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. 2025 Jul;34(7):2215-2227.
doi: 10.1007/s00787-025-02640-w. Epub 2025 Jan 13.

Acceptance of online therapy for children and adolescents with digital media use disorders: perspectives from child and adolescent psychiatrists and psychotherapists in Germany

K Busch  1 , G A Ten Hoor  2 , K Paschke  3 , R Thomasius  3 , N Arnaud  3
Affiliations

Acceptance of online therapy for children and adolescents with digital media use disorders: perspectives from child and adolescent psychiatrists and psychotherapists in Germany

K Busch et al. Eur Child Adolesc Psychiatry. 2025 Jul.

Abstract

Online therapies have the potential to improve access to psychological services for individuals in need while alleviating the burden on healthcare systems. However, child and adolescent psychiatrists and psychotherapists (CAPPs) rarely integrate these services into their daily practice. This exploratory study investigates CAPPs' acceptance of online therapy, with a focus on treating children and adolescents with digital media use disorders (DMUD). The study aimed to examine attitudes toward online therapy for DMUD treatment and to identify barriers and facilitating factors to its implementation. A cross-sectional online survey (5-10 min) was distributed to 1000 members of a German practitioner network, with 142 respondents completing it in full. Attitudes toward online therapy were assessed using adapted versions of the Attitude towards Telemedicine in Psychiatry and Psychotherapy (ATiPP) questionnaire. Barriers and facilitating factors were explored using open-ended questions. Descriptive statistics, correlations, and regressions were used to analyze the closed-ended questions, while responses to open-ended questions were categorized. CAPPs reported considerable experience with DMUD, but less experience with online therapy. Attitudes towards online therapy were generally neutral, with less favorable views on its use for DMUD treatment. Key barriers to implementation in outpatient care included technical challenges, lack of personal contact or control, and concerns about data security. Facilitators included access to adequate technical resources, user-friendly and evidence-based programs, interactive tools, and opportunities for regular face-to-face interactions. The results highlight the need to develop online therapy solutions that align practitioners' needs and acceptance. However, further qualitative and quantitative research with more representative samples is essential for a more comprehensive understanding of this topic.

Keywords: Acceptance; Child and adolescent psychiatrists and psychotherapists; Digital media use disorders; Online survey; Online therapy.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no competing interests. Ethics approval: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the Center for Psychosocial Medicine at the University-Medical Center Hamburg-Eppendorf, Germany (LPEK-0586). Consent to participate: All participants digitally provided informed consent.

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