Patient experience of supported computerized CBT in an inner-city IAPT service: a qualitative study

Perera-Delcourt, Ramesh; Sharkey, Gemma

doi:10.1017/s1754470x18000284

Cited by 9 publications

(29 citation statements)

References 53 publications

(140 reference statements)

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“…Studies have examined the question of online therapeutic alliances using standardized measures such as the Working Alliance Inventory (Horvath and Greenberg, 1989), along with qualitative studies of therapist emails, or interviews with clients. These studies have shown that clients can and do report strong working alliances with their therapist (Andersson et al, 2012b;Hadjistavropoulos et al, 2017;Kiluk et al, 2014;Knaevelsrud and Maercker, 2007;Perera-Delcourt and Sharkey, 2019;Schneider et al, 2016), and that these are in line with the strength of those reported for face-to-face interventions (Andersson et al, 2012b; Knaevelsrud and Maercker, 2007). Providing questionnaire feedback (i.e.…”

Section: Commonly Held Beliefsmentioning

confidence: 84%

IAPT and the internet: the current and future role of therapist-guided internet interventions within routine care settings

Thew

2020

tCBT

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Compared with the traditional face-to-face format, therapist-guided internet interventions offer a different approach to supporting clients in learning skills to manage and overcome mental health difficulties. Such interventions are already in use within IAPT (Improving Access to Psychological Therapies) and other routine care settings, but given their potential to deliver treatment more efficiently and therefore increase availability and access to evidence-based interventions, their use is likely to increase significantly over the coming years. This article outlines what is meant by therapist-guided internet interventions and why an online format is thought to be advantageous for clients, therapists, services, and communities more broadly. It reviews the current evidence in the context of common therapist beliefs about internet-based treatment. It aims to identify gaps where further research is required, particularly in relation to the broader implementation of these treatments in IAPT and other routine clinical services. Specifically, it emphasises the importance of choosing the right programmes, providing adequate therapist training in their use, and considering practical and organisational issues, all of which are likely to determine the success of implementation efforts. Key learning aims (1) To understand what therapist-guided internet interventions are and their potential advantages. (2) To understand the current evidence base for these interventions. (3) To learn where further research is needed with regard to both the interventions themselves, and to their broader implementation in IAPT.

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Section: Commonly Held Beliefsmentioning

confidence: 84%

IAPT and the internet: the current and future role of therapist-guided internet interventions within routine care settings

Thew

2020

tCBT

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“…Helpful aspects of online interventions reported by clients include the provision of information, learning therapeutic skills and techniques, autonomy and flexibility, and therapist support [7,16,21,46,51,61]. These features lead to experiences of feeling supported, validated, reassured, relieved and empowered, and more pragmatic experiences of gaining self-awareness and insight, behavioural change and crucially, seeing an improvement in mood or a reduction in symptoms [7,16,36,46,51]. The convenience, accessibility and flexibility of online treatment is particularly significant when compared with traditional face-to-face therapies, which consist of structured, time-bound appointments [49].…”

Section: Experience Of Online Therapymentioning

confidence: 99%

“…Unhelpful aspects of treatment identified in the literature include program content that is not tailored to individual needs, technical accessibility or usability issues, privacy concerns, the amount of work involved and inadequate support or generic therapist feedback [7,16,46,51,54,76]. These factors lead to experiences of frustration, irritation, isolation, confusion, feeling under pressure, self-criticism and increased anxiety or low mood.…”

Section: Experience Of Online Therapymentioning

confidence: 99%

“…Another area of relevance to the client's experience of online therapy, as with technology, is their expectations. The one crucial expectation that has been shown to mediate outcomes and adherence to treatment is the expectation that the treatment will be effective [9,17,46,49]. A reason for this could be that high expectations lead to early engagement and uptake, a factor linked to more persistent adherence [62].…”

Section: Expectations Of Online Therapymentioning

confidence: 99%

“…Despite the body of research presented here, researchers have called for further in-depth qualitative exploration of client experiences of online therapy [34,38,46,57,67] as there are still a number of gaps in our understanding of this unique setting. One area that has not been explored in the data is how client experiences and expectations change over time.…”

Section: A Gap In Our Knowledgementioning

confidence: 99%

See 2 more Smart Citations

The Experience of Guided Online Therapy: A Longitudinal, Qualitative Analysis of Client Feedback in a Naturalistic RCT

Jardine

Earley

Richards

et al. 2020

Proceedings of the 2020 CHI Conference on Human Factors in Computing Systems

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Internet-delivered Cognitive Behavioural Therapy (iCBT) is an effective treatment for depression and anxiety disorders. However longitudinal qualitative research into the client's subjective experience of this form of treatment 'in the wild' is relatively scarce. We present an analysis of secondary outcomes in a naturalistic RCT conducted within the UK's Improving Access to Psychological Therapies programme. We evaluated clients' expectations, experience, and context of usage of iCBT, across three timepoints. Results are discussed in terms of the creation of a therapeutic space online, the impact of hope, expectations and personal factors on the therapeutic experience, iCBT as "therapy on the go" and developing skills for life. While iCBT on the whole provides a positive, supportive and therapeutic experience for clients, the study identified managing expectations, polarized preferences, momentary help-seeking and longterm support as important aspects of the experience to consider in future design.

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Service users experience of psychological interventions in primary care settings: A qualitative meta‐synthesis

Finazzi

MacBeth

2021

Clin Psychology and Psychoth

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Primary care mental health services play a crucial role in public mental health by providing local and accessible psychological interventions that meet individuals' needs. Despite growing research investigating service users' perspectives of psychological interventions, a qualitative systematic review in this context is not available. The present meta-synthesis collates the existing articles and gives a thematic synthesis of qualitative studies on service users' experience of psychological interventions in primary care. Multiple databases (CINAHL, EMBASE, PsychINFO, MEDLINE, and Cochrane Library) were searched for published qualitative studies of service users' experiences of psychological interventions delivered in primary care. Articles were included if they met inclusion criteria. Study quality was assessed using the Critical Appraisal Skills Programme tool. All types of psychological interventions were considered across model and delivery format (e.g., face-to-face, computerised programmes, and group). NVIVO was used to code the dataset and themes were extracted following thematic synthesis. Twenty-two studies were included. Four analytical themes and 10 subthemes emerged. The identified themes were as follows: (1) 'Access and Acceptability: facilitators and barriers', (2) 'Structural aspects'; (3) 'Therapeutic process' and (4) 'Outcomes'. A model of interrelationships between themes is proposed. Findings suggest several 'essential ingredients' across psychological interventions and modalities. The crucial role of relational factors, the importance of assessing service users' perceptions of treatment features (e.g., remote delivery) and of tailoring the intervention to their needs were emphasised. Results also suggest involving service users more in discussions and decisions about psychological interventions offered might enhance access, acceptability, and engagement. Recommendations for practice and research are provided.

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Patient experience of supported computerized CBT in an inner-city IAPT service: a qualitative study

Cited by 9 publications

References 53 publications

IAPT and the internet: the current and future role of therapist-guided internet interventions within routine care settings

IAPT and the internet: the current and future role of therapist-guided internet interventions within routine care settings

The Experience of Guided Online Therapy: A Longitudinal, Qualitative Analysis of Client Feedback in a Naturalistic RCT

Service users experience of psychological interventions in primary care settings: A qualitative meta‐synthesis

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