Improving adherence and effectiveness of computerised cognitive behavioural therapy without support for depression: A qualitative study on patient experiences
Background: Several studies have evaluated the efficacy and effectiveness of computerized cognitive behavioural therapy (CCBT) for depression, but research on the patient perspective is limited. Aims: To gain knowledge on patient experiences with the online self-help CCBT program Colour Your Life (CYL) for depression, and find explanations for the low treatment adherence and effectiveness. Method: Qualitative data were collected through semi-structured interviews with 18 patients. Interviewees were selected from a CCBT trial. An inductive, content analysis of the interviews was performed. Results: The main theme throughout the interviews concerns barriers and motivators experienced with CCBT. The most important barriers included experiences of a lack of identification with and applicability of CCBT-CYL, lack of support to adhere with the program or to gain deeper understanding, and inadequate computer/Internet skills, equipment, or location. Confusion between CCBT and Internet questionnaires resulted in no CCBT uptake of some study participants. Motivators included experiencing self-identification and improvement through CCBT-CYL, participating in a scientific study, and the freedom and anonymity associated with online computer self-help. The addition of support to CCBT was suggested as an improvement towards adherence and the course content. Conclusion: The CCBT program CYL in its current form does not work for a large group of people with depressive symptoms. More tailoring, the provision of support (professional or lay) and good computer conditions could improve CCBT.
|Keywords||Adherence, Computerized cognitive behavioural, Depression, Internet, Patient experience, Qualitative study, Self-help, adult, article, clinical article, cognitive therapy, computerized cognitive behavioural therapy, content analysis, depression, female, human, male, motivation, online system, patient compliance, priority journal, qualitative research, semi structured interview, therapy (CCBT)|
|Persistent URL||dx.doi.org/10.1016/j.jad.2010.09.012, hdl.handle.net/1765/23071|
Gerhards, S.A.H., Abma, A., Arntz, A., de Graaf, L.E., Evers, S.M.A.A., Huibers, M.J.H., & Widdershoven, G.A.. (2011). Improving adherence and effectiveness of computerised cognitive behavioural therapy without support for depression: A qualitative study on patient experiences. Journal of Affective Disorders, 129(1-3), 117–125. doi:10.1016/j.jad.2010.09.012