Abstract
BackgroundComputerized cognitive behavioral therapy (cCBT) has been proven to be effective in depression care. Moreover, cCBT packages are becoming increasingly popular. A central aspect concerning the take-up and success of any treatment is its user acceptance.ObjectiveThe aim of this study was to update and expand on earlier work on user acceptance of cCBT for depression.MethodsThis paper systematically reviewed quantitative and qualitative studies regarding the user acceptance of cCBT for depression. The initial search was conducted in January 2016 and involved the following databases: Web of Science, PubMed, the Cochrane Library, and PsycINFO. Studies were retained if they described the explicit examination of the user acceptance, experiences, or satisfaction related to a cCBT intervention, if they reported depression as a primary outcome, and if they were published in German or English from July 2007 onward.ResultsA total of 1736 studies were identified, of which 29 studies were eligible for review. User acceptance was operationalized and analyzed very heterogeneously. Eight studies reported a very high level of acceptance, 17 indicated a high level of acceptance, and one study showed a moderate level of acceptance. Two qualitative studies considered the positive and negative aspects concerning the user acceptance of cCBT. However, a substantial proportion of reviewed studies revealed several methodical shortcomings.ConclusionsIn general, people experience cCBT for depression as predominantly positive, which supports the potential role of these innovative treatments. However, methodological challenges do exist in terms of defining user acceptance, clear operationalization of concepts, and measurement.
Highlights
Depressive disorders are among the most common and serious mental illnesses [1]
We provide a systematic overview on user acceptance of Computerized cognitive behavioral therapy (cCBT) for depression over the last 10 years and widen the perspective to include the notion that the process of user acceptance spans a number of phases, including accepting, experiencing, and being satisfied with cCBT
56 publications were excluded mainly because depression was not defined as a primary outcome (n=28), and user acceptance was not examined as described in their titles or abstracts (n=17)
Summary
Depressive disorders are among the most common and serious mental illnesses [1]. Globally, 350 million people of all ages are estimated to suffer from depression. Individuals suffering from depression often find themselves confronted with barriers to receiving appropriate care such as social stigma associated with mental disorders, long waiting times, or the logistical difficulties of appearing in person for treatment [4,5]. For these reasons, computerized programs present an innovative approach to improving access to psychological treatments for depression. There is evidence that computerized cognitive behavioral therapy (cCBT) is effective in the treatment of various mental disorders, including depression [6,7,8,9,10]. Methodological challenges do exist in terms of defining user acceptance, clear operationalization of concepts, and measurement
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