Patients’ experiences of a computerised self-help program for treating depression – a qualitative study of Internet mediated cognitive behavioural therapy in primary care

Abstract

ObjectiveThe objective of this study was to explore primary care patients’ experiences of Internet mediated cognitive behavioural therapy (iCBT) depression treatment.DesignQualitative study. Data were collected from focus group discussions and individual interviews.SettingPrimary care.MethodData were analysed by systematic text condensation by Malterud.SubjectsThirteen patients having received iCBT for depression within the PRIM-NET study.Main outcome measuresAnalysis presented different aspects of patients’ experiences of iCBT.ResultsThe informants described a need for face-to-face meetings with a therapist. A therapist who performed check-ups and supported the iCBT process seemed important. iCBT implies that a responsibility for the treatment is taken by the patient, and some patients felt left alone, while others felt well and secure. This was a way to work in privacy and freedom with a smoothly working technology although there was a lack of confidence and a feeling of risk regarding iCBT.ConclusioniCBT is an attractive alternative to some patients with depression in primary care, but not to all. An individual treatment design seems to be preferred, and elements of iCBT could be included as a complement when treating depression in primary care. Such a procedure could relieve the overall treatment burden of depression.Key pointsInternet mediated cognitive behavioural therapy (iCBT) can be effective in treating depression in primary care, but patients’ experiences of iCBT are rarely studied Most patients express a need for human contact, real-time interaction, dialogue and guidance when treated for depression.The patient’s opportunity to influence the practical circumstances about iCBT is a success factor, though this freedom brings a large responsibility upon the receiver.An individual treatment design seems to be crucial, and elements of iCBT could be included as a complement to face-to-face meetings.

Participants’ experiences of an Internet-based cognitive behavioural therapy intervention for tinnitus

“…Participants mentioned a range of both beneficial and difficult experiences while undertaking the intervention. Diverse experiences have also been reported regarding ICBT for depression (Holst et al 2017). In the present study, participants found the intervention beneficial in terms of ease of access, privacy, weekly input and the flexibility to do it at home.…”

“…Some of these factors have been identified before (Andersson and Titov 2014;Beattie et al 2009). Holst et al (2017) and Malmberg et al (2018) also reported that participants valued being able to revisit materials, the flexibility the intervention offers and having ease of access to information. One unique finding from the present study that has not been emphasised in prior research is that some that some individuals find attending clinics or hospitals stressful.…”

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

“…Previous studies have found that participants’ need for prior information has not been matched by what they received, and has made recommendations about how this is presented, including in written, oral or video presentations (Johansson et al , 2015). Study participants generally request more information about the treatment option than they have received (Holst et al , 2017). In this study as in others (Rennick-Egglestone et al ., 2016; Holst et al , 2017), being offered eCBT can actually offend or upset patients, so needs to be handled thoroughly and with clinical sensitivity.…”

Development of an Internet-Administered Cognitive Behavior Therapy Program (ENGAGE) for Parents of Children Previously Treated for Cancer: Participatory Action Research Approach (Preprint)

“…Indeed, the delivery of CBT via video conference is as effective as face-to-face CBT [24], allowing similar communication to that in face-to-face therapy [25]. The inclusion of some form of face-toface contact with an e-therapist may help develop a therapeutic alliance [26]. Further, supported by the wider literature, was the suggestion to enhance the acceptance of the internet-administered intervention, and thus potentially facilitate recruitment, by presenting an informative video about internet-administered CBT to potential participants [27][28][29].…”