Accepted for/Published in: JMIR Formative Research
Date Submitted: Jan 24, 2023
Date Accepted: Mar 6, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Barriers and facilitators to a blended cognitive behavioral therapy (bCBT) program for depression and anxiety based on experiences of university students: A qualitative study
ABSTRACT
Background:
Blended cognitive behavioral therapy (bCBT) programs have been proposed to increase the acceptance and adoption of digital therapeutics (DTx) such as digital health apps. These programs allow for more personalized care by combining regular face-to-face therapy sessions with DTx. However, facilitators and barriers to the usage of DTx in bCBT programs have yet rarely been examined. In this study, we focused on university students as they are likely to develop mental disorders.
Objective:
The aim of this study was to evaluate facilitators and barriers to the usage of the elona therapy app among university students with mild to moderate depression or anxiety symptoms for the use in bCBT.
Methods:
Semi-structured interviews were conducted via videoconference between January and April 2022 with N = 102 students from universities in North Rhine-Westphalia, Germany, after they had completed weekly individual CBT sessions (25 minutes each) via videoconference for six weeks and regularly used the depression (n = 67) or anxiety (n = 35) module of the app. Interviews were coded using grounded theory.
Results:
Most participants stated that they benefited from using the app in the bCBT program. Many highlighted the intuitive handling of the app and indicated that they perceived it as a supportive tool between sessions. Participants listed other benefits, e. g., increased self-reflection and disorder-specific knowledge as well as the transfer of the content of therapy sessions into their daily life. Some stated that they would have benefited from more personalized and interactive tasks. In general, participants mentioned the time requirement, increased usage of the smartphone and the feeling of being left alone with potentially arising emotions while working on tasks for the next therapy session as possible barriers to the usage of the app.
Conclusions:
Students had mostly positive attitudes toward elona therapy as part of the bCBT program. Our study shows that DTx complementing face-to-face therapy sessions can be perceived as helpful tools to accompany university students with mild to moderate anxiety or depression symptoms in their daily life. Clinical Trial: Not applicable
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