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Guided iCBT in Routine Mental Health Care: A Qualitative Interview and Observational Study of Therapists’ Professional Roles
ABSTRACT
Background:
Therapist guided internet-delivered cognitive behavioral therapy (guided iCBT) is increasingly implemented in routine mental health care. While its clinical effectiveness is well established, less is known about how guided iCBT influences mental health care professionals’ work practices and professional roles.
Objective:
This study aimed to explore how mental health care professionals experience and interpret changes in their professional roles when delivering guided iCBT in routine clinical practice.
Methods:
We conducted a qualitative study using semi-structured interviews with 31 healthcare professionals and participatory observations in three Norwegian outpatient clinics in specialized mental health care delivering guided iCBT. Reflexive thematic analysis was used to identify patterns across the dataset.
Results:
The analysis identified two main themes describing how guided iCBT redefines therapeutic work: 1) increased professional agency, including greater control over work schedules, and enhanced autonomy in tailoring digital treatment and 2) expansion of the therapist role, characterized by new functions such as administration (“the administrative therapist”) and encouraging patients to engage with the treatment (“the professional salesperson”). Although therapists reported more flexibility and control in daily practice, guided iCBT simultaneously constrained professional discretion by introducing unanticipated tasks, leading to a transformation of their therapist role.
Conclusions:
Guided iCBT changes professional work practices and role expectations for mental health care professionals. Recognizing and addressing these changes is important for the sustainable implementation of digital mental health services and for supporting professionals as clinical work becomes increasingly digitally mediated.
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Copyright
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