A Solution-Focused Research Approach to Achieve an Implementable Revolution in Digital Mental Health

A Solution-Focused Research Approach to Achieve an Implementable Revolution in Digital Mental Health Digital mental health (DMH) interventions have promised to revolutionize mental health care by increasing its accessibility, availability, attractiveness, and costeffectiveness.The first generation of web-based DMH interventions have consistently been found to be clinically effective for common mental disorders, such as depression and anxiety, in more than 100 randomized clinical trials (RCTs) and meta-analyses, particularly when accompanied by low-intensity coaching. 1Inspired by this research, numerous health care systems have attempted to implement DMH interventions to address the large burden of mental health.However, these realworld implementation efforts have failed, often because they are not used by patients or therapists.This large research to practice gap suggests failures at many points, including DMH intervention design, research methods, and implementation approaches.The promised revolution in mental health will require a paradigm shift that addresses all 3 components to overcome the design, research, and routine care chasms.In this Viewpoint, we propose addressing this research to practice gap by shifting to a solutionfocused research approach. 2A solution-focused approach differs from an efficacy approach by prioritizing the development of a solution to a practical problem over the production of generalizable efficacy knowledge that might be correct in abstract but does not represent or translate to any specific real-world setting.We will more likely be successful if we produce a sustainable solution in a real-world setting and then adapt to other contexts.We suggest that solution-focused research can achieve its goals more rapidly by progressing through the 3 stages of create, trial, and sustain 3 rather than the traditional phases of discovery, pilot, efficacy, and effectiveness that are more familiar to clinical scientists.