A qualitative exploration of Internet-based treatment for comorbid depression and alcohol misuse

Darvell, Millie J., Kavanagh, David J., & Connolly, Jennifer M. (2015) A qualitative exploration of Internet-based treatment for comorbid depression and alcohol misuse. Internet Interventions, 2(2), pp. 174-182.

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Abstract

Background

Many Internet-based treatments for depression and for alcohol misuse have a positive impact, yet little is known about how these treatments work. Most research on web-based interventions involves efficacy trials which, while important, offer little explanation about how people perceive and use online programs.

Objective

This study aimed to undertake a qualitative exploration of participants' experience, perceived impact and use of an integrated web-based program for comorbid depression and alcohol misuse. Specifically, it explored users' perspectives on the intensity of their treatment and the level of support they received.

Methods

Interviewees were drawn from participants in a randomised controlled trial of the OnTrack web-based treatment for depression and alcohol misuse, which compared Brief Self-Guided, Comprehensive Self-Guided and Comprehensive Therapist-Assisted versions of the program. Twenty-nine people (9–11 from each condition) completed semi-structured telephone interviews asking about their impressions and experiences with the program. Interview transcriptions were subject to a 6-step thematic analysis, employing a conceptual matrix to identify thematic differences across groups.

Results

Positive experiences and outcomes were more pronounced among participants receiving the comprehensive treatments than the brief one, but other responses were relatively consistent across conditions. A major theme was a wish for more individualisation and human contact, even in participants receiving emailed assistance. Some confused follow-up research assessments with therapist support. There was little correspondence between the perceived impact of the program and the amount reportedly completed, and some participants said they used strategies offline or completed exercises mentally.

Conclusions

This study highlighted discrepancies between how web-based treatments are intended to be used and how people actually engage with them. A challenge for the next wave of these interventions is the provision of individualised responses and coaching that retains an emphasis on self-management and constrains cost.

Impact and interest:

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ID Code: 91331
Item Type: Journal Article
Refereed: Yes
Keywords: web-based intervention, internet-based treatment, comorbid depression and alcohol misuse, user's perspective
DOI: 10.1016/j.invent.2015.03.003
ISSN: 2214-7829
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Psychology & Counselling
Copyright Owner: Copyright 2015 Elsevier
Copyright Statement: This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/).
Deposited On: 17 Dec 2015 02:17
Last Modified: 11 Jan 2016 08:59

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