title: 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.
abstract: 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.
authors.affiliation: Clinical Trials Research Unit, University of Sheffield, Sheffield S1 4DA, UK. d.hind@sheffield.ac.uk
authors.forename: Daniel
authors.initials: D
authors.lastname: Hind
authors.forename: Alicia
authors.initials: A
authors.lastname: O'Cathain
authors.forename: Cindy L
authors.initials: CL
authors.lastname: Cooper
authors.forename: Glenys D
authors.initials: GD
authors.lastname: Parry
authors.forename: Claire L
authors.initials: CL
authors.lastname: Isaac
authors.forename: Anita
authors.initials: A
authors.lastname: Rose
authors.forename: Leonie
authors.initials: L
authors.lastname: Martin
authors.forename: Basil
authors.initials: B
authors.lastname: Sharrack
mesh_terms: 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