The acceptability of computerised cognitive behavioural therapy for the treatment of depression in people with chronic physical disease: a qualitative study of people with multiple sclerosis.
BACKGROUND
People with chronic physical conditions are at elevated risk of depression. Due to a shortage of Cognitive Behavioural Therapy (CBT) practitioners, computerised CBT (CCBT) is recommended for people with mild to moderate depression. We assessed the applicability of CCBT for the treatment of depression in people with multiple sclerosis (MS).


METHODS
Depth interviews with 17 people with MS and mild to moderate depression who used one of the two CCBT packages for either eight (Beating the Blues; n = 8) or five (MoodGym; n = 9) weekly sessions were analysed using 'Framework'.


RESULTS
Participants found CCBT-use burdensome due to their physical symptoms. In addition to perpetuating social isolation, the lack of human input meant some participants were unable to define problems, set goals or distinguish between events, thoughts and beliefs as required. CCBT did not legitimise their grief over losses concomitant with their MS. They characterised depression symptom inventories as contaminated by somatic symptoms of their MS. One CCBT package (MoodGym) was perceived as using inappropriate case material for people with the symptoms of MS.


CONCLUSIONS
It is likely that generic CCBT packages for the treatment of depression will need to be adapted for people with chronic physical conditions to maximise their potential for health benefit.
Hind
Daniel
D
Clinical Trials Research Unit, University of Sheffield, Sheffield S1 4DA, UK. d.hind@sheffield.ac.uk
O'Cathain
Alicia
A
Cooper
Cindy L
CL
Parry
Glenys D
GD
Isaac
Claire L
CL
Rose
Anita
A
Martin
Leonie
L
Sharrack
Basil
B
D000328:Adult; D002908:Chronic Disease / Q000523:psychology*; D015928:Cognitive Behavioral Therapy; D003863:Depression / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000523:psychology*; D010342:Patient Acceptance of Health Care; D013813:Therapy, Computer-Assisted