Improving adherence and effectiveness of computerised cognitive behavioural therapy without support for depression: A qualitative study on patient experiences

S.A.H. Gerhards, T.A. Abma, A. Arntz, L.E. De Graaf, S.M.A.A. Evers, M.J.H. Huibers, G.A.M. Widdershoven

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)117-125
JournalJournal of Affective Disorders
Volume129
Issue number1-3
DOIs
Publication statusPublished - 2011
Externally publishedYes

Bibliographical note

Funding Information:
This qualitative study was an addition to a trial financed by ZonMw (Netherlands Organisation for Health Research and Development; project number 945-04-417), research institute EPP and research institute CAPHRI. Municipalities Eijsden, Meerssen, Sittard-Geleen, Valkenburg and Maastricht sponsored the trial study. The study sponsors had no role in the design of the study; in the collection, analysis, and interpretation of the data; in the writing of the report; and in the decision to submit the article for publication.

Funding

This qualitative study was an addition to a trial financed by ZonMw (Netherlands Organisation for Health Research and Development; project number 945-04-417), research institute EPP and research institute CAPHRI. Municipalities Eijsden, Meerssen, Sittard-Geleen, Valkenburg and Maastricht sponsored the trial study. The study sponsors had no role in the design of the study; in the collection, analysis, and interpretation of the data; in the writing of the report; and in the decision to submit the article for publication.

Keywords

  • Adherence
  • Computerized cognitive behavioural
  • Depression
  • Patient experience
  • Qualitative study
  • Self-help
  • therapy (CCBT)

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