Patients’ experiences of a computerised self-help program for treating depression – a qualitative study of Internet mediated cognitive behavioural therapy in primary care

Abstract

Objective: The objective of this study was to explore primary care patients’ experiences of Internet mediated cognitive behavioural therapy (iCBT) depression treatment. Design: Qualitative study. Data were collected from focus group discussions and individual interviews. Setting: Primary care. Method: Data were analysed by systematic text condensation by Malterud. Subjects: Thirteen patients having received iCBT for depression within the PRIM-NET study. Main outcome measures: Analysis presented different aspects of patients’ experiences of iCBT. Results: The informants described a need for face-to-face meetings with a therapist. A therapist who performed check-ups and supported the iCBT process seemed important. iCBT implies that a responsibility for the treatment is taken by the patient, and some patients felt left alone, while others felt well and secure. This was a way to work in privacy and freedom with a smoothly working technology although there was a lack of confidence and a feeling of risk regarding iCBT. Conclusion: iCBT is an attractive alternative to some patients with depression in primary care, but not to all. An individual treatment design seems to be preferred, and elements of iCBT could be included as a complement when treating depression in primary care. Such a procedure could relieve the overall treatment burden of depression.Key points Internet mediated cognitive behavioural therapy (iCBT) can be effective in treating depression in primary care, but patients’ experiences of iCBT are rarely studied • Most patients express a need for human contact, real-time interaction, dialogue and guidance when treated for depression. • The patient’s opportunity to influence the practical circumstances about iCBT is a success factor, though this freedom brings a large responsibility upon the receiver. • An individual treatment design seems to be crucial, and elements of iCBT could be included as a complement to face-to-face meetings.

Keywords

• Depression
• primary care
• Internet based treatment
• iCBT
• qualitative research
• focus groups
• general practice
• Sweden