Dropping out of a transdiagnostic online intervention: A qualitative analysis of client's experiences

Abstract

IntroductionAn important concern in Internet-based treatments (IBTs) for emotional disorders is the high dropout rate from these protocols. Although dropout rates are usually reported in research studies, very few studies qualitatively explore the experiences of patients who drop out of IBTs. Examining the experiences of these clients may help to find ways to tackle this problem.MethodA Consensual Qualitative Research study was applied in 10 intentionally-selected patients who dropped out of a transdiagnostic IBT.Results22 categories were identified within 6 domains. Among the clients an undeniable pattern arose regarding the insufficient support due to the absence of a therapist and the lack of specificity of the contents to their own problems.ConclusionsThe analyzed content has direct impact on the clinical application of IBTs. A more tailored manage of expectations as well as strategies to enhance the therapeutic relationship in certain clients are identified as the two key elements in order to improve the dropout in IBTs. Going further, in the mid and long run, ideographic interventions would be vital. The present study permits to better grasp the phenomenon of dropout in IBTs and delineate specific implications both in terms of research, training and practice.

Predictors of treatment outcomes and adherence in internet-based cognitive behavioral therapy for social anxiety in China

“…Meanwhile, some researchers have adopted qualitative methods to obtain detailed and individual feedback from participants in order to gain a more thorough understanding of participants' experience. For example, insufficient support due to the absence of a therapist and the lack of specificity of the contents to one's own problems were identified as two common reasons for drop-out of a transdiagnostic online intervention (Fernandez-Alvarez et al, 2017). Studies exploring motivations to persist with ICBT suggest offering supporting conditions such as enhancing a sense of control and autonomy and building identification with and trust in the programme (Donkin and Glozier, 2012; Wilhelmsen et al, 2013).…”

The Feasibility of Using Guided Self-Help in Anorexia Nervosa: An Analysis of Drop-Out From the Study Protocol and Intervention Adherence

“…This is particularly relevant for mental illnesses that are difficult to identify, for which access to specialized services is challenging and that are marked by high levels of stigmatization and shame. At the same time, concerns have been raised regarding the high dropout rates from online interventions (on average 31%) among people with psychological disorders (Melville et al, 2010) and recent studies have highlighted the need for more research on patient individual factors associated with drop-out (Fernández-Álvarez et al, 2017). The aim of this paper is to examine dropout from a novel online guided self-help intervention in anorexia nervosa.…”

Impact and change of attitudes toward Internet interventions within a randomized controlled trial on individuals with depression symptoms

“…None of the existing studies have investigated whether and how attitudes (emotional and cognitive factors that refer to Internet interventions in general) moderate the intensity of program usage or even treatment response. Although a number of qualitative oriented studies have been conducted on people's perceptions of Internet interventions (Fernández-Álvarez et al, 2017;Knowles et al, 2014;Lillevoll et al, 2013;Rennick-Egglestone et al, 2016), the findings have not been sufficiently transferred to quantitative research in this field, yet. Although a number of qualitative oriented studies have been conducted on people's perceptions of Internet interventions (Fernández-Álvarez et al, 2017;Knowles et al, 2014;Lillevoll et al, 2013;Rennick-Egglestone et al, 2016), the findings have not been sufficiently transferred to quantitative research in this field, yet.…”

“…This question deserves more research attention because attitudes are an important outcome predictor in the context of psychotherapy and antidepressant medication treatment (Greenberg, Constantino, & Bruce, 2006;Moradveisi, Huibers, Renner, & Arntz, 2014). Although a number of qualitative oriented studies have been conducted on people's perceptions of Internet interventions (Fernández-Álvarez et al, 2017;Knowles et al, 2014;Lillevoll et al, 2013;Rennick-Egglestone et al, 2016), the findings have not been sufficiently transferred to quantitative research in this field, yet. Only results of one study among healthcare professionals and laypersons indicated that individuals who had personal experiences with Internet interventions were more positively inclined toward such interventions than participants without these experiences (Gun, Titov, & Andrews, 2011).…”