Starting an online psychotherapy: a choice influenced only by age?

Starting an online psychotherapy: a choice influenced only by age?

A recent study conducted in China by Teo and colleagues (2020), investigated whether intergenerational differences could constitute a discriminating factor in modulating the intention to take advantage of online psychotherapy.


Advertising message Recent technological development has certainly revolutionized our lives in unpredictable ways, changing our lifestyles, cities, professions and societies permanently and irreversibly. Fundamental to this revolution was the introduction of the internet, which contributed significantly to the evolution of an interconnected ‘global village’, as defined by media theorist Marshall McLuhan (1962). The speed with which technology changes and evolves makes it almost impossible to keep up, what is new today becomes obsolete in a couple of years and we can easily find that in our daily life many common customs or activities have inevitably changed to accommodate technological omnipresence: setting an alarm,

Recently, the world of psychology is also opening up to the possibility of exploiting new technological means in its clinical and consultancy practice. On the one hand, this trend perhaps reflects a desire for innovation within the discipline, on the other it is certainly a need implicitly expressed by the users themselves, both for needs related to the flexibility and mobility guaranteed by these tools, but also, and perhaps above all , because digital natives, the new generations of future patients, are growing immersed in a technological reality, from which psychology can no longer exempt itself, under penalty of being perceived as alienated and not current.

In recent years, therefore, work has been done to create applications that allow you to ‘carry your own psychological well-being tool in your pocket’, think for example of the excellent Headspace which provides members with guided daily mindfulness courses, in inTheapy, a beneficial use tool for therapists. to assign homework to their patients and monitor their progress over time, or cybertherapy, or the possibility of carrying out sessions remotely, using video call or instant messaging services, a practice whose effectiveness has been confirmed by various studies (for a review see Postel et al. 2008).

However, in the historical imagination of those countries where an adequate psychological culture has not developed, the old idea of ​​the patient lying on a bed remains, in a study closed to the world and almost out of time, where mystically resolve the mental problems of people: a vision that is not easily reconciled with the flexibility and mobility that distinguish modern times (as well as being comically wrong). So a question spontaneously arises, the tools have been created, but will patients now want to use them?

Advertising message A recent study conducted in China by Teo and colleagues (2020), investigated whether intergenerational differences could constitute a discriminating factor in modulating the intention to take advantage of cybercounseling, observing how being an adult patient, for example, belonging to the so-called X and Y generations (born between 1965 and 1989) in which the technological presence arrived late, or a young patient, such as the children of generation Z or ‘network generation’ (born between 1995 and 2015), would probably have led to different trajectories, accounting for the generational differences in familiarity but also the ease in using the new technological means available.

The study draws its theoretical foundation from Mak and Davis’ Extended Theory of Planned Behavior (E-TPB, extension of the original TPB of Ajzen, 1991) which foresees how different factors intervene in modulating an individual’s intention to use administered therapies electronically. If in the classic model the intention is determined by the coexistence of attitudes, subjective norms and perception of control over the target behavior, in the extended version these three factors are in turn affected respectively by the attitude towards the use of the internet, the social stigma towards request for psychological help and finally the perception of one’s self-efficacy in the use of IT tools. The researchers collected data from self-report questionnaires administered to 1,494 individuals,

The results showed that self-efficacy in the use of the computer on the perception of behavior control on the one hand and the effect of the attitude in influencing the actual intention of using online therapy on the other, resulted to have a greater weight in the older registry group, in line with the results of previous studies (Morris et al., 2005; Wagner et al., 2010), suggesting how the development of easy-to-use interfaces to facilitate users of all levels of computer literacy could contribute to greater involvement of adult patients. Contrary to expectations, the effect of subjective rules on intention was weaker in the younger age group, a result that has been interpreted as a reflection of obedience and respect for the wishes of parents and a collectivist mentality (as opposed to Western indivisualist ones) strongly present in Chinese culture, an effect that may differ in other cultures. Contrary to what the authors hypothesized, there were no generational differences in the effects that both the attitude towards the use of the Internet and the perception of behavior control had on the attitude, hypothetically allowing to postpone these aspects in the ideation of promotional campaigns for the use of cybercounseling. Similarly, the effect of the perception of the stigma linked to the search for psychological help on subjective norms was not significant.

With the due limitations, given primarily to the non-generalizability of the results obtained to samples of different nationalities, this study suggests that it is necessary to take into consideration the impact that the background of knowledge and familiarity with the computer media have on the attitude towards cybertherapy , without neglecting aspects that reflect the rapid and inevitable evolution of technologies and the implications that this has had and will continue to have increasingly on the personal experience of patients.