Developing a Dialogue-Based Assessment Method for Depressive Disorder in Adolescents: A Qualitative Research on the Opportunities and Challenges for Integration into Practice

Abstract

Interest in digital interventions for depressive disorders has grown, yet limited usage exists in practice despite many limitations of the current interventions for assessment. My thesis aimed to explore the opportunities, challenges, strategies, considerations, implementation improvements and general limitations associated with integrating a dialogue-based assessment method for depressive disorders into practice. In this assessment method, adolescents engage in a conversation with a non-player character that asks the player about their experience with symptoms of a depressive disorder. Based on a thematic qualitative analysis with semi-structured interviews (N=6), the findings of this research revealed a range of insights. Opportunities included potential stimulation of honest responses, more reliable measurements, enhanced engagement and extra diagnostic support. Challenges involved high workloads, resistance from practitioners and finding funding. The strategies and considerations for successful implementation encompassed creating clarity on usage, linkage with the current system and writing implementation plans. Implementation improvements suggested changes to the storyline and characters but also further questioning symptoms, while also changing the target group and the questionnaire the dialogue is based on. Finally, the remaining limitations revealed difficulties with the heterogeneous and comorbid nature of depressive disorders and challenges related to using questionnaires as a base for the assessment method. Overall, this study contributes to understanding the integration of a dialogue-based assessment method for depressive disorders into practice, providing insights for future research to better bridge the gap between digital interventions and clinical practice.