TY - JOUR
T1 - Improving adherence and effectiveness of computerised cognitive behavioural therapy without support for depression: a qualitative study on patient experiences
AU - Gerhards, S.A.H.
AU - Abma, T.A.
AU - Arntz, A.
AU - de Graaf, L.E.
AU - Evers, S.M.A.A.
AU - Huibers, M.J.H.
AU - Widdershoven, G.A.M.
PY - 2011/1/1
Y1 - 2011/1/1
N2 - 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.
AB - 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.
U2 - 10.1016/j.jad.2010.09.012
DO - 10.1016/j.jad.2010.09.012
M3 - Article
C2 - 20889214
SN - 0165-0327
VL - 129
SP - 117
EP - 125
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
IS - 1-3
ER -