiveness of BC with transdiagnostic and transtheoretical online modules compared to conventional PT in routine care in Germany. The study included a large naturalistic sample of 1159 patients, randomized to BC vs. routine psychotherapy PT.Results: Contrary to our hypotheses, we did not find differences between BC and PT in outcomes, including anxiety, depression, satisfaction with life, level of functioning, therapist-rated severity / changes, and satisfaction with treatment at 6-months post-randomization. BC and PT also did not differ in the number of PT sessions. Regarding usage of the BC platform, 534 patients (91.6%) received at least one online chapter, with M = 7.26 (SD = 7.01) online chapters assigned on average. Discussion: In real-world applications of BC, therapists have considerable flexibility in integrating digital interventions with therapy sessions. Our findings suggest that the benefits observed in more controlled BC settings may not fully translate to routine care, possibly due to variations in implementation and adherence to BC.