The self-help site '15 minutes 4 me' (www.15Minutes4Me.com) has been available online for more than three years now. Positive results have recently been published in international literature. Those who think that they might be suffering from burnout, stress, anxiety, depression, or hyperventilation, can take a self-test on '15 Minutes 4 Me'. After that they can subscribe to the self-help program. By answering questions and suggestions, the participant works on their problems. After fifteen minutes of computer based consult per day, the average person in the population sees one's stress reduce by over 50% after just 3 weeks. By this time, the DASS-score has reduced to the stress-free zone in the average participant. “What has stood out to me, especially lately, is that the step toward the use of the internet has become a lot smaller”, initiator and doctor Paul Koeck (Antwerp) says. "If people get the chance to differentiate between useful and not useful material on the internet, they are prepared to use a scientifically valid self-help program via their computer. For some people the use of '15 Minutes 4 Me' is the first step. After that, the program can steer them toward a doctor, if this is needed. We originally considered only to allow people into the program after having spoken to their doctor first, but that would lead to a partial loss of the step-reducing effect which '15 Minutes 4 Me' has.”
Hesitation and waiting lists
Of the people who are recommended psychotherapy by their doctor, only a fraction actually takes this step, doctor Koeck knows. "This morning I got up and saw that someone had signed up that night at 4 o'clock for '15 Minutes 4 Me'. That is the typical profile of the patient who gets a hyperventilation attack and thinks: tomorrow I will call a doctor. For some reason many people do not have the courage the next day to actually do what they said that they would." A reason why people do not get help could be because they do not like to talk, while this is something which one must do in a face-to-face-consult. Some are afraid that they might have to uncover their sexual youth during the course of treatment for years. On top of this, patients in centers for mental healthcare sometimes have to enter waiting lists with a length of several months. With '15 Minutes 4 Me' they can undertake steps while waiting, so that their issues are partially solved by the time they get to the top of the waiting list.
A new therapeutic type
The smaller step effect which self-help programs have can also be seen in the sexes. It is well-known: in psychotherapy, most patients are women. This is also true in '15 Minutes 4 Me', but there still are more men who are interested, relatively speaking. This confirms what Paul Koeck has seen in international circles: makes of the audio programs for self-help believe that their tools alter the sex-ratio of the group reached toward increased numbers of men. This type of observation leads to a clear conclusion: online self-help programs are a new type of therapy, different from medication and conversational therapy. The patient can, for example, choose between psychotherapy and '15 Minutes 4 Me'. The one option is not just better than the other, but can sometimes adhere more to the preference of the patient. "Recently I had a patient of whom I though: we will not get anywhere with only conversational therapy. I recommended him to also take '15 Minutes 4 Me'", doctor Koeck says. "One can imagine that an engineer who enjoys working with computers feels more comfortable with an online program. Yet, a woman who regularly discusses everything with her friends, is likely to prefer conversational therapy." Self-help programs convince through a paradox: the psychological contact is stronger with these than with a help provider in human form. Patients normally sign a psychological contract with the person who helps them. But with whom do you sign this contract if there is no other person? "With yourself", Paul Koeck responds. "A participant told us on our site that she had built up an important relationship with herself through '15 Minutes 4 Me'. The program asks questions every day which make you reflect about your own persona. That explains why the compliance of the participants is so good." Another reason for good compliance is that the access to the program is given via an acceptable financial contribution: once this has been paid, people want to get as much as possible for their money. In the Netherlands there are some freely accessible sites for self-help available, but only a small percentage of those who signed up actually finish the program.
New uses come into existence
Participants on '15 Minutes 4 Me' get the advice to discuss their results with their doctor, so that other options may be taken up if the self-help program were to be non-sufficient. That which can be discussed with the doctor for starters are the graphs which the program delivers, which make it possible to see the patient's results in an easy way. "The graphs have led to new uses", doctor Koeck says. "First of all, we can see that the doctor actually uses this material as a way of checking how the patient evolves. But patients who miss work due to their illness can also bring the graphs to the doctor who checks up on them. This makes it possible for some people to convince their employer that they are not just skipping work, but that they are actually working on their situation." THe certificates of participation have a similar relevance, and are given by the program when participants have gone through 75% of the daily sessions. When employers got these certificates, some decided to reimburse the subscription to '15 Minutes 4 Me' for their employees - 55 to 110 euros, a small amount for a company if this helps them avoid that a person from their team sinks into a burnout. This new trend takes up the question of the government regarding how companies would work on burnout prevention. The participating comes mainly from large structures, while some smaller companies have also taken this up by now.