Thinking flexibly about who digital mental health interventions are for and how they should be evaluated and used: Commentary on McClure et al. (2023)

Less than 20% of individuals with eating disorders (EDs) ever receive treatment. Digital interventions offer one solution to this problem and have demonstrated promise, but there is a need to understand predictors, moderators, and mediators of response, which McClure and colleagues aimed to do in their systematic review. Yet their review also raised key definitional and measurement issues pertinent to conducting research on digital interventions for EDs and other mental health problems, which may have impacted the conclusions drawn and which may stem from applying what has "always been done" in research on more traditional psychological interventions to research on digital interventions. This commentary suggests that digital interventions for EDs and other mental health problems should not be conceived as a 1:1 replacement for individual psychotherapy, and rather, these interventions should be viewed as one option in a wide-ranging menu of services that should be available, as the reality is that not all individuals want or can access the same type of care. If we accept that digital interventions need not be viewed as a 1:1 replacement for psychotherapy, then it logically follows that we should not evaluate or use these two approaches in the exact same manner.