Blended Therapy for Depression: Processes, Outcomes, and Barriers

Depression remains a major global mental health burden, while limited access to adequate psychological treatment highlights the need for accessible and flexible treatment approaches. Blended therapy (BT), which combines face-to-face psychotherapy with digitally delivered interventions, has emerged as a promising avenue for addressing these treatment gaps. This narrative review synthesized research published between ۲۰۲۳ and ۲۰۲۶ on BT for adult depression, focusing on treatment effectiveness, therapeutic processes, patient experience, long-term outcomes, and implementation challenges. Relevant literature was identified through searches of PsycINFO, PubMed, Scopus, and Web of Science and was synthesized narratively due to methodological and clinical heterogeneity. The reviewed evidence generally supported the effectiveness of BT, with supplementary models in which digital interventions complement therapist-delivered treatment showing particularly favorable outcomes. Evidence also indicated meaningful improvements in depressive symptoms and broader functioning, with benefits maintained over longer-term follow-up. Therapeutic alliance, patient satisfaction, and system usability appeared to be relevant to treatment outcomes. However, implementation remains challenging due to limited professional knowledge, workload pressures, insufficient time and training, and unclear implementation procedures. Conceptual heterogeneity also limits consistency across research and practice. Overall, BT represents a promising and flexible approach to adult depression, but its successful integration into routine care requires attention not only to clinical effectiveness but also to therapist training, organizational support, and clearer theoretical and implementation frameworks.

کلیدواژه ها:

blended therapy ، depression ، psychotherapy ، digital interventions ، implementation ، therapeutic alliance