Internet-based cognitive behavioral therapy for anxiety in an outpatient specialized care setting: A qualitative study of the patients' experience of the therapy

Scand J Psychol. 2020 Dec;61(6):846-854. doi: 10.1111/sjop.12665. Epub 2020 Jul 23.

Abstract

Knowledge about user experiences of internet-based cognitive behavioral therapy (iCBT) has mostly been drawn from non-clinical groups or with iCBT offered via self-referral. The present study therefore focused on patients who had undergone iCBT with minimal support while actively awaiting outpatient psychological treatment in the form of face-to-face CBT. To seek out barriers to adherence the study also included patients who had withdrawn from the iCBT treatment before completion. The study was performed in an outpatient clinic for anxiety disorders where twelve participants with a primary diagnosis of either social anxiety disorder or panic disorder were recruited from an ongoing randomized control trial for semi-structured interviews. Statements from the interviews showed that the iCBT treatment was unfavorably compared to the usual face-to-face treatment at the clinic. Despite this, a majority of the interview participants still expressed to have experienced various benefits from the treatment. Some participants did however, experience difficulties putting the materials to practical use. Furthermore, a large majority of the participants expressed a need for additional support, with a strong tendency for non-completers specifically expressing a need for face-to-face contact with a clinician. Implications for future research and implementation of iCBT in clinical practice are discussed.

Keywords: Anxiety; ICBT; Internet; Patient experience; clinical setting; internet-based cognitive behavioral therapy.

MeSH terms

  • Adult
  • Anxiety Disorders / therapy*
  • Cognitive Behavioral Therapy*
  • Female
  • Humans
  • Internet-Based Intervention*
  • Male
  • Middle Aged
  • Outpatients*
  • Patient Satisfaction*
  • Qualitative Research