Technology
Systematic meta-synthesis of qualitative studies on consumer and provider perspectives of iCBT for anxiety and depression
Allison Peipert, B.S.
Graduate Student
Indiana University- Bloomington
Bloomington, Indiana
Robinson De Jesús-Romero, M.S.
Graduate Student
Indiana University
Bloomignton, Indiana
Lorenzo Lorenzo-Luaces, Ph.D.
Assistant Professor
Indiana University
Bloomington, Indiana
Internet-based cognitive-behavioral therapy (iCBT) can deliver treatment while circumventing many barriers that exist with face-to-face care. Despite evidence for its efficacy, iCBT use remains rare in most countries. To understand this research-practice gap, we conducted a systematic review and thematic synthesis of qualitative results on consumer and provider perspectives of iCBTs for depression and anxiety. The initial search identified 342 study references across two databases (PubMed and PsychINFO). We reviewed 298 abstracts, read the full text of 80 articles, and included 37 articles for review. Our thematic synthesis yielded 25 themes across 7 categories. The most common themes identified within the included studies were perspectives of the intervention materials, satisfaction with intervention guidance, positive outcomes following iCBT, the need for flexibility, positive appraisals about the interventions, and comments on intervention length, personalization, and necessary motivation. Across articles, consumers noted satisfaction with, acceptability of, and usability of iCBT treatment for depression and anxiety. They also noted a preference for material that is brief, interactive, and personalized to the individual. Providers identified concerns about the suitability of iCBT for specific patients, data security, emergencies, guidelines for training and treatment, and additional implementation barriers. Both groups identified technical issues as a barrier to iCBT use. Though iCBT addresses numerous barriers to accessing traditional face-to-face CBT, there remain barriers to iCBT use, including access to computers, technical issues, and the need for privacy. These perspectives may highlight barriers and facilitators to iCBT use and implementation in clinical settings.