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Journal Article

Citation

Richards D, Dowling M, O'Brien E, Viganò N, Timulak L. Counsell. Psychother. Res. J. 2018; 18(1): 35-48.

Copyright

(Copyright © 2018, John Wiley and Sons)

DOI

10.1002/capr.12142

PMID

unavailable

Abstract

OBJECTIVE

The advantages and effectiveness of Internet interventions have been established. Little is known about the critical processes of change in Internet-delivered interventions and of the psychological experience of users. These are both clinically relevant and have a link to the overall outcome of therapy. The goal of this article was to gain an insight into the important therapeutic processes in an 8-week supported online self-administered CBT-based treatment for depression.


Method

Respondents were participants (N = 88) in a randomised controlled trial with an initial score of 14-28 on the Beck Depression Inventory (BDI-II), who completed at least one module of the online intervention, and at least one Helpful Aspects of Therapy (HAT) questionnaire.


Analysis

The HAT data were analysed using descriptive-interpretative qualitative analysis to (i) identify helpful and hindering events, (ii) describe key events and (iii) describe the corresponding impacts of these events on the clients.


Results

In total, six helpful events were reported (provision of information, core CBT activities, mindfulness, platform accessibility and usability, supporter, personal stories and examples) and eight associated impacts (applying new coping skills/behavioural change, awareness and insight, improved well-being, support/validation, expression/relief, self-efficacy/empowerment/sense of achievement, personal connection). In total, five hindering events were identified (platform features/design, external factors, internal factors, supporters' feedback and content of the programme) and five associated impacts (disappointment, frustration/irritation, confusion, mood deterioration and being self-critical/blaming) were reported.


Conclusions

The current results support previous findings that CBT principles are important in online delivery. The role of the supporter emerges as a key ingredient in online delivery worthy of further investigation.


Language: en

Keywords

depression; cognitive behaviour therapy; community sample; Internet-delivered; significant events research

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