Therapeutic Content: What Healthcare Needs to Strive For

I firmly believe health content holds the power to drive health behavior change, enhance patient outcomes, and significantly influence a healthcare organization's capacity to provide quality care. The current state of research, however, fails to explore the potential impact of health content, leaving critical gaps in our understanding.

Unfortunately, most people aren’t sure if and how much health content actually affects their or other people’s health behaviors. And researchers don’t know either because, to date, they’ve simply never asked that question. Two decades ago, researchers Akerkar and Bichile found that 81% of patients use search engines to seek health information, but only about 25% of patients check the source and timeliness of the information they seek (1). While other studies have been published to evaluate the relationship between health literacy and the ability to identify quality information online, surprisingly, no studies have evaluated the effects of health literacy, specifically of digital content, on patient outcomes (2).?

Most healthcare organizations are aware that content as a form of communication, together with patient health literacy, has the potential to play a significant role in clinical outcomes. But I am convinced that how content is designed, written, and delivered matters, too. Health content can promote illness (it could be pathogenic), promote health and wellness (it could be therapeutic), or stand somewhere in between, not having much of an effect on peoples’ health at all.?

Content is arguably the most common form of communication between healthcare providers and patients, even after one-on-one communication during appointments. It’s a way to collect information from, and deliver information to, patients, and includes:

• Intake forms
• Patient portals
• Surveys
• Pamphlets
• Blogs
• Informative videos
• Microcontent delivered through apps
• Website copy
• Marketing campaign elements
• Training curriculums for healthcare providers

Additionally, a commonly overlooked category of content are the written and visual tools used by healthcare companies to assist, train, and inform providers and streamline processes. So, if content is everywhere, and healthcare providers are consistently communicating with a range of people in a variety of indirect ways, how can healthcare providers ensure that the communication is effective and transformative? The answer lies in creating therapeutic content.?

By expanding one’s understanding of health content, and exploring what therapeutic content is, who it’s for, and how it differs from standard content, healthcare providers can begin to implement it into their care models to solve their biggest problems.?

What is Therapeutic Content??

Note: Ideated along with Tim Frie ; edited by Kahryn Pedroza

Therapeutic content is written, visual, and audible content that embodies, supports, and equips the patient care experience. It is present in each stage of the care process, from informing patients about the existence of the company and its unique care delivery model, to patient intake, patient follow-up, and behavior change support.?

Therapeutic content is a form of therapeutic communication where the process of receiving, interpreting, and understanding the content is affirming and empowering to the audience; often, this is an entirely new experience for patients who have chronically received inadequate care. Therapeutic content, like any therapeutic process, is designed to maximize engagement, so that it has the potential to engage and promote sustainable, realistic health behavior change in the individual.

Therapeutic content lives under the umbrella of therapeutic communication. Therapeutic communication has traditionally referred to verbal and non-verbal communication that takes place in-person between patient and provider (3). In general, the function is to improve health and wellness in real time or in the time following the interaction as a result of what was said, what was shared, and the way it was shared. A healthcare professional who communicates therapeutically is one whose spoken language, body language, expressions, and written communication honors the whole person and contributes to their physical, mental, and emotional health.?

However, as we’ve learned more about the complex ways in which people receive information and have the potential to apply it to modify behaviors, communication in healthcare extends far beyond in person-communication. These indirect forms of communication include multimedia content, surveys, questionnaires, and courses patients receive before and between appointments, as well as the content utilized to train, update, and assist health professionals.?

Thus, it is vital that we begin to widen our perception of what therapeutic communication is.?

Therapeutic content is one form of therapeutic communication. It is represented by a multimedia product, such as writing, design and art, video, photography, and audible resources.

To help understand what makes therapeutic content embody, support, and act as part of the care process, we’ve proposed seven principles of therapeutic content and communication.?

7 Principles of Therapeutic Content and Communication

1. Inclusivity

Therapeutic content reflects and respects the diverse audience base, their needs, goals, culture, and language. By nature, inclusive content should embody accessibility, anti-oppressiveness, trauma-informed care, cultural responsiveness, and empathy and it should be salutogenic and evidence-informed.?

2. Cohesiveness

Therapeutic content is in line with the existing care process, and each piece of content should build on each other. It should share the same key messages and embody inclusive language, and it should be delivered at the right time to the right people.?

More often than not, healthcare companies have a multitude of messages, tones, and voices being used with patients across different communication platforms. Even if providers are trauma-informed and culturally empathetic, patients can feel confused or cheated if they take home information from the healthcare provider that re-traumatizes them and perpetuates cultural stereotypes.??

The script can flip as well - the multimedia communication of a digital healthcare company could embody the elements of inclusive content, but if the healthcare providers do not embody those same elements in their communication, patients will likely avoid engaging with their healthcare process.?

3. Consistency

All forms of multimedia communication, to be used internally and externally within the cycle of care, are part of the healthcare services’ care content.?

Patients will quickly notice a disconnect if they have an interaction with a healthcare provider who is promoting weight loss and then receive a newsletter from the healthcare company touting body inclusivity and Health at Every Size (HAES). For content to be therapeutic, inclusive language and outlooks need to be adopted by patient-facing healthcare providers and employees who impact the patient experience.?

Consistency in communication positively affects the relationship between the patient and the provider and the patient and the healthcare organization. When a patient receives consistent messaging across communication platforms that embody values that respect and empower them, patients have greater trust in the provider and organization, they feel more satisfied with the care they receive, they have a clear understanding of their diagnosis and treatment plan, have better treatment adherence, and ultimately support continuity of care (4, 5, 6).?

4. Resonance

In the context of communication, resonance is when the message a person is receiving reflects their beliefs, values, thoughts, and experience. For content to be therapeutic, it should resonate with the intended audience.?

To fully understand the concept of resonance in content, think back to the last time you watched an interview, listened to a podcast, or read an article that made you think, “Yes, this is exactly what I’ve been saying!”, or “Wow, I’ve never felt so seen!”, that is a piece of content that resonates with you.?

For therapeutic content to embody resonance, it must reflect lived experiences, which requires the content developers to have a comprehensive, intersectional understanding of privilege, oppression, social determinants of health, discrimination, language, and cultural agility.?

In addition, for therapeutic content to resonate it should intend for the patient to feel empowered to make decisions that are right for them.?

5. Purpose

Content for content's sake has no place in the therapeutic process. Each piece of therapeutic content should have a clear and concrete objective for improving patients’ health and wellbeing.?

Some examples of objectives for therapeutic content include:?

• A trauma-informed intake form effectively translated into multiple languages that has the objective of respectfully collecting information from the patient that allows the healthcare organization and provider to identify the patient and offer personalized care.?
• A blog article integrated into a website with top-notch accessibility features written for a neurodivergent audience with the objective of providing them tools and scripts for advocating for their sensory needs.?
• A checklist for physicians to use during follow-up appointments with the objective of facilitating the implementation of therapeutic verbal and non-verbal communication techniques.?

Content that is repetitive or simply re-written to garner better SEO scoring and with no clear purpose to improve patients’ wellbeing is not therapeutic content.

6. Usefulness

Therapeutic content should be grounded in day-to-day practices and activities. For educational materials, the usefulness can be increased by integrating examples, scenarios, and clear avenues of application. Meanwhile,tools and questionnaires should be useful to the health organization. And trainings and CMEs should provide concrete takeaways and avenues of application to healthcare professionals to provide better care.?

7. Activation?

Activation is, in many ways, the result of the previous six principles being applied effectively. Therapeutic content should lift up patients when they interact with it, remedying a state of anger or disillusion, improving their sense of self-efficacy.?

No matter how well health content is written, recorded, or designed, if the audience has low health literacy, the usefulness of the content will be limited and the objectives will not be met. Little by little, therapeutic content, together with therapeutic verbal and non-verbal communication from the health provider, builds health literacy, so that the next piece of health content the patient interacts with is a little bit easier to understand and evaluate.??

How Does Therapeutic Content Differ from Standard Content??

More often than not, health content and content used in the cycle of care (or eHealth content as it was originally referred to in the digital health space), is not therapeutic.?

The purpose of standard health content is two-fold:?

1. To inform the audience about topics related to disease and illness, biomedical interventions, and lifestyle factors that influence health outcomesStandard views of health content do not consider content utilized within the health system or content utilized to support, educate and inform physicians.?
2. To promote the healthcare organizationContent is published either directly or indirectly, utilizing standard content marketing techniques.?

While standard health content tends to prioritize evidence-based biomedical research, it often takes the research at face value. While the aim is often to be direct and use simple language, there is often a risk of over-simplifying research and disregarding the diverse human experience of health and wellness.?

Standard health content tends to focus on individual choice, habits, and behaviors, without acknowledging the impact that social determinants of health and the development of health conditions and how factors such as language and discrimination impact the care experience.

Additionally, standard health content delivery prioritizes marketing measures of reach and clicks to determine? effectiveness, without giving much, if any, thought to its impact on patient engagement or health outcomes in the intended populations.??

At best, standard health content has a neutral impact on health outcomes, as people read and understand the content, but may not be sure if and how it relates to them.? Neutral health content does not put a patient in motion to work towards better health behaviors but leaves them unsure of what the right next step is within their health journey. At worst, standard health content can be pathogenic; it can inadvertently dissuade the audience from receiving or continuing care and treatment, or make the audience feel shame, sadness, or anger.?

Therapeutic content, on the other hand, is designed by content creators who are highly aware of:?

• Biomedical research and patient experiences
• Potential bias in biomedical research
• The importance of implementing marketing principles to promote web-based content, but not allowing the content to be corrupted by profit over people’s experience?
• The harm of sensationalizing or over-simplifying research outcomes?
• The importance of acknowledging nuance in healthcare experiences
• The multiple platforms and levels in which patients interact with content throughout the care experience
• How multidisciplinary approaches to healthcare improve health outcomes for patients?
• How language and health literacy are barriers to accessing quality care
• How cultural humility and agility must be embedded in communication?
• The importance of centering lived experiences when writing about, or for, different audiences?
• Its potential to engage patients in their care process, and garner interest in their health and wellness?
• Information delivery methods that maximize accessibility?

Ultimately, therapeutic content is that which is designed to have a positive and sustainable impact on outcomes of health and wellbeing.?

Even though, as far as I know, we at #CloveHealth are the first to utilize the term “therapeutic content” in this context, many health communicators and providers are well aware of the potential positive impact content can have on health outcomes when it is written and delivered effectively. Check out Clove Health's post on the #ContentImpactContinuum that discusses how therapeutic content and pathogenic content can be imagined on a continuum:.: https://www.dhirubhai.net/feed/update/urn:li:activity:7046161042053185537

Takeaway

Therapeutic content represents a transformative approach to patient care by going beyond the conventional educational and informational content typically found in healthcare settings. By adhering to the seven principles of therapeutic content and communication – inclusivity, cohesiveness, consistency, resonance, purpose, pragmatism, and activation – content creators can develop materials that truly resonate with patients, fostering an environment that is affirming and empowering.

Adopting therapeutic content within the healthcare ecosystem can revolutionize the patient experience, bridging the gap between medical professionals and patients, and facilitating more meaningful and supportive relationships. As a crucial component of the cycle of care, therapeutic content can help alleviate the challenges faced by patients who have often been subjected to inadequate and even harmful care, while simultaneously providing invaluable resources to healthcare providers.

By recognizing and embracing the power of therapeutic content, healthcare providers, educators, and content creators can work together to foster a more compassionate, understanding, and effective healthcare environment. This collaborative effort will ultimately lead to improved patient outcomes, increased satisfaction among both patients and healthcare providers, and a more well-rounded, holistic, and sustainable approach to healthcare that truly meets the needs of all involved.

As a final note, consider: Is the health content that you produce or consume contributing to healing or harm?

References

1. Akerkar, S.M., Bichile, L.S. (2004). Health information on the internet: patient empowerment or patient deceit?. Indian Journal of Medical Sciences, 58(8), 321–326. https://pubmed.ncbi.nlm.nih.gov/15345885/?

2. Diviani, N., van den Putte, B., Giani, S., van Weert J.C. (2015). Low Health Literacy and Evaluation of Online Health Information: A Systematic Review of the Literature. Journal of Medical Internet Research, 7(5), e112.? https://doi.org/10.2196/jmir.4018?

3. Sharma, N. (2023). Therapeutic Communication. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK567775/

4. U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. (2007). Patient-Centered Communication in Cancer Care:? Promoting Healing and Reducing Suffering. https://cancercontrol.cancer.gov/sites/default/files/2020-06/pcc_monograph.pdf

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10. Xiao, H., Zhang, Y., Kong, D., Li, S., & Yang, N. (2020). The Effects of Social Support on Sleep Quality of Medical Staff Treating Patients with Coronavirus Disease 2019 (COVID-19) in January and February 2020 in China. Medical science monitor : International Medical Journal of Experimental and Clinical Research, 26, e923549. https://doi.org/10.12659/MSM.923549

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