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: 2.21). 06/2011; 11(107):107. DOI: 10.1186/1471-244X-11-107
Source: PubMed


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, Oct 04, 2015
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    • "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). "
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    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
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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 · 0.93 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.
    Internet Interventions 12/2014; 151(1). DOI:10.1016/j.invent.2014.12.002
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