Article

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

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.

Download full-text

Full-text

Available from: Gerhard Andersson
  • Source
    • "Using qualitative research as a way of investigating how participants themselves apprehend and use Internet interventions is an important issue, as it could help identify the advantages and disadvantages of the treatment format (Bendelin et al., 2011), and distinguish factors that might increase adherence and decrease the number of drop-outs (Rozental et al., 2014a). Prior investigations have, for instance, found that Internet interventions could benefit from tailoring the frequency and type of feedback to the needs and characteristics of the specific participant (Svartvatten et al., 2015), the use of reminders and motivational prompts to help increase compliance (Donkin and Glozier, 2012), the provision of an intuitive and more interactive interface (Beattie et al., 2009), and the adaption of texts and procedures to account for individual differences in reading comprehension and computer skill (Gerhards et al., 2011). "

    Full-text · Dataset · Dec 2015
    • "However, most of this research has been carried out from a quantitative standpoint, and has thus provided limited in-depth understanding for the differences. The few qualitative studies that do exist show far more complex differences, such as clients experiencing the same aspect in treatment in completely different ways (Bendelin et al., 2011; Olsson Halmetoja, Malmquist, Carlbring, & Andersson , 2014). This study aims to fill some of the abovementioned knowledge gaps. "
    [Show abstract] [Hide abstract]
    ABSTRACT: This study has explored therapists' experiences of conducting cognitive behavioural therapy (CBT) online and face-to-face. Eleven therapists partook in semi-structured interviews, which were thematically analysed using an abductive approach. The results indicate that the therapists viewed face-to-face therapy as a stronger experience than Internet-based CBT (ICBT), and the latter as being more manualised, but providing more work-time control. Several participants also thought that working alliance may be achieved faster and more easily in face-to-face therapy, and might worsen with fewer modalities of communication. Clinical implications in need of investigation are whether working with ICBT might buffer therapist exhaustion, and whether this therapy form can be improved by becoming less manual dependant in order to be easier to individualise.
    No preview · Article · Jun 2015 · Cognitive behaviour therapy
  • Source
    • "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.
    Full-text · Article · Jun 2015 · Behavior Therapy
Show more