Experiences of guided Internet-based cognitive-behavioral treatment for depression: A qualitative study

Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
BMC Psychiatry (Impact Factor: 2.24). 06/2011; 11(107):107. DOI: 10.1186/1471-244X-11-107
Source: PubMed

ABSTRACT Internet-based self-help treatment with minimal therapist contact has been shown to have an effect in treating various conditions. The objective of this study was to explore participants' views of Internet administrated guided self-help treatment for depression.
In-depth interviews were conducted with 12 strategically selected participants and qualitative methods with components of both thematic analysis and grounded theory were used in the analyses.
Three distinct change processes relating to how participants worked with the treatment material emerged which were categorized as (a) Readers, (b) Strivers, and (c) Doers. These processes dealt with attitudes towards treatment, views on motivational aspects of the treatment, and perceptions of consequences of the treatment.
We conclude that the findings correspond with existing theoretical models of face-to-face psychotherapy within qualitative process research. Persons who take responsibility for the treatment and also attribute success to themselves appear to benefit more. Motivation is a crucial aspect of guided self-help in the treatment of depression.

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Available from: Gerhard Andersson, Aug 28, 2015
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    • "In contrast, a minority would have preferred counselling. Other studies of cCBT have also found that some users want more personal assistance (Bendelin et al., 2011; Lillevoll et al., 2013; MacGregor, Hayward, Peck, & Wilkes, 2009). Together these studies highlight that cCBT is not the same as face-to-face therapy, that cCBT is appealing to many, but not to all, and that individual treatment preferences are important. "
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    ABSTRACT: Background Computerised cognitive behavioural therapy (cCBT) has the potential to increase access to therapy for underserved groups. We aimed to explore the views of adolescents attending alternative education (AE) programmes who participated in a trial of immediate compared with delayed cCBT (SPARX).Methods Semi-structured interviews and brief satisfaction questionnaires were completed post-cCBT (n = 39, 24 male, 15 Māori, 12 Pacific Island, 30 with Children's Depression Rating Scale scores indicating symptoms of depression, all 13–16 years old). Interview findings were analysed using a general inductive analysis.ResultsThose with and those without symptoms had similar views. Most reported they completed all seven levels of cCBT and experienced it as helpful and fun. Most considered that cCBT had benefited them, primarily in terms of increased calmness or reduced anger and fighting. Participants described cCBT as different from counselling, with cCBT seen as freeing and empowering although potentially less responsive to personal needs. Most considered that cCBT might increase help-seeking and thought it should be offered to all their peers as targeting individuals would not succeed and all would benefit.Conclusions Educationally alienated adolescents considered cCBT beneficial and thought it should be offered universally in AE and similar programmes. SPARX youtube video:
    Clinical Psychologist 02/2015; DOI:10.1111/cp.12052 · 0.43 Impact Factor
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    • "The analysis of the participants' accounts of the treatment sixth months after the treatment yielded three distinct themes, with a couple of sub-themes related to each theme. The results indicate that the participants' experiences on the whole are comparable with previous findings within qualitative research of internet-based guided self-help treatment (Bendelin et al., 2011; Beattie et al., 2009; Khan et al., 2007; MacDonald et al., 2007). What seems to be unique to the experience of this study's participants is that the smartphone-based treatment felt more accessible and present in their everyday life, something that has been suggested earlier (Ly et al., 2012, 2014; Palmier-Claus et al., 2013). "
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    ABSTRACT: Recently, a number of studies have investigated treatments administered via smartphones showing that this treatment format have a potential to be effective. However, we still have limited knowledge of how patients experience this treatment format. The objective of this study was to explore participants' views of a smartphone-based behavioral activation treatment. In-depth interviews were conducted with 12 strategically (participants with different overall experiences) selected participants, suffering from major depression according to the DSM-IV. The interview data were processed with the aid of thematic analysis. The analysis generated the three main themes: Commitment, Treatment and Lack of important components, with attached subthemes. In conclusion, the findings from the current study correspond with existing knowledge in the field of internet-based treatment. Considering that this kind of treatment is still quite new, the need for further research and development is considerable. Nevertheless, its availability, assimilation into users' everyday lives and possible motivational qualities speak to its potential.
    12/2014; 151(1). DOI:10.1016/j.invent.2014.12.002
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    • "Knowledge of the expectations, experiences, and attitudes of those involved in the therapeutic process is very important if this new form of treatment is to be implemented successfully. To date, research on these issues has been restricted to the perspective of the patient [32-35] without adequately addressing the perspectives of health officials who would be involved in recommending this type of intervention. Interestingly, these professionals show greater resistance to the use of this kind of intervention than the patients themselves do. "
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    ABSTRACT: Background In the year 2020, depression will cause the second highest amount of disability worldwide. One quarter of the population will suffer from depression symptoms at some point in their lives. Mental health services in Western countries are overburdened. Therefore, cost-effective interventions that do not involve mental health services, such as online psychotherapy programs, have been proposed. These programs demonstrate satisfactory outcomes, but the completion rate for patients is low. Health professionals’ attitudes towards this type of psychotherapy are more negative than the attitudes of depressed patients themselves. The aim of this study is to describe the profile of depressed patients who would benefit most from online psychotherapy and to identify expectations, experiences, and attitudes about online psychotherapy among both patients and health professionals that can facilitate or hinder its effects. Methods A parallel qualitative design will be used in a randomised controlled trial on the efficiency of online psychotherapeutic treatment for depression. Through interviews and focus groups, the experiences of treated patients, their reasons for abandoning the program, the expectations of untreated patients, and the attitudes of health professionals will be examined. Questions will be asked about training in new technologies, opinions of online psychotherapy, adjustment to therapy within the daily routine, the virtual and anonymous relationship with the therapist, the process of online communication, information necessary to make progress in therapy, process of working with the program, motivations and attitudes about treatment, expected consequences, normalisation of this type of therapy in primary care, changes in the physician-patient relationship, and resources and risks. A thematic content analysis from the grounded theory for interviews and an analysis of the discursive positions of participants based on the sociological model for focus groups will be performed. Discussion Knowledge of the expectations, experiences, and attitudes of both patients and medical personnel regarding online interventions for depression can facilitate the implementation of this new psychotherapeutic tool. This qualitative investigation will provide thorough knowledge of the perceptions, beliefs, and values of patients and clinicians, which will be very useful for understanding how to implement this intervention method for depression.
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