Well Connected, a platform for safe online communication and therapy

Well Connected, a platform for safe online communication and therapy Introduction Well Connected is a flexible, safe and user friendly e-health platform with a wide range of applications. Over the last 7 years 5000 patients were treated or a variety of addiction related problems. Besides creating an effective treatment for existing target groups, the main challenge was to reach groups that had previously not received addiction related care. Reducing drop-out was and is another important goal of the new platform. Over the past years several strategies where implemented to improve treatment adherence. Intervention The core of the platform is formed by a secure way of a-synchronous communication between client and professional via a personal dossier. This part of the platform enables multiple forms of therapy. From simple online communication, via blended therapy, to fully protocolized online treatments of (among other possibilities) addictions or psychiatric disorders. Besides regular communication, the professional has the option to add questionnaires, assignments, images, printable documents and sound files to any message. Clients have access to a logbook, used to register relevant events or behaviour, like drinking, gambling or anxiety episodes. The structure of these logbooks is based on the principles of Cognitive Behavioural Therapy with questions about situation, thoughts, feelings and behaviour. Therapy content can be added and revised via a simple CMS. New insights and techniques can be integrated continuously. The platform provides a high level of data security. Access to the platform for all professionals is restricted by a name/password/randomized code technique. All (client) data is stored using strong encryption. Daily backups are stored on off-site locations. All data is stored for a period of 15 years, in accordance with Dutch laws. Integration Integrated into the application are possibilities for professional and administrative processes for client and therapist, and also supporting roles like coordinators, administrators, trainers and others. This facilitates online and real-time training, coaching and supervising, simple allocation of clients to different therapists or to different health-care organisations and financial administration of paying clients. Different professionals such as therapists, coordinators and researchers have the possibility to apply alerts and filters, to manage case-loads, client lists and research data. The platform incorporates research possibilities, including the option to run a RCT. The export options provide integration with statistical programs like IBM's SPSS. The platform also consists of a website with information and self tests and a forum for peer support. Method We conducted various studies to investigate the applications on the platform, including target group research, pilot studies and randomized controlled trials (RCT). Most studies focused on the (first available) web-based treatment program for problem drinkers (www.alcoholdebaas.nl). Results The target group research showed that the platform successfully attracted new client populations, compared to regular face-to-face treatment services: more women, older and higher educated people, more people with jobs, and less people with prior treatment. RCT results showed that the web-based alcohol treatment group decreased their mean weekly alcohol consumption by 28.8 units compared to 3.1 units in the control group, corresponding with a large between-group effect size (d=1.21). The web-based treatment group also showed greater improvements on general health and depressive symptoms. Pilot studies of other programs (e.g. eating disorder, gambling) showed that participants improved significantly between pre- and post-test and their satisfaction was high. Conclusion The e-health platform reached new target groups and has proven to be effective for the treatment of addiction problems. The research tool allows the continuous collection of data and improvement of treatments. Challenges are further dissemination of the platform and improvement of adherence. These topics will be discussed.