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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    • "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). "

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    • "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. "
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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. "
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