Blended Therapy From the Perspective of Mental Health Professionals in Routine Mental Health Care: Mixed Methods Analysis of Cross-Sectional Survey Data.

Background: Digital interventions play an innovative role in the treatment of mental health disorders, offering evidence-based solutions across a wide range of conditions. Blended therapy (BT), which integrates digitally delivered interventions with face-to-face therapy, has shown promise. However, challenges such as low uptake hinder widespread implementation. Mental health professionals are key stakeholders for the adoption of BT in routine care settings. Objective: This study explores mental health professionals' perspectives on BT, specifically assessing their perceived knowledge of, acceptance of, usage of, and perceptions of different BT types. Additionally, it examines mental health professionals' perceived advantages and disadvantages of BT, challenges associated with implementation, and wishes toward the future application of BT. Methods: A survey study was conducted among 203 mental health professionals (152 psychological psychotherapists and 51 psychiatrists, including also individuals in training) in Switzerland. The data were analyzed using both quantitative methods and qualitative content analysis. Results: Participants reported limited knowledge of BT (mean 2.71, SD 1.32), attitudes toward BT were somewhat positive (mean 5.25, SD 1.34), and acceptance was moderate (mean 3.64, SD 1.20). Among various digitally delivered interventions, teletherapy (video) was most frequently integrated with face-to-face treatment and considered more suitable for BT than chat, email, or new technologies. More than 75% (n=152) of the respondents deemed BT appropriate for the treatment of affective (mood) disorders (F30-F39) and for the treatment of neurotic, stress-related, and somatoform disorders (F40-F48; ICD-10). The qualitative analyses of open-ended questions highlighted key advantages of BT as perceived by mental health professionals. These include increased treatment flexibility, the ability to outsource therapy components, and enhanced treatment efficiency. However, disadvantages such as increased effort and potential disruptions to the therapeutic relationship were also noted. Participants identified barriers to BT implementation, including financing and data security concerns. To facilitate BT adoption, respondents emphasized the desire for better cost coverage, easy access to digitally delivered interventions, and seamless integration of digital tools into face-to-face therapy. Conclusions: The findings indicate that mental health professionals report limited knowledge of BT and consider it more suitable for certain disorders than others. Moreover, from their perspective, while BT offers advantages, it also presents disadvantages. Addressing mental health professional knowledge gaps, alongside resolving perceived implementation barriers, may be key to the successful future implementation of BT in routine mental health settings.