Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-26T15:07:56.819Z Has data issue: false hasContentIssue false
  • English
  • Français

A questionnaire-based qualitative study of therapist views on computerized CBT

Published online by Cambridge University Press:  17 August 2016

J. Newton  and
E. C. Sundin
J. Newton
Affiliation:
Division of Psychology, Nottingham Trent University, Nottingham, UK
E. C. Sundin*
Affiliation:
Division of Psychology, Nottingham Trent University, Nottingham, UK
*
*Author for correspondence: Dr E. C. Sundin, Division of Psychology, Nottingham Trent University, Nottingham NG1 4BU, UK (email: [email protected]).
Get access Rights & Permissions [Opens in a new window]

Abstract

Few studies have explored therapists’ views on computerized cognitive behavioural therapy (cCBT) and this study aimed to provide an in-depth understanding of accredited therapists’ views on cCBT's role in treating depression. Twelve therapists constituted this self-selected sample (eight female, four male). Mean age was 52 years (range 46–61). The data obtained from a semi-structured questionnaire were analysed using thematic analysis. Three themes were identified and discussed: (1) the standardized nature of cCBT for depression, (2) the importance of the therapeutic relationship in cCBT, and (3) the pros and cons with cCBT as an alternative to CBT. The therapists in this study emphasized that innovations in CBT delivery formats (e.g. internet-based, computerized) show promise. However, participants expressed some views that clash with the evidence-based viewpoint. More work is needed to improve the implementation of evidence-based practice and policy.

Keywords

Cognitive behavioural therapycCBTdepressionthematic analysistherapist views
Type
Original Research
Information
the Cognitive Behaviour Therapist , Volume 9 , 2016 , e15
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Recommended follow-up reading

Anderson, R, Spence, S, Donovan, C, March, S, Prosser, S, Kenardy, J (2012). Working alliance in online cognitive behavior therapy for anxiety disorders in youth: comparison with clinic delivery and its role in predicting outcome. Journal of Medical Internet Research 14, e88.CrossRefGoogle ScholarPubMed
Ormrod, J, Kennedy, L, Scott, J, Cavanagh, K (2010) Computerised cognitive behavioural therapy in an adult mental health service: a pilot study of outcomes and alliance. Cognitive Behaviour Therapy 39, 188–192.CrossRefGoogle Scholar
Shafran, R, Clark, DM, Fairburn, CG, Arntz, A, Barlow, DH, Ehlers, A, Freeston, M, Garety, PA, Hollon, SD, Ost, LG, Salkovskis, PM, Williams, JM, Wilson, GT (2009). Mind the gap: Improving the dissemination of CBT. Behaviour Research and Therapy 47, 902–909.CrossRefGoogle Scholar
Waller, R, Gilbody, S (2009). Barriers to the uptake of computerized cognitive behavioural therapy: a systematic review of the quantitative and qualitative evidence. Psychological Medicine 39, 705–712.CrossRefGoogle Scholar

References

Anderson, R, Spence, S, Donovan, C, March, S, Prosser, S, Kenardy, J (2012). Working alliance in online cognitive behavior therapy for anxiety disorders in youth: comparison with clinic delivery and its role in predicting outcome. Journal of Medical Internet Research 14, e88.CrossRefGoogle ScholarPubMed
Angermeyer, MC, Matschinger, H, Riedel-Heller, SG (2001). What to do about mental health disorder – help seeking recommendations of the lay public. Acta Psychiatrica Scandinavica 103, 220–225.CrossRefGoogle Scholar
Barazzone, N, Cavanagh, K, Richards, DA (2012). Computerised cognitive behavioural therapy and the therapeutic alliance: a qualitative enquiry. British Journal of Clinical Psychology 51, 396–417.CrossRefGoogle ScholarPubMed
Beattie, A, Shaw, A, Kaur, S, Kessler, D (2009). Primary-care patients' expectations and experiences of online cognitive behavioural therapy for depression: a qualitative study. Health Expectations 12, 45–59.CrossRefGoogle ScholarPubMed
Braun, V, Clarke, V (2006). Using thematic analysis in psychology. Qualitative Research in Psychology 3, 77–101.CrossRefGoogle Scholar
Buchanan, DR (1992). An uneasy alliance: combining qualitative and quantitative research methods. Health Education Quarterly 19, 117–357.CrossRefGoogle ScholarPubMed
Calkins, DR, Davis, RB, Reiley, P, Phillips, RS, Pineo, KL, Delbanco, TL, Iezzoni, LI (1997). Patient-physician communication at hospital discharge and patients' understanding of the postdischarge treatment plan. Archive of Internal Medicine 157, 1026–1030.CrossRefGoogle ScholarPubMed
Christensen, H, Griffiths, KM, Farrer, L (2009). Adherence in internet interventions for anxiety and depression. Journal of Medical Internet Research 11, e13.CrossRefGoogle ScholarPubMed
De Graaf, LE, Gerhards, SAH, Arntz, AR, Riper, H, Metsemakers, JFM, Evers, SMAA, Severens, JL, Widdershoven, G, Huibers, MJH (2009). Clinical effectiveness of online computerized cognitive behavioural therapy without support for depression in primary care: a randomized trial. British Journal of Psychiatry 195, 73–80.CrossRefGoogle Scholar
Department of Health (2007). Improving Access to Psychological Therapies (IAPT) programme: computerised cognitive behavioural therapy implementation guidelines. (http://www.scie-socialcareonline.org.uk)Google Scholar
Du, E, Quayle, E, Macleod, H (2013). Service providers’ perceptions on the uptake of computerised cognitive behavioural therapy (cCBT). Psychology 11, 213–233.Google Scholar
Foroushani, S, Schneider, P, Assareh, N (2011). Meta-review of the effectiveness of computerised CBT in treating depression. BMC Psychiatry 11, 131.CrossRefGoogle ScholarPubMed
Gellatly, J, Bower, P, Hennessy, S, Richards, D, Gilbody, S, Lovell, K (2007). What makes self-help interventions effective in the management of depressive symptoms? Meta-analysis and meta-regression. Psychological Medicine 37, 1217–1228.CrossRefGoogle ScholarPubMed
Gerhards, SAH, Abma, TA, Arntz, A, de Graaf, LE, Evers, SMAA, Huibers, MJH, Widdershoven, GAM (2011). Improving adherence and effectiveness of computerised cognitive behavioural therapy without support for depression: a qualitative study of patient experiences. Journal of Affective Disorders 129, 117–125.CrossRefGoogle ScholarPubMed
Gerhards, SAH, De Graaf, LE, Jacobs, LE, Severens, JL, Huibers, MJH, Arntz, A, Riper, H, Widdershoven, G, Metsemakers, JFM, Evers, SMAA (2010). Economic evaluation of online computerised cognitive-behavioural therapy without support for depression in primary care: randomised trial. British Journal of Psychiatry 196, 310–318.CrossRefGoogle ScholarPubMed
Gilbody, S, Littlewood, E, Hewitt, C, Brierley, G, Tharmanathan, P, Araya, R, Barkham, M, Bower, P, Cooper, C, Gask, L, Kessler, D, Lester, H, Lovell, K, Parry, G, Richards, DA, Andersen, P, Brabyn, S, Knowles, S, Shepherd, C, Tallon, D, White, D (2015). Computerised cognitive behaviour therapy (cCBT) as treatment for depression in primary care (REEACT trial): large scale pragmatic randomised controlled trial. British Medical Journal 351, 351.Google ScholarPubMed
Glaser, BG, Strauss, AL (1967). The discovery of grounded theory. London: Weidenfield and Nicolson.Google Scholar
Golafshani, N (2003). Understanding reliability and validity in qualitative research. The Qualitative Report 8, 597–607.Google Scholar
Graham, AL, Cha, S, Papandonatos, GD, Cobb, NK, Mushro, A, Fang, Y, Niaura, RS, Abrams, DB (2013). Improving adherence to web-based cessation programs: a randomized controlled trial study protocol. Trials 14, 48.CrossRefGoogle ScholarPubMed
Green, KE, Iverson, KM (2009). Computerised cognitive-behavioural therapy in a stepped care model of treatment. Professional Psychology Research and Practice 40, 96–103.CrossRefGoogle Scholar
Griffiths, KM, Christensen, H (2007). Internet-based mental health programs: a powerful tool in the rural medical kit. Australian Journal of Rural Health 15, 81–87.CrossRefGoogle ScholarPubMed
Hefferon, K, Gil-Rodriguez, E (2011). Reflecting on the rise in popularity of interpretive phenomenological analysis. The Psychologist 24, 756–759.Google Scholar
Høifødt, RS, Lillevoll, KR, Griffiths, KM, Wilsgaard, T, Eisemann, M, Waterloo, K, Kolstrup, N (2013). The clinical effectiveness of web-based cognitive behavioral therapy with face-to-face therapist support for depressed primary care patients: randomized controlled trial. Journal of Medical Internet Research 15, e153.CrossRefGoogle ScholarPubMed
IAPT (n.d.). About us (http://www.iapt.nhs.uk/about-iapt). Improving Access to Psychological Therapies. Accessed September 2013.Google Scholar
Kaltenthaler, E, Brazier, J, De Nigris, E, Tumur, I, Ferriter, M, Beverley, C, Parry, G, Rooney, G, Sutcliffe, P (2006). Computerised cognitive behaviour therapy for depression and anxiety update: a systematic review and economic evaluation. Health Technology Assessment 10, 1–186.CrossRefGoogle ScholarPubMed
Kenicer, D, McClay, A, Williams, C (2012). A national survey of health service infrastructure and policy impacts on access to computerised CBT in Scotland. BMC Medical Informatics and Decision Making 12, 102–107.CrossRefGoogle ScholarPubMed
Kenwright, M, Marks, I, Graham, C, Franses, A, Mataix-Cols, D (2005). Brief scheduled phone support from a clinician to enhance computer-aided self-help for obsessive-compulsive disorder: randomized controlled trial. Journal of Clinical Psychiatry 61, 1499–1508.Google ScholarPubMed
Koeser, L, Dobbin, A, Ross, S, McCrone, P (2013). Economic evaluation of audio based resilience training for depression in primary care. Journal of Affective Disorders 149, 307–312.CrossRefGoogle ScholarPubMed
MacLeod, M, Martinez, R, Williams, C (2009). Cognitive Behaviour Therapy self-help: who does it help and what are its drawbacks? Behavioural and Cognitive Psychotherapy 37, 61–72.CrossRefGoogle ScholarPubMed
Makaryus, AN, Friedman, EA (2005). Patients' understanding of their treatment plans and diagnosis at discharge. Mayo Clinic Proceedings 80, 991–994.CrossRefGoogle ScholarPubMed
Marks, IM, Cavanagh, K, Gega, L (2007). Hands on help: computer-aided psychological therapies. London: Maudsley Monograph.CrossRefGoogle Scholar
McHugh, RK, Whitton, SW, Peckham, AD, Welge, JA, Otto, MW (2013). Patient preference for psychological vs pharmacologic treatment for psychiatric disorders; a meta-analytic review. Journal of Clinical Psychiatry 74, 595–602.CrossRefGoogle ScholarPubMed
Melville, KM, Casey, LM, Kavanagh, DJ (2010). Dropout from internet-based treatment for psychological disorders. British Journal of Clinical Psychology 49, 455–471.CrossRefGoogle ScholarPubMed
Meyer, B, Pilkonis, PA, Krupnik, JL, Egan, MK, Simmens, SJ, Sotsky, SM (2002). Treatment expectations, patient alliance, and outcome: further analyses from the national institute of mental health treatment of depression collaborative research programme. Journal of Consulting Clinical Psychology 70, 1051–1055.CrossRefGoogle Scholar
Murray, K, Schmidt, U, Pombo-Carril, MG, Grover, M, Alenya, J, Treasure, J, Williams, C (2007). Does therapist guidance improve uptake, adherence and outcome from a CD-ROM based cognitive-behavioural intervention for the treatment of bulimia nervosa? Computers and Human Behaviour 23, 850–859.CrossRefGoogle Scholar
National Health Service Centre for Reviews and Dissemination (2002). Improving the recognition and management of depression in primary care. Effective Health Care 7, 1–11.Google Scholar
Newman, MG, Szkodny, LE, Llera, SJ, Przeworski, A (2011). A review of technology-assisted self-help and minimal contact therapies for anxiety and depression: is human contact necessary for therapeutic efficacy? Clinical Psychology Review 31, 89–103.CrossRefGoogle Scholar
NICE (2009). Depression in adults: the treatment and management of depression in adults. (https://www.nice.org.uk/guidance/cg90/chapter/1-guidance#footnote_12). National Institute for Health and Care Excellence.Google Scholar
Oliver, MI, Pearson, N, Coe, N, Gunnel, D (2005). Help-seeking behaviour in men and women with common mental health problems: cross-sectional study. British Journal of Psychiatry 186, 297–301.CrossRefGoogle ScholarPubMed
Ormrod, J, Kennedy, L, Scott, J, Cavanagh, K (2010). Computerised cognitive behavioural therapy in an adult mental health service: a study of outcomes and alliance. Cognitive Behaviour Therapy 39, 188–192.CrossRefGoogle Scholar
Palmqvist, B, Carlbring, P, Andersson, G (2007). Internet-delivered treatments with or without therapist input: does the therapist factor have implications for efficacy and cost? Expert Review of Pharmacoeconomics & Outcomes Research 7, 291–297.CrossRefGoogle ScholarPubMed
Pittaway, S, Cupitt, C, Palmer, D, Arowobusoye, N, Milne, R, Holttum, S, Pezet, R, Patrick, H (2009). Comparative, clinical feasibility study of three tools for delivery of cognitive behavioural therapy for mild to moderate depression and anxiety provided on a self-help basis. Mental Health Family Medicine 6, 145–154.Google ScholarPubMed
Powell, J, Hamborg, T, Stallard, N, Burls, A, McSorley, J, Bennett, K, Griffiths, KM, Christensen, H (2012). Effectiveness of a web-based cognitive-behavioral tool to improve mental well-being in the general population: randomized controlled trial. Journal of Medical Internet Research 15, e2.CrossRefGoogle ScholarPubMed
Proudfoot, J, Goldberg, D, Mann, A, Everitt, B, Marks, I, Gray, J (2003a). Computerized, interactive, multimedia cognitive behavioural therapy reduces anxiety and depression in general practice: a randomised controlled trial. Psychological Medicine 33, 217–227.CrossRefGoogle Scholar
Proudfoot, JG (2004). Computer based treatment for anxiety and depression: is it feasible? Is it effective? Neuroscience and Behavioural Reviews 28, 353–363.CrossRefGoogle ScholarPubMed
Proudfoot, JG, Ryden, C, Everitt, B, Shapiro, DA, Goldberg, D, Mann, A, Tylee, A, Marks, I, Gray, J (2004). Clinical efficacy of computerised behavioural therapy for anxiety and depression in primary care. British Journal of Psychiatry 185, 46–54.CrossRefGoogle ScholarPubMed
Proudfoot, JG, Swain, S, Widmer, S, Watkins, E, Goldberg, D, Marks, I, Mann, A, Gray, JA (2003b). The development and beta-test of a computer-therapy program for anxiety and depression: hurdles and lessons. Computers in Human Behaviour 19, 277–289.CrossRefGoogle Scholar
Rhodes, H, Grant, S (2012). A review of computerised cognitive behavioural therapy (cCBT) for depression. Cumbria Partnership Journal of Research Practice and Learning 2, 2–9.Google Scholar
Shafran, R, Clark, DM, Fairburn, CG, Arntz, A, Barlow, DH, Ehlers, A, Freeston, M, Garety, PA, Hollon, SD, Ost, LG, Salkovskis, PM, Williams, JM, Wilson, GT (2009). Mind the gap: improving the dissemination of CBT. Behaviour Research and Therapy 47, 902–909.CrossRefGoogle Scholar
Spek, V, Cuijpers, P, Nyklicek, I, Riper, H, Keyzer, J, Pop, V (2007). Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis. Psychological Medicine 37, 319–328.CrossRefGoogle ScholarPubMed
Titov, N, Andrews, G, Perminder, S (2010). Computer-delivered cognitive behavioural therapy: effective and getting ready for dissemination. Medicine Reports Limited 2, 49–53.Google ScholarPubMed
Waller, R, Gilbody, S (2009). Barriers to the uptake of computerized cognitive behavioural therapy: a systematic review of the quantitative and qualitative evidence. Psychological Medicine 39, 705–712.CrossRefGoogle Scholar
Whitfield, G, Williams, C (2004). If the evidence is so good – why doesn't anyone use them? A national survey of the use of computerized cognitive behaviour therapy. Behavioural and Cognitive Psychotherapy 32, 57–65.CrossRefGoogle Scholar
Wiles, N, Thomas, L, Abel, A, Ridgway, N, Turner, N, Campbell, J, Garland, A, Hollinghurst, S, Jerrom, B, Kessler, D, Kuyken, W, Morrison, J, Turner, K, Williams, C, Peters, T, Lewis, G (2013). Clinical effectiveness and cost-effectiveness of cognitive behavioural therapy as an adjunct to pharmacotherapy for treatment-resistant depression in primary care: the CoBalT randomised controlled trial. Lancet 381, 375–384.CrossRefGoogle Scholar
Wilhelmsen, M, Lillevoll, K, Risør, M, Høifødt, R, Johansen, M, Waterloo, K, Eisemann, M, Kolstrup, N (2013). Motivation to persist with internet-based cognitive behavioural treatment using blended care: a qualitative study. BMC Psychiatry 13, 296–304.CrossRefGoogle ScholarPubMed
Willig, C (2001). Introducing Qualitative Research in Psychology: Adventures in Theory and Method. Buckingham: Open University Press.Google Scholar
Winter, SE, Barber, JP (2013). Should treatment for depression be based more on patient preference? Patient Preference and Adherence 7, 1047–1057.CrossRefGoogle ScholarPubMed
Yardley, L (2000). Dilemmas in qualitative health research. Psychology and Health 15, 215–228.CrossRefGoogle Scholar
Yardley, L (2008). Demonstrating validity in qualitative psychology. In: Qualitative Psychology: A Practical Guide to Methods, 2nd edn (ed. Smith, A.), pp. 235–251). London: Sage.Google Scholar
Yardley, L, Moss-Morris, R (2009). Current issues and new directions in psychology and health: increasing the quantity and quality of health psychology research. Psychology & Health 24, 1–4.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.