Duffy Daniel, Richards Derek, Earley Caroline, Timulak Ladislav
SilverCloud Science, SilverCloud Health, Dublin, Ireland.
School of Psychology, Trinity College Dublin, Dublin, Ireland.
Front Digit Health. 2023 Sep 26;5:1139125. doi: 10.3389/fdgth.2023.1139125. eCollection 2023.
This study consisted of a qualitative exploration of stakeholder experience regarding the implementation of internet-delivered cognitive behavioral therapy (iCBT) as part of routine service provision within the UK's Improving Access to Psychological Therapies program.
Stakeholder groups included service providers ( = 6), commercial iCBT representatives ( = 6) and patients who received a course of iCBT as part of treatment at the service ( = 7). Participants took part in a semi-structured interview over the telephone, and subsequent data were qualitatively analyzed using the descriptive-interpretive approach.
Service providers highlighted the importance of effective leadership and management, training initiatives, the provision of feedback to commercial iCBT representatives and creating work structures around iCBT to facilitate iCBT supporting staff in their use of it. Commercial iCBT representatives similarly reported the importance of training clinicians in iCBT use, identifying the appropriate individuals at all levels of the service to drive iCBT implementation, and the importance of being responsive to any problems or needs that arise from the service. Patients reported an overall positive experience of receiving iCBT but highlighted a need for more information from their supporter and the intervention to better structure their usage. Contextual factors, in terms of barriers and facilitators, were also highlighted by service provider and commercial participants; citing negative clinician attitudes and technological issues/bugs as barriers to implementation, and the exposure to iCBT created by COVID-19 and perseverance in using iCBT over time as facilitators.
The findings contribute to a growing field of literature that seeks to understand the experience of relevant stakeholders who are involved with and contribute to iCBT implementation, including commercial iCBT representatives who, to our knowledge, have not been accounted for as part of published research to date.
本研究对利益相关者在英国改善心理治疗可及性计划中将互联网认知行为疗法（iCBT）作为常规服务提供一部分的实施经验进行了定性探索。
利益相关者群体包括服务提供者（6人）、商业iCBT代表（6人）以及在该服务中接受iCBT疗程治疗的患者（7人）。参与者通过电话参与了半结构化访谈，随后使用描述性解释方法对数据进行了定性分析。
服务提供者强调了有效领导和管理、培训举措、向商业iCBT代表提供反馈以及围绕iCBT创建工作结构以促进iCBT支持人员使用它的重要性。商业iCBT代表同样报告了培训临床医生使用iCBT、确定服务各级合适人员以推动iCBT实施的重要性，以及对服务中出现的任何问题或需求做出响应的重要性。患者报告了接受iCBT的总体积极体验，但强调需要从其支持者和干预措施中获得更多信息，以便更好地安排使用。服务提供者和商业参与者还强调了背景因素，包括障碍和促进因素；将临床医生的负面态度和技术问题/故障视为实施障碍，将COVID-19带来的iCBT接触以及随着时间推移坚持使用iCBT视为促进因素。
这些发现为一个不断发展的文献领域做出了贡献，该领域旨在了解参与iCBT实施并为之做出贡献的相关利益者的经验，包括商业iCBT代表，据我们所知，他们迄今尚未作为已发表研究的一部分得到考虑。
