Abstract
The purpose of this chapter is to review qualitative research on user experiences with internet interventions for depression and present original results from in-depth interviews from a preventive unguided intervention for postpartum depression. The first part reviews the literature on qualitative studies of client experiences and perceptions of internet interventions for depression. The next part describes original data from a study investigating participants' experiences using semi-structured interviews, following the modified SWOT-format (i.e., strengths, weakness, opportunities, and threats). In total, 10 pregnant and postpartum women aged 28 to 41 were interviewed. Insights from the current review and study are used as a point of departure for discussing future directions in research on internet interventions for depression. This chapter should be valuable for clinicians, researchers, and other health professionals interested in the applicability of internet interventions for their clients, design of future studies, and development of internet interventions.
TopLiterature Review
A recent meta-synthesis of user experiences of computer-based interventions identified two overarching themes (Knowles et al., 2014); (1) First, interventions need to be more personalized and sensitive to the individual users’ needs, so that users can identify with the program and relate the program content to themselves and their daily lives (e.g., use of role models, examples, and homework assignments). Second, the level of support and guidance, either by a professional or lay person, is experienced as contradictory. For some, support may help identify different clinical needs and relate program content to the user’s situation, and recognize and acknowledge personal emotional and motivational difficulties. For others, support may be experienced negatively (e.g., perceptions of high demands or expectations from the therapist). The authors also concluded that these findings may not generalize to other user groups (e.g., ethnic minorities, elderly or pregnant women) and approaches other than cognitive behavior therapy (CBT). In addition, this synthesis included mixed qualitative studies on anxiety and depression, and 7 out of 8 included studies were desktop-based CBT interventions. Thus, it is necessary to examine experiences among other user groups, include different therapeutic approaches, and examine user experiences that are specifically related to internet interventions for depression.
Key Terms in this Chapter
Perinatal Depression: Onset or elevated symptoms of depression during pregnancy and the first 6 months following childbirth.
Mamma Mia: An unguided internet intervention designed to prevent pre- and postnatal depression and promote subjective well-being among pregnant and postpartum women.
Unguided Intervention: A fully automated and self-guided internet intervention without any therapist-support or human involvement.
Internet-Based Cognitive Behavioral Therapy (iCBT): The most commonly used psychotherapeutic approach for treating mental health problems on the internet based on the same principles as in-person cognitive behavior therapy.
Subjective Well-Being: Refers to people’s experience of the quality of their lives and encompasses cognitive evaluations of life and emotional reactions.
Strengths, Weaknesses, Opportunities, and Threats (SWOT): A systematic method and tool for assessment of internal and external environments to support strategic planning and decision-making, and development of products, organizations, and services.
Tunneled Design: A directive information architecture that guides users step-by-step through a predetermined sequence of web pages and/or sessions in order to improve the chances of achieving a goal.