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Aim of the Study: In order to develop an online portal for the preparation for inpatient psychosomatic rehabilitation, information requirements as well as the online use behavior of rehabilitants were determined first., Methods: Four focus groups with rehabilitants (N=31) as well as two with the treatment team (N=18) were performed and evaluated qualitatively., Results: A total of 419 statements by rehabilitants and 333 statements by the treatment team were coded and assigned to categories. Current information materials on rehabilitation have been regarded as too extensive and difficult to understand by rehabilitants. They were uncertain regarding the effectiveness and sustainability of the treatment. While practitioners assumed that rehabilitants expect wellness and relaxation during rehabilitation, rehabilitants themselves reported more of an active treatment orientation., Conclusion: Online portals for preparation should address the effectiveness and sustainability of psychosomatic rehabilitation by means of illustrative case studies., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Objectives: The feasibility of psychodynamic online treatments has remained an issue of debate. The paper presents rationale and technique of a psychodynamic online intervention discussing therapeutic process and alliance based on two case examples from an RCT., Methods: A weekly writing task is followed by individual feedback from the online therapist. Treatment focuses on a 'Core Conflict Relationship Theme' based on relationship episodes according to the wish of the patient, reactions of the others and reactions of the self. Maladaptive interpersonal interactions are worked through by supportive and expressive therapeutic interventions., Results: Case reports from our study illustrate a productive therapeutic process without immediate personal contact or nonverbal communication., Conclusions: Emotional reactions and felt concern of the online therapist promote engagement in patients. Online therapists need to detect alliance ruptures based on text messages and remedy them. We discuss psychodynamic online treatments as adjuncts to face to face psychotherapy.

Introduction: Internet- and mobile-based health interventions (IMIs) e. g. in the form of internet-based aftercare can supplement existing treatments of inpatient rehabilitation. Acceptance presents a key precondition to the utilization and clinical implementation of new technologies and was examined in patients and health professionals with qualitative research methods., Methods: In 3 inpatient rehabilitation clinics with various diagnostic and age groups, we interviewed n=15 patients individually and n=29 health professionals of various occupational groups in focus groups based on the 'Unified Theory of Acceptance and Use of Technology'., Results: Benefits of online-aftercare were seen in the access to health information, motivation to health promotion or in monitoring or correcting health behavior. Occupational stress was not seen as an area of application. Reservations were expressed in terms of lack of trust in online contact. Overall, acceptance was higher in patients in comparison to health professionals., Conclusion: Barriers of uptake or application of IMIs in rehabilitation exceed technical and demographic aspects and provide important information for specific facilitation of acceptance of patients as well as health professionals., Competing Interests: Die Autoren geben an, dass keine Interessenkonflikte bestehen., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: Web-based aftercare can help to stabilize treatment effects and support transition after inpatient treatment, yet uptake by patients seems limited in routine care and little is known about the mechanisms of adoption and implementation., Objective: The aim of this study was to (1) determine acceptance of Web-based aftercare and (2) explore its drivers and barriers in different subgroups of a mixed inpatient sample., Method: In a cross-sectional design, 38.3% (374/977) of the inpatients from a broad spectrum of diagnostic groups (psychosomatic, cardiologic, orthopedic, pediatric, and substance-related disorders) filled out a self-administered questionnaire prior to discharge. Drivers and barriers to patients' acceptance of Web-based aftercare were examined based on an extension to the "unified theory of acceptance and use of technology" (UTAUT). In total, 16.7% (59/353) of the participants indicated prior use of eHealth interventions., Results: Acceptance (min 1, max 5) was low (mean 2.56, SD 1.22) and differed between diagnostic groups (Welch F 4,133.10 =7.77, P<.001), with highest acceptance in adolescent patients (mean 3.46, SD 1.42). Acceptance was significantly predicted by 3 UTAUT predictors: social influence (beta=.39, P<.001), performance expectancy (beta=.31, P<.001), and effort expectancy (beta=.22, P<.001). Furthermore, stress due to permanent availability (beta=-.09, P=.01) was negatively associated with acceptance., Conclusion: This study demonstrated a limited acceptance of Web-based aftercare in inpatients. Expectations, social environment's attitude, and negative experience with permanent availability influence eHealth acceptance. Improving implementation, therefore, means increasing eHealth experience and literacy and facilitating positive attitudes in patients and health professionals through education and reduction of misconceptions about effectiveness or usability., Competing Interests: Conflicts of Interest: None declared., (©Severin Hennemann, Manfred E Beutel, Rüdiger Zwerenz. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 23.12.2016.)

Background: Patients' treatment expectations are a key factor in psychotherapy. Several studies have linked higher expectations to better treatment success. Therefore, we want to evaluate the impact of a targeted video-based intervention on patients' expectations and the treatment success of inpatient rehabilitation., Methods/design: All patients who will be referred to inpatient psychosomatic rehabilitation in three clinics will receive a study flyer with information about how to log in to the study platform together with the usual clinic information leaflet. Patients will receive the study information and informed consent upon login and will be randomized into the intervention or the control group. The intervention group (n = 394) will get access to our virtual online clinic, containing several videos about inpatient rehabilitation, until their admission to inpatient rehabilitation. The control group (n = 394) will receive no special treatment preparation. Questionnaires will be given at study inclusion (T0), two weeks before admission to (T1), and at the end of (T2) inpatient rehabilitation. The primary outcome is the outcome expectancy measured with the Credibility Expectancy Questionnaire at T1. Secondary outcomes include treatment motivation, mental health, work ability, depression, anxiety, and satisfaction with and usage of the Internet platform., Discussion: We expect the intervention group to benefit from the additional preparation concerning their outcome expectancy. If successful, this approach could be used in the future to enhance the efficacy of inpatient rehabilitation., Trial Registration: ClinicalTrials.gov: NCT02532881 . Registered on 25 August 2015.

Background: Mental disorders are the main reasons for rising proportions of premature pension in most high-income countries. Although inpatient medical rehabilitation has increasingly targeted work-related stress, there is still a lack of studies on the transfer of work-specific interventions into work contexts. Therefore, we plan to evaluate an online aftercare program aiming to improve vocational reintegration after medical rehabilitation., Methods: Vocationally strained patients (n = 800) aged between 18 and 59 years with private internet access are recruited in psychosomatic, orthopedic and cardiovascular rehabilitation clinics in Germany. During inpatient rehabilitation, participants in stress management group training are cluster-randomized to the intervention or control group. The intervention group (n = 400) is offered an internet-based aftercare with weekly writing tasks and therapeutic feedback, a patient forum, a self-test and relaxation exercises. The control group (n = 400) obtains regular e-mail reminders with links to publicly accessible information about stress management and coping. Assessments are conducted at the beginning of inpatient rehabilitation, the end of inpatient rehabilitation, the end of aftercare, and 9 months later. The primary outcome is a risk score for premature pension, measured by a screening questionnaire at follow-up. Secondary outcome measures include level of vocational stress, physical and mental health, and work capacity at follow-up., Discussion: We expect the intervention group to stabilize the improvements achieved during inpatient rehabilitation concerning stress management and coping, resulting in an improved vocational reintegration. The study protocol demonstrates the features of internet-based aftercare in rehabilitation., Trial Registration: International Standard Randomised Controlled Trial Number Register (ISRCTN:ISRCTN33957202).