1. Emerging Characteristics of Internet-Assisted Psychological Interventions: Analysis of Journal Publications 1996-2013 Azy Barak University of Haifa, Israel ISRII, Valencia, October 2013

2. The Big Picture Need to zoom-out See the big picture of Internet-assisted psych interventions as reflected in journal publications Some of the intriguing questions:  What do we study?  What do we write about?  How have theoretical and empirical papers evolved?  What theoretical issues have been discussed and how this has changed?  What are the problem areas for which interventions have been developed and how this has changed?  Who are the prominent researchers and where do they come from?

3. Review of all Journal Publications The search used Google Scholar Scopus Web of Science PubMed Searching for all journal publications on psychological Internet- assisted interventions (using different terms)  Papers in English only (books, book chapters – not included)  Published in 1996-2013  Peer-reviewed journals (printed and online)  Intervention = prevention or treatment  Psychological intervention – any psych approach, but not medical, technological, or physical per se  Any online platform and technology

4. Final Data Base

5. What Journals Papers were published in 310 different journals Top 5 journals in number of publications Journal of Medical Internet Journal Cognitive Behavior Therapy Behavior Research and Therapy CyberPsychology, Behavior, and Social Networking Journal of Consulting and Clinical Psychology 50% of all papers published in these 5 journals

6. Papers by Problem Area Problem Area All PapersEmpirical Papers General Issues25566 Depression148115 Eating Disorders and Weight Control9572 Anxiety Disorders8968 Smoking Cessation8573 Medical Issues5952 Drinking5339 Fears5143 Addictions and Substance Abuse3320 PTSD2822 Stress19 Health Promotion158 Sleep1311 Compulsive Behaviors116 Marriage and Family102 Sex98 (Other)1510 Total1000*640* *64 papers were classified in more than one problem area

7. Number of Theoretical Papers by Year of Publication

8. Theoretical Papers by Year of Publication

9. Trend of Publication of Theoretical Papers

10. Trend of Publication of Theoretical Papers Relative to All Publications

11. The Leading Problem Areas Theoretical Papers Dealt With Issues / Problem AreaNumber% General Issues17962.4 Depression165.6 Eating Disorders & Weight Control155.2 Addictions & Substance Abuse134.5 Drinking124.2 These issues cover 82% of all theoretical papers

12. Focus of Theoretical Papers *25 papers were classified in more than one category

13. Trends in Focus of Theoretical Papers

14. Relative Trends in Focus of Theoretical Papers

18. Type of Empirical Papers TypeNumber% Outcome48073.7 Process17126.3 Total651*100 *56 papers were classified as both process and outcome

19. Trends in Type of Empirical Research (1)

20. Trends in Type of Empirical Research (2)

21. Trends in Type of Empirical Research (3)

22. Empirical Outcome papers Have We Really Studied Effectiveness of Internet-Assisted Interventions? “Empirical studies and reviews of computer-assisted and Internet-based therapies are now emerging that demonstrate the effectiveness of these models in reducing distress (…). However, randomized controlled trials of these models remain scant, and little is known about the impact of computers on the therapeutic alliance.” (p. 220, emphasis added) Barrett, M. S., & Gershkovich, M. (2014). Computers and psychotherapy: Are we out of a job? Psychotherapy, 51, 220-223.

23. Types of Outcome Papers TypeNumber% RCT247*41.7 Pre-Post of a Single Group18531.3 Pre-post Interventions Comparison10818.2 Qualitative193.2 Survey335.6 Total592**100 **including 112 studies classified both outcome and process. Incidentally, 16 empirical studies have been published on online therapeutic alliance *This is double from a recent Internet-assisted RCT-based research review (Ye, X., Bapuji, S. B., Winters, S., Metge, C., & Raynard, M. (2014). Quality and methodological challenges in Internet-based mental health trials. Telemedicine and e-Health, 20, 744-747).

24. Trends in RCT Outcome Papers

25. Papers on Interventions by Type of Primary Online Platform* PlatformTheoreticalEmpirical Web76460 Email3045 Chat2438 Videoconferencing1728 VR & 2 nd Life76 Online Games54 Forum14 Social Networking22 Blogging21 Internet in General and Other Online Technologies 24139 Total303612 *47 papers referred to more than a single primary platform. Case studies and meta-analyses not included in the table.

26. Papers on Web as a Platform by Problem Area* Problem AreaEmpiricalTheoretical Depression10513 Anxiety Disorders625 Eating Disorders and Weight Control586 Smoking Cessation568 Medical Issues462 Drinking3611 Fears380 Addictions and Substance Abuse187 PTSD142 Stress190 Health Promotion42 Sleep111 Compulsive Behaviors62 Marriage and Family10 Sex60 General Issues1323 (Other)82 Total50184 *Including 49 papers of Web and additional platform as primaries

27. Age of Intervention Target Population Age GroupNumber% Adults59380.7 Children and Adolescents10314.0 Families395.3 Total735*100 *In 201 papers age not reported

28. Trends in Target Population Age

29. Gender of Intervention’s Target Population Patient’s GenderNumber% Male & Female66790.5 Female only486.5 Male only223.0 Total737*100 *In 199 papers gender not reported

30. Countries of Most Publications In Absolute Numbers USA Australia Sweden UK Netherland Numbers Relative to Population Size SwedenSweden Australia Netherland Switzerland Norway Numbers Relative to GDP SwedenSweden Australia Netherland Switzerland New Zealand / Israel

31. The Most Publishing Scholars Kathy Griffiths

32. Helen Christensen Kathy Griffiths The Most Publishing Scholars

33. Pim Cuijpers Helen Christensen Kathy Griffiths The Most Publishing Scholars

34. Per Carlbring Pim Cuijpers Helen Christensen Kathy Griffiths The Most Publishing Scholars

35. Gerhard Andersson Per Carlbring Pim Cuijpers Helen Christensen Kathy Griffiths The Most Publishing Scholars

36. Thanks for listening! azy@edu.haifa.ac.il http://tinyurl.com/azybarak