JMIR Publications

ABSTRACT

Background:

During the COVID-19 pandemic, both physical and psychological health were at risk. Internet-based cognitive behavioral therapy (ICBT) is a psychological treatment alternative that does not inherently increase the risk of virus transmission, as face-to-face interactions are not required. ICBT has been found to be effective for a variety of mental health problems, both before and during the COVID-19 pandemic. Although the experiences of undergoing ICBT have been investigated in previous studies, the specific experiences of participating in ICBT during the COVID-19 pandemic have been less examined.

Objective:

The aim of this qualitative study was to investigate the experiences of participating in individually tailored ICBT with weekly support by a therapist during the COVID-19 pandemic.

Methods:

We approached trial participants who had received ICBT for psychological symptoms related to the COVID-19 pandemic during the summer of 2020. A strategic sample, based on the number of logins to the platform, among other factors, was selected in an effort to achieve the highest possible variation. Semistructured telephone interviews were conducted four to six months after treatment completion, depending on whether the participant was initially assigned to the treatment or control group. Data were transcribed and then analyzed based on thematic analysis.

Results:

A total of 16 participants, aged between 23 and 78 years, were interviewed. Four main themes and a total of ten subthemes were derived from the thematic analysis: 1. Functions of the treatment (Initiating and motivating, Perspective widening), 2. Treatment equals work (Experience of the treatment as demanding, Going from text to action, Post treatment engagement, The participant agency), 3. Changes experienced (Changes in relation to the COVID-19 pandemic, Other changes not related to the COVID-19 pandemic), 4. Wishing for something else (Individually tailored, Contact with the therapist).

Conclusions:

The results closely align with findings from earlier qualitative studies on experiences of ICBT. Experiences of appreciated content and format of the treatment were identified. Suggestions and wishes for changes were also described in the interviews. However, unique findings indicate that experiences of changes in well-being related to the COVID-19 pandemic were present among the participants. At the same time, there were also reports of changes in other symptoms, not related to the pandemic. Further studies are needed on the experiences of participants who drop out of ICBT and what type of therapist contact they prefer.