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Background: Depression affects 5% of adults and it is a major cause of disability worldwide. Digital psychotherapies offer an accessible solution addressing this issue. This systematic review examines a spectrum of digital psychotherapies for depression, considering both their effectiveness and user perspectives. Objective: This review focuses on identifying (1) the most common types of digital psychotherapies, (2) clients'and practitioners' perspectives on helpful and unhelpful aspects, and (3) the effectiveness of digital psychotherapies for adults with depression. Methods: A mixed methods protocol was developed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search strategy used the Population, Intervention, Comparison, Outcomes, and Study Design (PICOS) framework covering 2010 to 2024 and 7 databases were searched. Overall, 13 authors extracted data, and all aspects of the review were checked by >1 reviewer to minimize biases. Quality appraisal was conducted for all studies. The clients' and therapists' perceptions on helpful and unhelpful factors were identified using qualitative narrative synthesis. Meta-analyses of depression outcomes were conducted using the standardized mean difference (calculated as Hedges g) of the postintervention change between digital psychotherapy and control groups. Results: Of 3303 initial records, 186 records (5.63%; 160 studies) were included in the review. Quantitative studies (131/160, 81.8%) with a randomized controlled trial design (88/160, 55%) were most common. The overall sample size included 70,720 participants (female: n=51,677, 73.07%; male: n=16,779, 23.73%). Digital interventions included "stand-alone" or non--human contact interventions (58/160, 36.2%), "human contact" interventions (11/160, 6.8%), and "blended" including stand-alone and human contact interventions (91/160, 56.8%). What clients and practitioners perceived as helpful in digital interventions included support with motivation and accessibility, explanation of task reminders, resources, and learning skills to manage symptoms. What was perceived as unhelpful included problems with usability and a lack of direction or explanation. A total of 80 studies with 16,072 participants were included in the meta-analysis, revealing a moderate to large effect in favor of digital psychotherapies for depression (Hedges g=--0.61, 95% CI --0.75 to --0.47; Z=--8.58; P<.001). Subgroup analyses of the studies with different intervention delivery formats and session frequency did not have a statistically significant effect on the results (P=.48 and P=.97, respectively). However, blended approaches revealed a large effect size (Hedges g=--0.793), while interventions involving human contact (Hedges g=--0.42) or no human contact (Hedges g=--0.40) had slightly smaller effect sizes. Conclusions: Digital interventions for depression were found to be effective regardless of format and frequency. Blended interventions have larger effect size than those involving human contact or no human contact. Digital interventions were helpful especially for diverse ethnic groups and young women. Future research should focus on understanding the sources of heterogeneity based on intervention and population characteristics. [ABSTRACT FROM AUTHOR]

Psychological flow can be experienced in various occupational, recreational and creative domains and may confer increased well-being. Yet, very few studies have examined flow as a potential feature of creative arts therapies – particularly therapies which prioritise embodied/enactive processes. This study tested the acute effects of a 90-minute workshop (Arts for the Blues; A4B) on participants' (N = 18) mood and personal goal attainment. Psychological flow was measured, and participants rated the importance of flow in relation to A4B's psychotherapeutic aims. Results show significantly improved mood, increased goal attainment and substantial flow scores, suggesting that A4B processes may invoke flow. Participants' importance ratings of different flow dimensions indicate that some were considered as more important than others. Results are discussed in relation to methodological limitations, helpful creative therapeutic factors that may enable flow, and implications for researchers and practitioners who wish to encourage flow in their practice. [ABSTRACT FROM AUTHOR]

There have been several arguments for the need to generate evidence‐based creative forms of psychological interventions in Improving Access to Psychological Services (IAPT), the main primary mental health provider in hospitals in England, UK. In this feasibility study, we sought to identify helpful and unhelpful factors of a new creative group psychotherapy, titled Arts for the Blues. We also wanted to find out whether the research tools used were acceptable and sensitive. We therefore engaged a group of seven patients attending an IAPT service in the North West of England, and a group of six staff working in the same service, to attend one creative workshop each, followed by a focus group. The two focus groups were transcribed and analysed using thematic analysis. We also collected pre‐ and post‐measures of depression (PHQ‐9) and anxiety (GAD‐7), measures commonly used in IAPT services, plus measures of well‐being (WHO‐5), the PANAS, and goal‐setting, which were considered for acceptability and sensitivity. We received largely positive responses from service users and staff in the use of creative methods in psychotherapy. Although the measures used had limitations due to the short duration of one‐off creative workshops, we found that they were sensitive enough, easy to complete and, thus, were acceptable. We concluded that Arts for the Blues is a promising intervention in IAPT, especially since it is shaped by service users and staff working in these services. Further work is needed to establish the effectiveness of this new intervention. [ABSTRACT FROM AUTHOR]

Introduction: Depression affects many adults in the UK, often resulting in referral to primary care mental health services (e.g. improving access to psychological therapies, IAPT). CBT is the main modality for depression within IAPT, with other approaches offered in a limited capacity. Arts psychotherapies are rarely provided despite their attractiveness to clients. However, the recent dropout rate of 64% within IAPT suggests that clients' needs are not being fully met. Therefore, in order to expand clients' choice we developed a new creative psychological therapy integrating evidence‐based approaches with arts psychotherapies. Method: A three‐level approach was used: (a) thematic synthesis of client‐identified helpful factors in evidence‐based approaches for depression and in arts psychotherapies; (b) studio practice exploring Cochrane Review findings on arts psychotherapies for depression; (c) pilot workshops for clients with depression and therapists. Findings and Discussion: Eight key ingredients for positive therapy outcomes were identified: encouraging active engagement, learning skills, developing relationships, expressing emotions, processing at a deeper level, gaining understanding, experimenting with different ways of being and integrating useful material. These ingredients were brought together as Arts for the Blues for clients with depression: a 12‐session evidence‐based pluralistic group psychotherapy integrating creative methods as well as talking therapy. Conclusion: The evidence‐based foundation, creative content and pluralistic nature of this new approach aligned with eight client‐identified key ingredients for positive therapy outcomes make it a promising therapy option that can be adapted to individual therapy. Implications include consideration for NICE approval as an additional therapy for depression. [ABSTRACT FROM AUTHOR]

Background: Women's health has received renewed attention in the last few years including health rehabilitation options for women affected by breast cancer. Dancing has often been regarded as one attractive option for supporting women's well-being and health, but research with women recovering from breast cancer is still in its infancy. Dancing with Health is multi-site pilot study that aimed to evaluate a dance programme for women in recovery from breast cancer across five European countries. Methods: A standardized 32 h dance protocol introduced a range of Latin American dances presented within a sports and exercise framework with influences from dance movement therapy. Fifty-four women (M age 53.51; SD 7.99) participated in the study who had a breast cancer diagnosis <3 years, chemotherapy >6 weeks, no indication of metastasis, or scheduled surgery/chemotherapy/radiation treatment for the duration of the intervention. Primary outcome data was collected for anthropometric and fitness measures next to cancer-related quality of life. T -tests and Wilcoxon signed ranked tests were used to establish differences pre and post intervention. Cohen's d was also calculated to determine the effect size of the intervention. Results: Statistically significant changes were found for: (i) weight, right and left forearm circumference and hip; (ii) 6 min walking, right and left handgrip, sit-to-stand and sit-and-reach; (iii) the EORTC-QLQ C30 summary score as well as the subscales of emotional and social functioning and symptoms. In all cases the direction of change was positive, while Cohen's d calculated showed that the effect of the intervention for these parameters ranged from intermediate to large. Conclusion: Changes on the above anthropometric, fitness and quality of life measures suggest that the intervention was of value to the participating women recovering from breast cancer. Results also advocate collaborative efforts across countries to further research. [ABSTRACT FROM AUTHOR]

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Routinely prescribed psychological therapies for depression are not always effective. Arts therapies, particularly Dance Movement Psychotherapy, may offer additional therapeutic mechanisms for depression. Therefore, client-reported helpful factors from various therapy types, along with client preferences, are key in devising new therapeutic interventions. We present a framework for a new pluralistic "meta-approach" of therapy for depression, based on an interdisciplinary thematic synthesis (Thomas, J., & Harden, A. (2008). Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Medical Research Methodology, 8[1], 45) of active ingredients from both talking therapies and creative approaches. Lastly, we offer an illustrative group therapy workshop based on this approach, to be piloted with clients and practitioners within an NHS mental health service. Further research is required to evaluate this pilot and to devise a full treatment for trialling within the service. [ABSTRACT FROM AUTHOR]

The introduction of dance movement psychotherapy (DMP) to a mainstream secondary school in the United Kingdom was explored from the perspectives of some educators (n = 5) and pupil-clients (n = 3) to discover perceptions of, and influences on the process of establishing a DMP practice to support pupils within this setting. Semi-structured interviews were analysed using constructivist grounded theory by an ethnographically situated therapist-researcher. Two polarities of themes emerged: constraints, normative inhibitions and expectations, versus empowerment, novel perceptions and awareness. These polarities were evident at two levels of process: school structures and community mind-set and individual engagement with DMP. The results highlight inherent dynamics in positioning of therapeutic provision within a school environment, amplified in unconventional, creative and embodied forms of intervention. An awareness of the tension between these opposites may be useful for dance movement psychotherapists in setting themselves within mainstream education. [ABSTRACT FROM AUTHOR]