Efficacy of Therapist Guided Internet Based Cognitive Behavioural Therapy for Depression: A Qualitative Exploration of Therapists and Clients Experiences

Abstract

Depression is an incapacitating mood disorder that is present among 20 million Pakistanis. About 3.4% of annual deaths in Pakistan are due to depression. CBT has been proven a successful treatment module for depression in Pakistan. However, whether individual therapist-guided internet-based Cognitive Behavioral Therapy (iCBT) practiced widely during the pandemic COVID-19 has been effective remains unclear. It was during this time that the educational institutions and government hospitals of Pakistan widely experienced tele-psychotherapy. Therefore, to generate evidence on the efficacy of iCBT and to maximize the benefits of adopting it, the present study was carried out. Semi-structured interviews were conducted from N=10 participants (5=Therapists, 5=Clients) experiencing iCBT via Zoom. The data was coded using NVivo software version 12 pro. An inductive approach to thematic analysis was used to form meaningful themes and subthemes. Analysis resulted into two major themes – (1) Similarities in Perspective of Therapists & Clients, consisting of three subthemes: (a) Clinical Efficacy of iCBT, (b) Ease of Use & Perceived Usefulness of iCBT, and (c) Additional Therapist Support & Extra-Therapeutic Influence; (2) Differences in Perspective of Therapists & Clients, consisting of two subthemes (a) Therapy Environment (b) Structure of Therapy. It was concluded that individual therapist-guided iCBT was experienced as effective by both therapists and clients. It was suggested that large scale experimental studies on iCBT be carried out in future to quantitatively test the efficacy of iCBT. The perceived benefits attached with tele-practice must be maximized to reduce disease burden and fill mental health treatment gap.