Primary‐care patients’ expectations and experiences of online cognitive behavioural therapy for depression: a qualitative study

Beattie, Angela; Shaw, Alison; Kaur, Surinder; Keßler, David

doi:10.1111/j.1369-7625.2008.00531.x

Cited by 165 publications

(202 citation statements)

References 28 publications

Supporting

Mentioning

182

Contrasting

Unclassified

Order By: Relevance

“…In summary, the results indicated that the participants' experiences on the whole were comparable with previous findings within qualitative research of internet-based guided self-help treatment (Beattie, Shaw, Kaur, & Kessler, 2009;Bendelin et al, 2011;Khan, Bower, & Rogers, 2007;Macdonald, Mead, Bower, Richards, & Lovell, 2007). What seemed to be unique in this study was that the smartphone-based treatment felt more accessible and present in the participants' everyday lives.…”

Section: Resultssupporting

confidence: 78%

Use of a Smartphone Application in the Treatment of Depression : The New Wave of Digital Tools in Psychological Treatment

Ly¹

2015

View full text Add to dashboard Cite

Internet-delivered programs based on cognitive behavior therapy (CBT) have during the past decade shown to work in an effective way for the treatment of depression. Due to its accessibility and independence of time and location, smartphone-based CBT might represent the next generation of digital interventions. Depression is an affective disorder that affects as many as 350 million people worldwide. However, with CBT, depression can be treated, but access to this treatment is scarce due to limited health care resources and trained therapists. As a result of this, health care could highly benefit from the use of smartphones for delivering cost-effective treatment that can be made available to a large part of the population who suffer from depression. One treatment that should be especially suitable for the smartphone format is behavioral activation (BA), since it has strong empirical support as well as the benefits of being flexible and rather simple.The overall aim of the thesis was to test and further develop a BA smartphone application, as well as to build a method for how this smartphone application could be used in a comprehensive and effective way in depression treatment. To fulfill this aim, four studies were conducted.Study I was a pilot study of the first version of the smartphone application, investigating how 11 participants experienced an intervention on a smartphone platform. The results showed initial implications that participants receiving the smartphone application used it in contexts where it would be difficult to use a traditional internet-based program.In Study II, the intervention was developed as a guided internet-based CBT intervention, but delivered through the smartphone application. The aim was to test the effects of this intervention compared to a smartphone-delivered mindfulness intervention. The results showed 5 large within-group effect sizes for both groups, but no between-group effect sizes. Subgroup analyses revealed a significant difference in favor of the BA program for participants with more severe depression at baseline. Contrary, for the participants with lower initial severity, the mindfulness program was significantly more effective than the BA program.Study III was an extension of the second study, using a qualitative approach investigating 12 participants' experiences of the intervention. One of the main findings was that the smartphone format seemed to be a portable and flexible way of accessing the treatment -and thus could be more present in everyday life.In Study IV, a blended treatment, using the BA smartphone application as an adjunct to four face-to-face sessions, was developed and tested against 10 face-to-face sessions. The results yielded large within-group effect sizes and no between-group effect sizes. This result is a preliminary indication that the number of face-to-face sessions can be reduced with the adjunct of a smartphone application.

show abstract

Section: Resultssupporting

confidence: 78%

Use of a Smartphone Application in the Treatment of Depression : The New Wave of Digital Tools in Psychological Treatment

Ly¹

2015

View full text Add to dashboard Cite

show abstract

“…Most papers originated in Europe (n = 18, including 11 in the UK), followed by the USA (n = 7), Canada (n = 3) and Australia (n = 1). The evidence base addressed a wide range of conditions, some of them relevant to the Healthlines study, particularly depression, 98,99 hypertension 100 and online counselling. 101 We identified three themes from these papers -perceived access, care and symptom management and technologies -and then focused on the question of which professionals or agencies should deliver services, as this was of particular interest to the Healthlines study in terms of designing the subsequent RCT.…”

Section: Resultsmentioning

confidence: 99%

“…97,[102][103][104] Rural patients with moderate depression perceived an improvement in access from using telehealth. 99 Patients reported advantages of online interventions for mental health and behavioural problems, including convenience, access and anonymity, 98,99 but these were often balanced by concerns about lack of closeness and therapist trust, privacy and confidentiality fears and lack of visual cues. Patients shown a video of a Home Telecare Management System were positive, mentioning perceived benefits of less travel time and fewer medical visits, but there were some concerns about whether or not it could be used by some patients with disabilities.…”

Section: Perceived Accessmentioning

confidence: 99%

An evidence-based approach to the use of telehealth in long-term health conditions: development of an intervention and evaluation through pragmatic randomised controlled trials in patients with depression or raised cardiovascular risk

Salisbury

O’Cathain

Thomas

et al. 2017

Programme Grants Appl Res

View full text Add to dashboard Cite

BackgroundHealth services internationally are exploring the potential of telehealth to support the management of the growing number of people with long-term conditions (LTCs).AimTo develop, implement and evaluate new care programmes for patients with LTCs, focusing on two common LTCs as exemplars: depression or high cardiovascular disease (CVD) risk.MethodsDevelopmentWe synthesised quantitative and qualitative evidence on the effectiveness of telehealth for LTCs, conducted a qualitative study based on interviews with patients and staff and undertook a postal survey to explore which patients are interested in different forms of telehealth. Based on these studies we developed a conceptual model [TElehealth in CHronic disease (TECH) model] as a framework for the development and evaluation of the Healthlines Service for patients with LTCs.ImplementationThe Healthlines Service consisted of regular telephone calls to participants from health information advisors, supporting them to make behaviour change and to use tailored online resources. Advisors sought to optimise participants’ medication and to improve adherence.EvaluationThe Healthlines Service was evaluated with linked pragmatic randomised controlled trials comparing the Healthlines Service plus usual care with usual care alone, with nested process and economic evaluations. Participants were adults with depression or raised CVD risk recruited from 43 general practices in three areas of England. The primary outcome was response to treatment and the secondary outcomes included anxiety (depression trial), individual risk factors (CVD risk trial), self-management skills, medication adherence, perceptions of support, access to health care and satisfaction with treatment.Trial resultsDepression trialIn total, 609 participants were randomised and the retention rate was 86%. Response to treatment [Patient Health Questionnaire 9-items (PHQ-9) reduction of ≥ 5 points and score of < 10 after 4 months] was higher in the intervention group (27%, 68/255) than in the control group (19%, 50/270) [odds ratio 1.7, 95% confidence interval (CI) 1.1 to 2.5;p = 0.02]. Anxiety also improved. Intervention participants reported better access to health support, greater satisfaction with treatment and small improvements in self-management, but not improved medication adherence.CVD risk trialIn total, 641 participants were randomised and the retention rate was 91%. Response to treatment (maintenance of/reduction in QRISK®2 score after 12 months) was higher in the intervention group (50%, 148/295) than in the control group (43%, 124/291), which does not exclude a null effect (odds ratio 1.3, 95% CI 1.0 to 1.9;p = 0.08). The intervention was associated with small improvements in blood pressure and weight, but not smoking or cholesterol. Intervention participants were more likely to adhere to medication, reported better access to health support and greater satisfaction with treatment, but few improvements in self-management.The Healthlines Service was likely to be cost-effective for CVD risk, particularly if the benefits are sustained, but not for depression. The intervention was implemented largely as planned, although initial delays and later disruption to delivery because of the closure of NHS Direct may have adversely affected participant engagement.ConclusionThe Healthlines Service, designed using an evidence-based conceptual model, provided modest health benefits and participants valued the better access to care and extra support provided. This service was cost-effective for CVD risk but not depression. These findings of small benefits at extra cost are consistent with previous pragmatic research on the implementation of comprehensive telehealth programmes for LTCs.Trial registrationCurrent Controlled Trials ISRCTN14172341 (depression trial) and ISRCTN27508731 (CVD risk trial).FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

show abstract

“…Further, PRPs' concerns regarding limitations of not being able to personalise the content of the intervention are consistent with wider research [14]. Moreover, the lack of personal interaction with an e-therapist has been highlighted [22], with participants reporting difficulties developing a relationship with an etherapist online in the absence of face-to-face contact [23]. However, the inclusion of a video call at the beginning of the intervention may overcome these concerns.…”

Section: Process Evaluationmentioning

confidence: 89%

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

Wikman¹,

Kukkola²,

Börjesson³

et al. 2017

Preprint

View full text Add to dashboard Cite

show abstract

Primary‐care patients’ expectations and experiences of online cognitive behavioural therapy for depression: a qualitative study

Cited by 165 publications

References 28 publications

Use of a Smartphone Application in the Treatment of Depression : The New Wave of Digital Tools in Psychological Treatment

Use of a Smartphone Application in the Treatment of Depression : The New Wave of Digital Tools in Psychological Treatment

An evidence-based approach to the use of telehealth in long-term health conditions: development of an intervention and evaluation through pragmatic randomised controlled trials in patients with depression or raised cardiovascular risk

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

Contact Info

Product

Resources

About