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Open Access 01-10-2018 | Brief Report

Patient Perspectives on Strengths and Challenges of Therapist-Assisted Internet-Delivered Cognitive Behaviour Therapy: Using the Patient Voice to Improve Care

Authors: H. D. Hadjistavropoulos, Y. N. Faller, A. Klatt, M. N. Nugent, B. F. Dear, N. Titov

Published in: Community Mental Health Journal | Issue 7/2018

Abstract

Therapist-assisted internet-delivered cognitive behaviour therapy (T-ICBT) involves patients reading online treatment materials, completing relevant exercises, and receiving therapist support. This study aimed to understand the preferences and recommendations of 225 patients enrolled in a T-ICBT course for depression and anxiety via an online therapy unit in collaboration with community mental health clinics dispersed across one Canadian province. An open-ended survey asked participants their opinions of the course and responses were analyzed using a content analysis approach. Patient comments addressed many strengths of the course (64%), with some opportunities for improvement (36%). Most-appreciated features included ability to download content for future use, reading other patients’ experiences, and content of lessons. Patients made suggestions for improving the breadth of patient stories, timeline of the course, and matching availability of the therapist to patient need. Patient feedback regarding preferences provides valuable information for improving the patient-centered nature of T-ICBT.

Andersson, G., Cuijpers, P., Carlbring, P., Riper, H., & Hedman, E. (2014). Guided Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: A systematic review and meta-analysis. World Psychiatry, 13(3), 288–295. https://doi.org/10.1002/wps.20151.CrossRefPubMedPubMedCentral

Andersson, G., Hesser, H., Veilord, A., Svedling, L., Andersson, F., Sleman, O., … Carlbring, P. (2013). Randomised controlled non-inferiority trial with 3-year follow-up of internet-delivered versus face-to-face group cognitive behavioural therapy for depression. Journal of Affective Disorders, 151(3), 986–994. https://doi.org/10.1016/j.jad.2013.08.022.CrossRefPubMed

Andersson, G., & Titov, N. (2014). Advantages and limitations of Internet-based interventions for common mental disorders. World Psychiatry, 13(1), 4–11. https://doi.org/10.1002/wps.20083.CrossRefPubMedPubMedCentral

Birks, M., Chapman, Y., & Francis, K. (2008). Memoing in qualitative research: Probing data and processes. Journal of Research in Nursing, 13(1), 68–75.CrossRef

Creswell, J. W. (2011). Designing and conducting mixed methods research (2nd edn.). Los Angeles: SAGE.

Dear, B. F., Staples, L. G., Terides, M. D., Karin, E., Zou, J., Johnston, L., … Titov, N. (2015). Transdiagnostic versus disorder-specific and clinician-guided versus self-guided internet-delivered treatment for generalized anxiety disorder and comorbid disorders: A randomized controlled trial. Journal of Anxiety Disorders, 36, 63–77. https://doi.org/10.1016/j.janxdis.2015.09.003.CrossRefPubMed

Eysenbach, G., Rydh, S., Fäldt, J., Khazaal, Y., Hedman, E., Furmark, T., … Andersson, G. (2011). A 5-year follow-up of internet-based cognitive behavior therapy for social anxiety disorder. Journal of Medical Internet Research. https://doi.org/10.2196/jmir.1776.CrossRefPubMedPubMedCentral

Hadjistavropoulos, H. D., Nugent, M. M., Alberts, N. M., Staples, L., Dear, B. F., & Titov, N. (2016). Transdiagnostic Internet-delivered cognitive behaviour therapy in Canada: An open trial comparing results of a specialized online clinic and nonspecialized community clinics. Journal of Anxiety Disorders, 42, 19–29. https://doi.org/10.1016/j.janxdis.2016.05.006.CrossRefPubMed

Hadjistavropoulos, H. D., Nugent, M. M., Dirkse, D., & Pugh, N. (2017). Implementation of internet-delivered cognitive behavior therapy within community mental health clinics: A process evaluation using the consolidated framework for implementation research. BMC Psychiatry. https://doi.org/10.1186/s12888-017-1496-7.CrossRefPubMedPubMedCentral

Hedman, E., Ljótsson, B., & Lindefors, N. (2012). Cognitive behavior therapy via the internet: A systematic review of applications, clinical efficacy and cost–effectiveness. Expert Review of Pharmacoeconomics & Outcomes Research, 12(6), 745–764.CrossRef

Hinyard, L. J., & Kreuter, M. W. (2007). Using narrative communication as a tool for health behavior change: A conceptual, theoretical, and empirical overview. Health Education & Behavior, 34(5), 777–792.CrossRef

Hollon, S. D., Stewart, M. O., & Strunk, D. (2006). Enduring effects for cognitive behavior therapy in the treatment of depression and anxiety. Annual Review of Psychology, 57, 285–315. https://doi.org/10.1146/annurev.psych.57.102904.190044.CrossRefPubMed

Hsieh, H.-F., & Shannon, S. E. (2005). Three approaches to qualitative content analysis. Qualitative Health Research, 15(9), 1277–1288. https://doi.org/10.1177/1049732305276687.CrossRefPubMed

Institute of Medicine Committee on Quality of Health Care in America. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington D.C.: National Academy Press.

Lillevoll, K., Wilhelmsen, M., Kolstrup, N., Hoifodt, R., Waterloo, K., Eisemann, M., & MB, R. (2013). Patients’ experiences of helpfulness in guided Internet-based treatment for depression: Qualitative study of integrated therapeutic dimensions. Journal of Medical Internet Research. https://doi.org/10.2196/jmir.2531.CrossRefPubMedPubMedCentral

Mar, R. A. (2004). The neuropsychology of narrative: Story comprehension, story production and their interrelation. Neuropsychologia, 42(10), 1414–1434. https://doi.org/10.1016/j.neuropsychologia.2003.12.016.CrossRefPubMed

Paxling, B., Almlöv, J., Dahlin, M., Carlbring, P., Breitholtz, E., Eriksson, T., & Andersson, G. (2011). Guided Internet-delivered cognitive behavior therapy for generalized anxiety disorder: A randomized controlled trial. Cognitive Behaviour Therapy, 40(3), 159–173. https://doi.org/10.1080/16506073.2011.576699.CrossRefPubMed

Richards, D., Murphy, T., Viganó, N., Timulak, L., Doherty, G., Sharry, J., & Hayes, C. (2016). Acceptability, satisfaction and perceived efficacy of “Space from Depression” an internet-delivered treatment for depression. Internet Interventions, 5, 12–22. https://doi.org/10.1016/j.invent.2016.06.007.CrossRefPubMedPubMedCentral

Rozental, A., Boettcher, J., Andersson, G., Schmidt, B., & Carlbring, P. (2015). Negative effects of Internet interventions: A qualitative content analysis of patients’ experiences with treatments delivered online. Cognitive Behaviour Therapy. https://doi.org/10.1080/16506073.2015.1008033.CrossRefPubMed

Shafran, R., Clark, D. M., Fairburn, C. G., Arntz, A., Barlow, D. H., Ehlers, A., … Wilson, G. T. (2009). Mind the gap: Improving the dissemination of CBT. Behaviour Research and Therapy, 47(11), 902–909. https://doi.org/10.1016/j.brat.2009.07.003.CrossRefPubMed

Titov, N., Dear, B. F., & Andersson, G. (2014). Internet-delivered psychotherapy for anxiety disorders and depression. Australian and New Zealand Journal of Psychiatry, 49, 299–308.

Titov, N., Dear, B. F., Staples, L. G., Terides, M. D., Karin, E., Sheehan, J., … McEvoy, P. M. (2015). Disorder-specific versus transdiagnostic and clinician-guided versus self-guided treatment for major depressive disorder and comorbid anxiety disorders: A randomized controlled trial. Journal of Anxiety Disorders, 35, 88–102. https://doi.org/10.1016/j.janxdis.2015.08.002.CrossRefPubMed

Urbanoski, K., Inglis, D., & Veldhuizen, S. (2017). Service use and unmet needs for substance use and mental disorders in Canada. The Canadian Journal of Psychiatry, 62(8), 551–559. https://doi.org/10.1177/0706743717714467.CrossRefPubMed

van Belijouw, I., Verhaak, P., Cuijpers, P., van Marwijk, H., & Penninx, B. (2010). The course of untreated anxiety and depression, and determinants of poor one-year outcome: A one-year cohort study. BMC Psychiatry, 10(1), 86. https://doi.org/10.1186/1471-244X-10-86.CrossRef

Title: Patient Perspectives on Strengths and Challenges of Therapist-Assisted Internet-Delivered Cognitive Behaviour Therapy: Using the Patient Voice to Improve Care
Authors: H. D. Hadjistavropoulos
Y. N. Faller
A. Klatt
M. N. Nugent
B. F. Dear
N. Titov
Publication date: 01-10-2018
Publisher: Springer US
Published in: Community Mental Health Journal / Issue 7/2018
Print ISSN: 0010-3853
Electronic ISSN: 1573-2789
DOI: https://doi.org/10.1007/s10597-018-0286-0

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Patient Perspectives on Strengths and Challenges of Therapist-Assisted Internet-Delivered Cognitive Behaviour Therapy: Using the Patient Voice to Improve Care

Abstract

Keynote webinar | Spotlight on sleep in brain health

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