Another limitiation of the study relates to the poten-
tial bias since two of the involved researc hers had
worked with the treatment trial. We tried t o handle the
bias by involving a researcher with no previous experi-
ence of Internet research and also included a fifth co-
author to handle the possible bias. Moreover, we con-
stantly reflected on the research process and our own
role when coding and interpreting the interviews ,
and were careful ton include not only participants who
were very pleased with the intervention but also persons
who had not improved.
The findings correspond with existing theoretical mod-
els of face-to-face psychotherapy within qualitati ve pro-
cess research. Persons who take responsibility for the
treatment and also attribute success to themselves
appear to benefit more from Internet-based treatment.
Further qualitative research is needed to investigate how
participants experience Internet-based treatment for
other problems than depression. This might not only
cast light upon how Internet based self-help t reatments
work but may also give additional information about the
active ingredients and the mechanism of change in face-
to-face psychotherapy, in particular in relation to com-
mon and specific factors.
This study was supported in part by a grant to the last author from the
“Swedish Science foundation” CHANGE TO Swedish Research Council. The
Swedish Research Council had no role in the study design, data collection,
data analysis, report writing, or the decision to submit the manuscript for
Department of Behavioural Sciences and Learning, Swedish Institute for
Disability Research, Linköping University, Linköping, Sweden.
Psychology, Umeå University, Umeå, Sweden.
Department of Clinical
Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden.
NB, JD and GA conceived of the study and its design. HH and GA worked
with the write-up and reanalyses, and KZN supervised the qualitative
analyses, PC added input on the treatment delivered and all authors read,
commented on and approved of the manuscript.
The authors declare that they have no competing interests.
Received: 15 February 2011 Accepted: 30 June 2011
Published: 30 June 2011
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