Qualitative meta-synthesis of user experience of computerised therapy for depression and anxiety

Objective: Computerised therapies play an integral role in efforts to improve access to psychological treatment for patients with depression and anxiety. However, despite recognised problems with uptake, there has been a lack of investigation into the barriers and facilitators of engagement. We aime...

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Main Authors: Knowles, Sarah, Toms, Gill, Sanders, Caroline, Bee, Penny, Lovell, Karina, Rennick-Egglestone, Stefan, Coyle, David, Kennedy, Catriona M., Littlewood, Elizabeth, Kessler, David, Gilbody, Simon, Bower, Peter
Format: Article
Published: Public Library of Science 2014
Online Access:https://eprints.nottingham.ac.uk/37395/
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author Knowles, Sarah
Toms, Gill
Sanders, Caroline
Bee, Penny
Lovell, Karina
Rennick-Egglestone, Stefan
Coyle, David
Kennedy, Catriona M.
Littlewood, Elizabeth
Kessler, David
Gilbody, Simon
Bower, Peter
author_facet Knowles, Sarah
Toms, Gill
Sanders, Caroline
Bee, Penny
Lovell, Karina
Rennick-Egglestone, Stefan
Coyle, David
Kennedy, Catriona M.
Littlewood, Elizabeth
Kessler, David
Gilbody, Simon
Bower, Peter
author_sort Knowles, Sarah
building Nottingham Research Data Repository
collection Online Access
description Objective: Computerised therapies play an integral role in efforts to improve access to psychological treatment for patients with depression and anxiety. However, despite recognised problems with uptake, there has been a lack of investigation into the barriers and facilitators of engagement. We aimed to systematically review and synthesise findings from qualitative studies of computerised therapies, in order to identify factors impacting on engagement. Method: Systematic review and meta-synthesis of qualitative studies of user experiences of computer delivered therapy for depression and/or anxiety. Results: 8 studies were included in the review. All except one were of desktop based cognitive behavioural treatments. Black and minority ethnic and older participants were underrepresented, and only one study addressed users with a comorbid physical health problem. Through synthesis, we identified two key overarching concepts, regarding the need for treatments to be sensitive to the individual, and the dialectal nature of user experience, with different degrees of support and anonymity experienced as both positive and negative. We propose that these factors can be conceptually understood as the ‘non-specific’ or ‘common’ factors of computerised therapy, analogous to but distinct from the common factors of traditional face-to-face therapies. Conclusion: Experience of computerised therapy could be improved through personalisation and sensitisation of content to individual users, recognising the need for users to experience a sense of ‘self’ in the treatment which is currently absent. Exploiting the common factors of computerised therapy, through enhancing perceived connection and collaboration, could offer a way of reconciling tensions due to the dialectal nature of user experience. Future research should explore whether the findings are generalisable to other patient groups, to other delivery formats (such as mobile technology) and other treatment modalities beyond cognitive behaviour therapy. The proposed model could aid the development of enhancements to current packages to improve uptake and support engagement.
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spelling nottingham-373952020-05-04T16:41:38Z https://eprints.nottingham.ac.uk/37395/ Qualitative meta-synthesis of user experience of computerised therapy for depression and anxiety Knowles, Sarah Toms, Gill Sanders, Caroline Bee, Penny Lovell, Karina Rennick-Egglestone, Stefan Coyle, David Kennedy, Catriona M. Littlewood, Elizabeth Kessler, David Gilbody, Simon Bower, Peter Objective: Computerised therapies play an integral role in efforts to improve access to psychological treatment for patients with depression and anxiety. However, despite recognised problems with uptake, there has been a lack of investigation into the barriers and facilitators of engagement. We aimed to systematically review and synthesise findings from qualitative studies of computerised therapies, in order to identify factors impacting on engagement. Method: Systematic review and meta-synthesis of qualitative studies of user experiences of computer delivered therapy for depression and/or anxiety. Results: 8 studies were included in the review. All except one were of desktop based cognitive behavioural treatments. Black and minority ethnic and older participants were underrepresented, and only one study addressed users with a comorbid physical health problem. Through synthesis, we identified two key overarching concepts, regarding the need for treatments to be sensitive to the individual, and the dialectal nature of user experience, with different degrees of support and anonymity experienced as both positive and negative. We propose that these factors can be conceptually understood as the ‘non-specific’ or ‘common’ factors of computerised therapy, analogous to but distinct from the common factors of traditional face-to-face therapies. Conclusion: Experience of computerised therapy could be improved through personalisation and sensitisation of content to individual users, recognising the need for users to experience a sense of ‘self’ in the treatment which is currently absent. Exploiting the common factors of computerised therapy, through enhancing perceived connection and collaboration, could offer a way of reconciling tensions due to the dialectal nature of user experience. Future research should explore whether the findings are generalisable to other patient groups, to other delivery formats (such as mobile technology) and other treatment modalities beyond cognitive behaviour therapy. The proposed model could aid the development of enhancements to current packages to improve uptake and support engagement. Public Library of Science 2014-01-17 Article PeerReviewed Knowles, Sarah, Toms, Gill, Sanders, Caroline, Bee, Penny, Lovell, Karina, Rennick-Egglestone, Stefan, Coyle, David, Kennedy, Catriona M., Littlewood, Elizabeth, Kessler, David, Gilbody, Simon and Bower, Peter (2014) Qualitative meta-synthesis of user experience of computerised therapy for depression and anxiety. PLoS ONE, 9 (1). e84323/1-e84323/12. ISSN 1932-6203 http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0084323 doi:10.1371/journal.pone.0084323 doi:10.1371/journal.pone.0084323
spellingShingle Knowles, Sarah
Toms, Gill
Sanders, Caroline
Bee, Penny
Lovell, Karina
Rennick-Egglestone, Stefan
Coyle, David
Kennedy, Catriona M.
Littlewood, Elizabeth
Kessler, David
Gilbody, Simon
Bower, Peter
Qualitative meta-synthesis of user experience of computerised therapy for depression and anxiety
title Qualitative meta-synthesis of user experience of computerised therapy for depression and anxiety
title_full Qualitative meta-synthesis of user experience of computerised therapy for depression and anxiety
title_fullStr Qualitative meta-synthesis of user experience of computerised therapy for depression and anxiety
title_full_unstemmed Qualitative meta-synthesis of user experience of computerised therapy for depression and anxiety
title_short Qualitative meta-synthesis of user experience of computerised therapy for depression and anxiety
title_sort qualitative meta-synthesis of user experience of computerised therapy for depression and anxiety
url https://eprints.nottingham.ac.uk/37395/
https://eprints.nottingham.ac.uk/37395/
https://eprints.nottingham.ac.uk/37395/