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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"Other possible predictors of face-to-face CBT for OCD, albeit with inconsistent findings, include patient motivation and depression severity (Keeley et al., 2008). In addition, very little research has been conducted on moderators of iGSH treatment formats for any disorder, although patient expectancy variables (e.g., motivation, self-efficacy) have shown some promising results as predictors (Bachofen et al., 1999b; Bendelin et al., 2011; Boettcher, Renneberg, & Berger, 2013). Treatment engagement is perhaps the most robust predictor of CBT for OCD across levels of therapist involvement. "
[Show abstract][Hide abstract] ABSTRACT: Internet-guided self-help (iGSH) has amassed significant empirical support for a variety of psychiatric conditions; however, it is not known who responds best to these treatments. This open trial examined the clinical outcomes and predictors of a 17-week iGSH program for obsessive-compulsive disorder (OCD). Therapist support was provided either in person or by phone 9 times for an average of 13 minutes per session. Twenty-four patients initiated treatment, and 17 of these (70.8%) completed. Results of the intent-to-treat sample indicated statistically significant improvements at posttreatment with large treatment effects for OCD symptoms as assessed by the Yale Brown Obsessive-Compulsive Scale (d = 0.87), and small to moderate improvements in depression (d = 0.19), functioning (d = 0.53), and quality of life (d = -0.18). These outcomes were largely maintained over a 6-month follow-up. Readiness to reduce avoidance of OCD triggers and attendance to therapist sessions were moderately associated with posttreatment response, and correctly classified the responder status (defined as clinically significant change) of nearly 9 out of 10 patients at posttreatment. These same variables did not predict responder status at 6-month follow-up. These results lend further empirical support to iGSH as a treatment for OCD and provide direction on the development of predictor models to identify patients who are and are not likely to acutely respond to iGSH.
"Research examining predictors of treatment support needs will help to tailor support intensity per individual need. This idea is consistent with another qualitative study of internet based treatment for depression that found that different levels of support may be appropriate for individuals at varying stages of change (e.g., action) (Bendelin et al., 2011). "
[Show abstract][Hide abstract] ABSTRACT: Women with postnatal depression (PND) face significant barriers to treatment that may be overcome by internet based delivery of treatment. Demand for a self-help internet postnatal treatment offered via a parenting site was high, but attrition rates were also high. Aims: To gain patient perspectives on engagement and barriers to the Netmums' "Helping with Depression" treatment. Method: Semi-structured interviews were conducted with 17 participants selected from the Netmums trial. Results: Thematic analysis revealed motivators and barriers to treatment. Women reported that the flexibility and anonymity of internet interventions fit with their postnatal circumstances. They identified that the relevance of the intervention to their personal circumstances, expectations of motherhood, stigma about depression and motherhood, hopelessness about their ability to improve, previous negative experiences with treatment and treatment seeking, and a lack of practical and emotional support contributed to feelings of being overwhelmed. Women who felt more overwhelmed were more likely to discontinue treatment. Women suggested that support would reduce the impact of barriers and improve adherence. Discussion: Open access, self-help internet interventions are acceptable to women with postnatal depression, but it is critical to provide tailoring and support to help overcome barriers and improve treatment adherence.
Internet Interventions 03/2015; 2(1):84-90. DOI:10.1016/j.invent.2014.11.003
"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. "
[Show abstract][Hide abstract] 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: