Implementation of an internet based psychotherapy platform in three Community Mental Health Centers in Albania: identifying and addressing obstacles in relation to treatment implementation

Andia Meksi^1,2, Gentiana Qirjako^1,2,3, ArildaDushaj^1,3, ArlindaCergaPashoja⁴

¹Community Center for Health and Wellbeing, Tirana, Albania;

²Institute of Public Health, Tirana, Albania;

³Faculty of Medicine, University of Medicine, Tirana, Albania;

⁴London School of Hygiene and Tropical Medicine, UK.

Aim: Presenting the implementation challenges of an e-intervention for depression called “I Fight Depression Tool” in three Community Mental Health Centers (CMHC) in Tirana, Shkodra and Korça. The aim is to present the intervention and provideinsights on the achievements and challenges faced when implementing and integrating this innovative intervention to current practices in CMHCs. The objectives are to identify implementation obstacles, possible solutions and preliminary results of the implementation process. 

Methodology:Site visits, individual and group interviews were carried out between 2017 to 2019, descriptive reports were used in order to evaluate the implementation activities for each site. Presentation of the organizational issues at implementation level and therapists self-perceptive challenges is provided.

Results: Implementation and integration of “I fight depression” tool remains a challengefor our implementation sites. In order to meet and resolve these challenges we have identified the following obstacles such as lack of internet usability and accessibility, patient’s level of education and cognitive barriers, unclear working roles and organizational issues related to the implementation staff.

Conclusions:Identifying and addressing patients’ individual needs in using the platform, staff’s issues related to implementation of ICB and organizational issues can contribute to a high rate of accessibility to patient’s uptake number, treatment compliance and good treatment outcome. Identifying and addressing these obstacles at individual and organizational level is of vital importance for a successfulimplementationof internet based interventions in community based mental health centers.

Keywords: internet-based psychotherapy platform, implementation challenges, organizational readiness for change.