PhD Defence Charlotte van Lotringen | Compassionate Technology - A compass for the design, implementation and evaluation of digital mental health interventions

Compassionate Technology - A compass for the design, implementation and evaluation of digital mental health interventions

Charlotte van Lotringen is a PhD student in the Department of Psychology, Health & Technology. Promotors are prof.dr. M.L. Noordzij, prof.dr. G.J. Westerhof and dr. S.M. Kelders from the Faculty of Behavioural, Management and Social Sciences.

Digital mental health interventions (DMHIs), such as online modules, mobile apps, wearables, and virtual reality, can improve accessibility, personalization, and sustainability of mental healthcare. However, their integration into routine practice remains limited. Mental health professionals often worry that digital tools may undermine the human aspect of care, while clients may experience them as impersonal. These concerns highlight the need for value-driven approaches to digital innovation.

This PhD thesis explores compassion as a guiding compass for the design, implementation, and evaluation of DMHIs. Compassion is conceptualized as recognizing suffering, shared humanity, empathy, tolerance of discomfort, and the motivation to alleviate suffering. As a core value in mental healthcare, compassion offers a promising framework to help align digital technologies with daily practice. The first part of the thesis examines how compassion is addressed in DMHI research, the quality of the therapeutic alliance in digital text-based psychotherapy, and how the values of clients and professionals relate to compassion. Although digital technologies may support compassionate care, compassion is rarely addressed in design or evaluation. This is important, as both clients and professionals value compassion, and professionals may resist technologies perceived as driven by efficiency or cost-saving. The second part of the thesis focuses on practical application. The Compassionate Technology Scale for Professionals (CTS-P) was developed in collaboration with professionals to assess compassion in DMHIs. Moreover, compassion-focused smartwatch implementation materials were co-designed and evaluated. Findings suggest these materials support initial adoption and meaningful use, but sustainable integration requires broader strategies. Overall, compassion offers a value-driven and practical framework for human-centred digital mental healthcare.