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Title: Service users' experience of computerised cognitive behavioural therapy : an interpretative phenomenological study
Author: Facer, April L.
Awarding Body: University of East London
Current Institution: University of East London
Date of Award: 2011
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Background: Computerised Cognitive Behavioural Therapy (CCBT) is used within the NHS to treat anxiety and mild to moderate depression. Research has quantitatively demonstrated the efficacy of CCBT but has neglected to examine its use from patients' perspectives or the processes which contribute to success in practice. Therefore this study aimed to qualitatively explore users' subjective experience of CCBT. This was contrasted with Therapist-led CBT (TCBT) to gain understanding through evaluation of similarities and differences. Method: Semi-structured interviews were conducted with eight participants who had received CCBT and eight TCBT, within a Primary Care Psychological Therapy Service. These were analysed using Interpretative Phenomenological Analysis (IPA). Results: Findings demonstrate participants perceive CCBT as insufficient in delivering CBT techniques without therapeutic interaction and interpersonal elements. The lack of these had a severely disabling effect upon 'Engagement' and 'Deep-Processing', which emerged as superordinate themes. Areas described as lacking in CCBT and in contrast enhanced engagement in TCBT included characteristics of a therapeutic relationship, e.g. being heard, therapist qualities, acceptance and empathic genuine feedback which promoted expectations and motivation. Deep-Processing was reliant upon engagement and encompassed utilisation of specific CBT techniques, through emotional exposure, personalisation and agency. This led to deeper understanding, meaningful processing, significant cognitive change and development of self-efficacy for the future. Conclusions: The limitations of CCBT highlights a disparity between current CCBT research and users views, whilst confirming the role of non-specific factors in therapeutic interventions. This suggests the necessity for critical appraisal of the evidence-base. Future research recommendations include incorporating and integrating qualitative and mixed-method research with empiricallysupported research paradigms, to ensure patient's experience, views and expectations are considered and practice-based process research also informs clinical practice.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Coun.Psych.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available