Article

Experiences of guided Internet-based cognitive-behavioural 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: 2.23). 06/2011; 11:107. 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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    ABSTRACT: Background Internet-administered cognitive behavioural therapy (iCBT) is an effective treatment of depression, yet much remains to be learned about the specific mechanisms influencing symptom reduction. Although previous research has consistently shown that therapist guided iCBT is more effective than unguided iCBT, it is unknown whether the medium used for therapist-client communication has an impact on results. Methods Thirty-eight subjects with major depression were recruited from the waiting-list of another iCBT study and randomised to a guided iCBT program with therapist guidance either by telephone calls (n = 19) or e-mail correspondence (n = 19). Outcome measures were self-rated measures of depression, anxiety and quality of life. Results At post-treatment, both groups showed significant and large symptom reductions yet did not differ from each other. Neither was there any between-group difference in client-rated therapeutic alliance or treatment engagement. Symptom reductions were maintained at a three-month follow-up. Conclusion Therapist guidance by telephone does not appear to differ from therapist guidance by e-mail in iCBT for depression, although further research featuring larger samples is necessary to draw more definite conclusions. Trial registration: None
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