Home » Internet-based interventions in chronic medical conditions – bridging the chasm between somatic and mental health

Internet-based interventions in chronic medical conditions – bridging the chasm between somatic and mental health

If you would like to join and/or learn more about this SIG, please contact Eileen Bendig (eileen.bendig@uni-ulm.de) or Natalie Bauereiss (natalie.bauereiss@uni-ulm.de).


Chronic medical conditions such as coronary heart disease, cancer, COPD, diabetes and HIV are characterized by a long lasting and mostly progressive disease course, and associated with various burdens for patients affected by them (Forouzanfar et al., 2016). Chronic medical conditions come with high costs, for the individual (e.g. quality of life, stress and disability) and the society at large (e.g. sick leave, early retirement, prolonged and expensive treatments) (Forouzanfar et al., 2016). For example, patients with chronic medical conditions might be confronted with threats to their life (e.g. cancer, HIV), threats to body integrity (e.g. mastectomy in breast cancer treatment, foot amputation as a potential diabetes complication), threats to independence and autonomy (e.g. being chair-bound after stroke) and threats to life goals, future plans, relationships and economic well-being (e.g. diminished capacity in work and social life) (Falvo & Holland 2014).

Thus, patients with chronic medical conditions are confronted with a multitude of disease management challenges, by adhering to complex and often ambivalent treatment plans over a longer period of time (Brown and Bussell, 2011), coping with the disease consequences including side-effects (Falvo 2014), as well as dealing with social and mental health issues such as depression, grief, anxiety, anger and guilt (Falvo 2014).

From health care services research it is well known that adherence to treatment regimens often falls short (Brown and Bussell, 2011) and patients struggle to establish effective and adaptive coping strategies. Self-management support can  in light of the overwhelming life demands they are confronted with, potentially leading to dysfunctional coping strategies such as denial of their disease or inadequate self-medication, i.e. use of alcohol and other drugs in order to relieve painful affects and numb emotions (Falvo 2014). Moreover, chronic medical diseases are associated with increased prevalence rates of mental disorders such as depression, anxiety disorders, somatoform disorders and substance-related disorders (Härter et al., 2007). In turn, mental disorders have negative effects on patient well-being and course of the disease (Prince et al., 2007) with substantially increased direct and indirect health care costs (Baumeister et al., 2012; Haschke et al., 2012; Hutter et al., 2010, 2011).

Internet-and mobile based interventions can be an integral part of the medical treatment or provided as stand-alone intervention to help improve health outcomes, both medical and psychological Areas of application comprise prevention, (co)-treatment and after-care, attuned to the changing needs in the course of the disease trajectory. Today, a vast amount of  evidence-based Internet and mobile based interventions is available for several chronic somatic diseases, with limited collaboration across diagnoses. From a scientific as well as clinical perspective, international collaboration is warranted to help further research in the field (Bendig et al., 2018).


The Chronic Medical Conditions SIG aims to:

  • Build a world-wide network of researchers, health care professionals and everyone devoted to exploring and advancing technological diagnostics and interventions for people living with chronic somatic conditions.
  • Systematize the very broad and heterogeneous field of IMIs for people living with chronic somatic disease, with its multiple possible technological solutions on the one hand and the varying medical conditions and respective specific health care demands on the other hand.
  • Build an interdisciplinary bridge between health care professionals and researchers by establishing best practices, facilitating transfer of knowledge and stimulating innovative ways of designing integrated technological health care solutions.
  • Promote patient-centered research by exploring needs and attitudes towards IMIs across target populations (i.e. different chronic somatic conditions), application areas and cultures and by establishing and fostering research methods that involve patients as experts.
  • Disseminate research results and activities from SIG members by organizing symposia, workshops and other activities on conferences and sharing relevant work on social media.
  • Develop guidelines for best practices for Internet Interventions for people living with chronic diseases

SIG Committee

Prof. Harald Baumeister

Harald Baumeister is head of the Department of Clinical Psychology and Psychotherapy and the associated outpatient psychotherapy clinical at Ulm University. The department is interested in innovative, digital assisted ways of improving somatic conditions and somatic health care services by means of psychological and behavioural health informed diagnostics and intervention approaches. Thematically, we focus on somatic-mental comorbidities, coping and acceptance, treatment motivation and behaviour change, self-management, empowerment and self-efficacy as well as grief and existence. Thereby our research mainly targets the fields of psychooncology, psychocardiology, psychodiabetology and psychological aspects of chronic pain.

Prof. Frank Snoek

Frank Snoek is professor and head of the medical psychology department at Amsterdam University Medical Centers and director of the diabetes psychology research group and specialized diabetes mental health clinic. My research focuses on improving self-management and mental health in diabetes by means of innovative (blended) online treatment, while the department at large is involved in developing and testing online treatment for a variety of patient groups: cancer, chronic fatigue, cystic fibrosis, dermatology, irritable bowel disease and multiple sclerosis.

Eileen Bendig, M.Sc., PhD Candidate (Germany)

Research interests: pschychological aspects of people living with chronic somatic disease, language and life narratives, fully automated software-agents (chatbots)
Eileen is a PhD candidate in the Department of Clinical Psychology and Psychotherapy at Ulm University, Germany since 2016. Additionally, she has started her training in cognitive behavioral therapy. She is responsible for the initiation and implementation of several pilot RCTs investigating internet interventions for people living with chronic somatic disease (e.g. cardiovascular disease, diabetes, cancer). Currently she investigates “next generation” technologies like chatbots to foster mental health.

Natalie Bauereiß, M.Sc., PhD Candidate (Germany)

Research interests: e-/m-Health in cancer and advanced disease, patient-centered approaches to intervention development and implementation
Natalie is a PhD candidate in the Department of Clinical Psychology and Psychotherapy at Ulm University, Germany since 2016. Additionally, she has started her training in cognitive behavioral therapy. Natalie has been responsible for the coordination of two pilot RCTs evaluating the feasibility and efficacy of psychological internet- and mobile-based interventions for people living with cancer. She is now undertaking a multinational project that aims at developing and evaluating an online intervention for people living with advanced cancer. Her research is based on different psychotherapeutic approaches (CBT, ACT, existential psychotherapy) and includes qualitative research methods.

Sarah Paganini, Dipl.-Psych., PhD Candidate (Germany)

Research interests: e-/m-Health for individuals with chronic (back) pain and comorbid depression, treatment and prevention of depression, health economic evaluations of e-/m-Health based interventions
Sarah is a PhD candidate and is working in the Department of Sports and Sport Science (Sport Psychology) at the University of Freiburg, Germany. One of her main topics is the health economic evaluation of internet- and mobile-based interventions. She is part of a project team evaluating the effectiveness and cost-effectiveness of an internet-based intervention for individuals with chronic back pain and comorbid depression after orthopedic inpatient care. She was involved in developing the intervention and the coordination of this multicenter pragmatic randomized controlled trial. Furthermore, Sarah is doing the training in cognitive behavioral therapy.

Prof. Gerhard Anderson

Prof. Andrea Evers

Dr. habil. David Daniel Ebert


Baumeister, H., Knecht, A., and Hutter, N. (2012). Direct and indirect costs in persons with chronic back pain and comorbid mental disorders-A systematic review. J. Psychosom. Res. 73, 79–85. doi:10.1016/j.jpsychores.2012.05.008.

Bendig, E., Bauereiß, N., Ebert, D. D., Snoek, F., Andersson, G., and Baumeister, H. (2018). Internet-based interventions in chronic somatic disease. Dtsch. Aerzteblatt Online, 659–666. doi:10.3238/arztebl.2018.0659.

Brown, M. T., and Bussell, J. K. (2011). Medication adherence: WHO cares? Mayo Clin. Proc. 86, 304–14. doi:10.4065/mcp.2010.0575.

Falvo, D. R., and Holland, B. E. Medical and psychosocial aspects of chronic illness and disability.

Forouzanfar, M. H., Afshin, A., Alexander, L. T., Anderson, H. R., Bhutta, Z. A., Biryukov, S., et al. (2016). Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 388, 1659–1724. doi:10.1016/S0140-6736(16)31679-8.

Härter, M., Baumeister, H., Reuter, K., Jacobi, F., Höfler, M., Bengel, J., et al. (2007). Increased 12-Month Prevalence Rates of Mental Disorders in Patients with Chronic Somatic Diseases. Psychother. Psychosom. 76, 354–360. doi:10.1159/000107563.

Haschke, A., Hutter, N., and Baumeister, H. (2012). Indirect costs in patients with coronary artery disease and mental disorders: A systematic review and meta-analysis. Int. J. Occup. Med. Environ. Health 25, 319–329. doi:10.2478/S13382-012-0042-6.

Hutter, N., Knecht, A., and Baumeister, H. (2011). Health care costs in persons with asthma and comorbid mental disorders. A systematic review. Gen. Hosp. Psychiatry 33, 443–453. doi:10.1016/j.genhosppsych.2011.06.013.

Hutter, N., Schnurr, A., and Baumeister, H. (2010). Healthcare costs in patients with diabetes mellitus and comorbid mental disorders-a systematic review. Diabetologia 53, 2470–2479. doi:10.1007/s00125-010-1873-y.

Prince, M., Patel, V., Saxena, S., Maj, M., Maselko, J., Phillips, M. R., et al. (2007). No health without mental health. Lancet 370, 859–877. doi:10.1016/S0140-6736(07)61238-0.

Relevant publications by SIG members published in peer-reviewed journals

Bendig, E., Bauereiß, N., Ebert, D.D., Snoek, F.J., Andersson, G. & Baumeister, H. (2018). Internet- based interventions in chronic somatic disease. Dtsch Arztebl Int, 115, 659–65. DOI: 10.3238/arztebl.2018.0659

Bendig, E., Erb, B., Schulze-Thuesing, L., & Baumeister, H. (accepted). Next Generation: Chatbots in clinical psychology and psychotherapy. Karger

Hennemann, S., Böhme, K., Baumeister, H., et al. (2018). Efficacy of a guided internet-based intervention (iSOMA) for somatic symptoms and related distress in university students: study protocol of a randomised controlled trial. BMJ Open, 8,e024929. doi:10.1136/bmjopen-2018-024929

Probst, T., Baumeister, H., McCracken, L.M., Lin, J. (2019). Baseline Psychological Inflexibility Moderates the Outcome Pain Interference in a Randomized Controlled Trial on Internet-based Acceptance and Commitment Therapy for Chronic Pain. Journal of Clinical Medicine, 8, 24.

Nobis, S., Ebert, D.D., Lehr, D., Smit, F., Buntrock, C., Berking, M., Baumeister, H., Snoek, F., Funk, B. & Riper, H. (2018). Web-based intervention for depressive symptoms in adults with types 1 and 2 diabetes mellitus: a health economic evaluation. British Journal of Psychiatry, 212, 199-206.

Lin, J., Faust, B., Ebert, D. D., Krämer, L., Baumeister, H., (2018). A Web-based acceptance-facilitating intervention for identifying patients’ acceptance, uptake, and adherence of Internet- and Mobile-based Pain interventions: randomized controlled trial. Journal of Medical Internet Research, 20, e244.

Lin, J., Klatt, L.I., McCracken, L.M., Baumeister, H. (2018). Psychological flexibility mediates the effect of an online-based acceptance and commitment therapy for chronic pain: an investigation of change processes. Pain, 159, 663-672.

Lin, J., Paganini, S., Sander, L., Lüking, M., Ebert, D.D., Buhrman, M., Andersson, G. & Baumeister, H. (2017). An internet-based Intervention for chronic pain: A three-armed randomised controlled study of the effectiveness of guided and unguided acceptance and commitment therapy. Deutsches Aerzteblatt International, 114, 681-688.

Lin, J., Sander, L., Paganini, S., Schlicker, S., Ebert, D., Berking, M., Bengel, J., Nobis, S., Lehr, D., Mittag, O., Riper, H. & Baumeister, H. (2017). Effectiveness and cost-effectiveness of a guided internet- and mobile-based depression intervention for individuals with chronic back pain: protocol of a multi-centre randomised controlled trial. BMJ Open, 7, e015226.

Sander, L., Paganini, s., Lin, J., Schlicker, S., Ebert, D.D., Buntrock, C. & Baumeister, H. (2017). Effectiveness and cost-effectiveness of a guided Internet- and mobile-based intervention for the indicated prevention of major depression in patients with chronic back pain – study protocoll of the PROD-BP multicenter pragmatic RCT. BMC Psychiatry, 17, 36.

Ebert, D.D., Nobis, S., Lehr, D., Baumeister, H., Riper, H.,  Kessler, R., Snoek, F. & Berking, M. (2017). 6-months effectiveness of Internet-based guided self-help for depression in adults with type 1 and 2 diabetes mellitus: Results of a randomized controlled trial. Diabetic Medicine, 34, 99-107.

Baumeister, H., Terhorst, Y. & Lin, J. (2016). The Internet and Mobile technology: a platform for behavior change and intervention in depression and CVDs. Baune, B. T. & Tully, P. (Ed.): Cardiovascular Diseases and Depression – Treatment and Prevention in Psychocardiology (pp. 395-410). Berlin: Springer.

Baumeister, H., Seifferth, H., Lin, J., Nowoczin, L., Lüking, M. & Ebert, D. (2015). Impact of an Acceptance Facilitating Intervention on Patients’ Acceptance of Internet-based Pain Interventions: A Randomized Controlled Trial. The Clinical journal of pain, 316, 528–535.

Lin, J., Lüking, M., Ebert, D. D., Buhrman, M., Andersson, G. & Baumeister, H. (2015). Effectiveness and cost-effectiveness of a guided and unguided internet-based Acceptance and Commitment Therapy for chronic pain: Study protocol for a three-armed randomised controlled trial. Internet Interventions. (2), 7–16.

Nobis, S., Lehr, D., Ebert, D. D., Baumeister, H., Snoek, F., Riper, H. & Berking, M. (2015). Efficacy of a web-based intervention with mobile phone support in treating depressive symptoms in adults with type 1 and type 2 diabetes: a randomized controlled trial. Diabetes care, 38, 776–783.

Baumeister, H., Nowoczin, L., Lin, J., Seifferth, H., Seufert, J., Laubner, K., & Ebert, D. D. (2014). Impact of an acceptance facilitating intervention on diabetes patients’ acceptance of Internet-based interventions for depression: a randomized controlled trial. Diabetes research and clinical practice, 105, 30–39.

Nobis, S., Lehr, D., Ebert, D. D., Berking, M., Heber, E., Baumeister, H., Becker, A., Snoek, F. & Riper, H. (2013). Efficacy and cost-effectiveness of a web-based intervention with mobile phone support to treat depressive symptoms in adults with diabetes mellitus type 1 and type 2: design of a randomised controlled trial. BMC psychiatry, 13, 306.

Abberger, B., Haschke, A., Wirtz, M., Kroehne, U., Bengel, J. & Baumeister, H. (2013). Development and evaluation of a computer adaptive test to assess anxiety in cardiovascular rehabilitation patients. Archives of physical medicine and rehabilitation, 94, 2433–2439.

Snoek, F. (2018). The challenge of treating comorbid mental health problems in patients with a somatic illness. Lancet Psychiatry, 5(6), 465. doi: 10.1016/S2215-0366(18)30130-5

Chatterjee, S., Davies, M.J., Heller, S., Speight, J., Snoek, F.J., Khunti, K. (2018). Diabetes structured self-management education programmes: a narrative review and current innovations. Lancet Diabetes Endocrinol, 6(2),130-142. doi: 10.1016/S2213-8587(17)30239-5.

Snoek, F.J., Bremmer, M.A., Hermanns, N. (2015). Constructs of depression and distress in diabetes: time for an appraisal. Lancet Diabetes Endocrinol, 3(6), 450-460. doi: 10.1016/S2213-8587(15)00135-7.

Rondags, S.M., de Wit M., Twisk, J.W., Snoek, F.J. (2016). Effectiveness of HypoAware, a Brief Partly Web-Based Psychoeducational Intervention for Adults With Type 1 and Insulin-Treated Type 2 Diabetes and Problematic Hypoglycemia: A Cluster Randomized Controlled Trial. Diabetes Care, 39(12), 2190-2196.

Rondags, S.M., de Wit, M., van Tulder, M.W., Diamant, M., Snoek, F.J. (2015). HypoAware-a brief and partly web-based psycho-educational group intervention for adults with type 1 and insulin-treated type 2 diabetes and problematic hypoglycaemia: design of a cost-effectiveness randomised controlled trial. BMC Endocr Disord, 15, 43. doi: 10.1186/s12902-015-0035-0.

Rondags, S.M., de Wit, M., Snoek, F.J. (2016). HypoAware: development and pilot study of a brief and partly web-based psychoeducational group intervention for adults with Type 1 and insulin-treated Type 2 diabetes and problematic hypoglycaemia. Diabet Med, 33(2), 184-91. doi: 10.1111/dme.12876.

van Vugt, M., de Wit, M., Sieverink, F., Roelofsen, Y., Hendriks, S.H., Bilo, H.J., Snoek, F.J. (2016). Uptake and Effects of the e-Vita Personal Health Record with Self-Management Support and Coaching, for Type 2 Diabetes Patients Treated in Primary Care. J Diabetes Res, 2016, 5027356. doi: 10.1155/2016/5027356.

van Vugt, M., de Wit, M., Cleijne, W.H., Snoek, F.J. (2013). Use of behavioral change techniques in web-based self-management programs for type 2 diabetes patients: systematic review. J Med Internet Res, 15(12), e279. doi: 10.2196/jmir.2800. Review.

van Bastelaar, K.M., Pouwer, F., Cuijpers, P., Riper, H., Twisk, J.W., Snoek, F.J. (2012). Is a severe clinical profile an effect modifier in a Web-based depression treatment for adults with type 1 or type 2 diabetes? Secondary analyses from a randomized controlled trial. J Med Internet Res, 14(1), e2. doi: 10.2196/jmir.1657.

van Bastelaar, K.M., Pouwer, F., Cuijpers, P., Riper, H., Snoek, F.J. (2011). Web-based depression treatment for type 1 and type 2 diabetic patients: a randomized, controlled trial. Diabetes Care, 34(2), 320-5. doi: 10.2337/dc10-1248.

van Bastelaar, K., Cuijpers, P., Pouwer, F., Riper, H., Snoek, F.J. (2011). Development and reach of a web-based cognitive behavioural therapy programme to reduce symptoms of depression and diabetes-specific distress. Patient Educ Couns, 84(1), 49-55. doi: 10.1016/j.pec.2010.06.013. Epub 2010 Jul 8.