Significant events in an Internet‐delivered (Space from Depression) intervention for depression
Open accessAbstract
Abstract Objective The advantages and effectiveness of Internet interventions have been established. Little is known about the critical processes of change in Internet‐delivered interventions and of the psychological experience of users. These are both clinically relevant and have a link to the overall outcome of therapy. The goal of this article was to gain an insight into the important therapeutic processes in an 8‐week supported online self‐administered CBT‐based treatment for depression. Method Respondents were participants (N = 88) in a randomised controlled trial with an initial score of 14–28 on the Beck Depression Inventory (BDI‐II), who completed at least one module of the online intervention, and at least one Helpful Aspects of Therapy (HAT) questionnaire. Analysis The HAT data were analysed using descriptive–interpretative qualitative analysis to (i) identify helpful and hindering events, (ii) describe key events and (iii) describe the corresponding impacts of these events on the clients. Results In total, six helpful events were reported (provision of information, core CBT activities, mindfulness, platform accessibility and usability, supporter, personal stories and examples) and eight associated impacts (applying new coping skills/behavioural change, awareness and insight, improved well‐being, support/validation, expression/relief, self‐efficacy/empowerment/sense of achievement, personal connection). In total, five hindering events were identified (platform features/design, external factors, internal factors, supporters' feedback and content of the programme) and five associated impacts (disappointment, frustration/irritation, confusion, mood deterioration and being self‐critical/blaming) were reported. Conclusions The current results support previous findings that CBT principles are important in online delivery. The role of the supporter emerges as a key ingredient in online delivery worthy of further investigation.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Participants highlighted the value and relevance of the content for them, for instance, increasing self-efficacy.
“Indeed, participants highlighted the value and relevance of the content for them, for instance, increasing self-efficacy (Richards et al., 2018).”
From Investigating the potential of a novel internet-based cognitive behavioural intervention for Dari and Farsi speaking refugee youth: A feasibility study (2022) · cites this paper as Richards et al., 2018
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The effect of mindfulness based therapy on anxiety and depression: A meta analytic review
Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0018555 · Cited by 3,846 · see citing works
Eysenbach, G. (2005) · Journal of Medical Internet Research · doi:10.2196/jmir.7.1.e11 · Cited by 2,524 · see citing works
Computer-based psychological treatments for depression: A systematic review and meta-analysis
Richards, D., & Richardson, T. (2012) · Clinical Psychology Review · doi:10.1016/j.cpr.2012.02.004 · Cited by 1,442 · see citing works
Internet-Based and Other Computerized Psychological Treatments for Adult Depression: A Meta-Analysis
Andersson, G., & Cuijpers, P. (2009) · Cognitive Behaviour Therapy · doi:10.1080/16506070903318960 · Cited by 1,368 · see citing works
Psychotherapy Relationships That Work: Therapist Contributions and Responsiveness to Patients
Weiner, I. B. (2003) · Psychotherapy Research · doi:10.1093/ptr/kpg044 · Cited by 1,158 · see citing works
The impact of guidance on Internet-based mental health interventions — A systematic review
Baumeister, H., Reichler, L., Munzinger, M., & Lin, J. (2014) · Internet Interventions · doi:10.1016/j.invent.2014.08.003 · Cited by 1,037 · see citing works
Safran, J. D., Muran, J. C., & Eubanks-Carter, C. (2011) · Psychotherapy · doi:10.1037/a0022140 · Cited by 823 · see citing works
Stages of change in psychotherapy: A follow-up report.
McConnaughy, E. A., DiClemente, C. C., Prochaska, J. O., & Velicer, W. F. (1989) · Psychotherapy · doi:10.1037/h0085468 · Cited by 555 · see citing works
van der Velden, A. M., Kuyken, W., Wattar, U., Crane, C., Pallesen, K. J., Dahlgaard, J., Fjorback, L. O., & Piet, J. (2015) · Clinical Psychology Review · doi:10.1016/j.cpr.2015.02.001 · Cited by 455 · see citing works
Computer‐Aided Psychotherapy for Anxiety Disorders: A Meta‐Analytic Review
Cuijpers, P., Marks, I. M., van Straten, A., Cavanagh, K., Gega, L., & Andersson, G. (2009) · Cognitive Behaviour Therapy · doi:10.1080/16506070802694776 · Cited by 429 · see citing works
Titov, N., Andrews, G., Davies, M., McIntyre, K., Robinson, E., & Solley, K. (2010) · PLoS ONE · doi:10.1371/journal.pone.0010939 · Cited by 406 · see citing works
Mindfulness-based cognitive therapy as a treatment for chronic depression: A preliminary study
Barnhofer, T., Crane, C., Hargus, E., Amarasinghe, M., Winder, R., & Williams, J. M. G. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.01.019 · Cited by 396 · see citing works
Desrosiers, A., Vine, V., Klemanski, D. H., & Nolen-Hoeksema, S. (2013) · Depression and Anxiety · doi:10.1002/da.22124 · Cited by 392 · see citing works
A randomised controlled trial of a brief online mindfulness-based intervention
Cavanagh, K., Strauss, C., Cicconi, F., Griffiths, N., Wyper, A., & Jones, F. (2013) · Behaviour Research and Therapy · doi:10.1016/j.brat.2013.06.003 · Cited by 350 · see citing works
Helpful and nonhelpful events in brief counseling interviews: An empirical taxonomy.
Elliott, R. (1985) · Journal of Counseling Psychology · doi:10.1037/0022-0167.32.3.307 · Cited by 333 · see citing works
Psychological therapy as viewed by clients and therapists
Llewelyn, S. P. (1988) · British Journal of Clinical Psychology · doi:10.1111/j.2044-8260.1988.tb00779.x · Cited by 319 · see citing works
Mindfulness-based cognitive therapy: evaluating current evidence and informing future research
Coelho, H. F., Canter, P. H., & Ernst, E. (2007) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.75.6.1000 · Cited by 227 · see citing works
Timulák, L. (2007) · Psychotherapy Research · doi:10.1080/10503300600608116 · Cited by 223 · see citing works
Brown, R. A., & Lewinsohn, P. M. (1984) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.52.5.774 · Cited by 202 · see citing works
Krusche, A., Cyhlarova, E., & Williams, J. M. G. (2013) · BMJ Open · doi:10.1136/bmjopen-2013-003498 · Cited by 192 · see citing works
Qualitative Psychotherapy Research-Methods and Methodology
Buchholz, M. B. (2002) · Psychotherapy Research · doi:10.1093/ptr/12.2.241 · Cited by 176 · see citing works
Bendelin, N., Hesser, H., Dahl, J., Carlbring, P., Nelson, K. Z., & Andersson, G. (2011) · BMC Psychiatry · doi:10.1186/1471-244x-11-107 · Cited by 173 · cited 1× · see citing works
“Helpful and Hindering Events in online delivered CBT A small number of studies have investigated the psychological experience of users in Internetdelivered treatments (Bendelin et al., 2011; de Graaf, Huibers, Riper, Gerhards & Arntz, 2009; Gerhards et al., 2011).”
BackgroundLlewelyn, S. P., Elliott, R., Shapiro, D. A., Hardy, G., & Firth‐Cozens, J. (1988) · British Journal of Clinical Psychology · doi:10.1111/j.2044-8260.1988.tb00758.x · Cited by 164 · see citing works
Psychotherapy in 2022: A Delphi poll on its future.
Norcross, J. C., Pfund, R. A., & Prochaska, J. O. (2013) · Professional Psychology: Research and Practice · doi:10.1037/a0034633 · Cited by 162 · see citing works
Significant events in psychotherapy: An update of research findings
Timulák, L. (2010) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1348/147608310x499404 · Cited by 158 · see citing works
Titov, N., Andrews, G., Robinson, E., Schwencke, G., Johnston, L., Solley, K., & Choi, I. (2009) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670903179269 · Cited by 147 · cited 1× · see citing works
“…(Baumeister, Reichler, Munzinger & Lin, 2014; Richards & Richardson, 2012), but the nature, type, duration of any support are still largely unanswered as it seems that a variety of implementations of support can achieve the same outcomes (Richards & Richardson, 2012; Titov et al., 2009, 2010).”
BackgroundGerhards, S. A. H., Abma, T. A., Arntz, A., de Graaf, L. E., Evers, S. M. A. A., Huibers, M. J. H., & Widdershoven, G. A. M. (2011) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.09.012 · Cited by 141 · cited 1× · see citing works
“Helpful and Hindering Events in online delivered CBT A small number of studies have investigated the psychological experience of users in Internetdelivered treatments (Bendelin et al., 2011; de Graaf, Huibers, Riper, Gerhards & Arntz, 2009; Gerhards et al., 2011).”
Theory of mind and neurocognition in early psychosis: a quasi-experimental study
Langdon, R. A., Connors, M. H., Still, M., Ward, P. B., & Catts, S. V. (2014) · BMC Psychiatry · doi:10.1186/s12888-014-0316-6 · Cited by 130 · see citing works
An update on mindfulness meditation as a self-help treatment for anxiety and depression
Edenfield, T. M., & Saeed, S. A. (2012) · Psychology Research and Behavior Management · doi:10.2147/prbm.s34937 · Cited by 127 · see citing works
Richards, D., Richardson, T., Timulak, L., & McElvaney, J. (2015) · Internet Interventions · doi:10.1016/j.invent.2015.07.003 · Cited by 111 · cited 4× · see citing works
“The findings of these quantitative measures are published elsewhere (Richards et al., 2015b).”
BackgroundMethodInfluentialRichards, D., Timulak, L., O'Brien, E., Hayes, C., Vigano, N., Sharry, J., & Doherty, G. (2015) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.10.005 · Cited by 109 · see citing works
Hind, D., O’Cathain, A., Cooper, C. L., Parry, G. D., Isaac, C. L., Rose, A., Martin, L., & Sharrack, B. (2010) · Psychology & Health · doi:10.1080/08870440902842739 · Cited by 101 · see citing works
Participants' identification and recall of important events in counseling.
Martin, J., & Stelmaczonek, K. (1988) · Journal of Counseling Psychology · doi:10.1037/0022-0167.35.4.385 · Cited by 100 · see citing works
Psychological outreach programmes for the depressed elderly: a meta-analysis of effects and dropout
Cuijpers, P. J. (1998) · International Journal of Geriatric Psychiatry · doi:10.1002/(sici)1099-1166(199801)13:1 · Cited by 95 · see citing works
de Graaf, L. E., Huibers, M. J. H., Riper, H., Gerhards, S. A. H., & Arntz, A. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2008.12.009 · Cited by 86 · see citing works
Topolovec‐Vranic, J., Cullen, N. K., Michalak, A., Ouchterlony, D., Bhalerao, S., Masanic, C. A., & Cusimano, M. D. (2010) · Brain Injury · doi:10.3109/02699051003709599 · Cited by 82 · see citing works
Flückiger, C., Holtforth, M. G., Znoj, H. J., Caspar, F., & Wampold, B. E. (2012) · Psychotherapy Research · doi:10.1080/10503307.2012.693773 · Cited by 73 · see citing works
Guided Internet-Based Treatments in Psychiatry
Lindefors, N., & Andersson, G. (2016) · Springer eBooks · doi:10.1007/978-3-319-06083-5 · Cited by 68 · see citing works
Clients' Perceptions of Treatment for Depression: I. Helpful Aspects
Gershefski, J., Arnkoff, D. B., Glass, C. R., & Elkin, I. (1996) · Psychotherapy Research · doi:10.1080/10503309612331331768 · Cited by 61 · see citing works
Richards, D., Murphy, T., Viganó, N., Timulak, L., Doherty, G., Sharry, J., & Hayes, C. (2016) · Internet Interventions · doi:10.1016/j.invent.2016.06.007 · Cited by 59 · see citing works
Self-citationRichards, D., Timulak, L., & Hevey, D. (2013) · Counselling and Psychotherapy Research · doi:10.1080/14733145.2012.733715 · Cited by 55 · see citing works
Self-citationGega, L., Smith, J., & Reynolds, S. (2013) · Psychotherapy Research · doi:10.1080/10503307.2013.766941 · Cited by 47 · see citing works
Richards, D., & Timulak, L. (2012) · Counselling Psychology Quarterly · doi:10.1080/09515070.2012.703129 · Cited by 40 · see citing works
Richards, D., Timulak, L., Doherty, G., Sharry, J., Colla, A., Joyce, C., & Hayes, C. (2014) · BMC Psychiatry · doi:10.1186/1471-244x-14-147 · Cited by 35 · see citing works
Self-citationFeather, J., Howson, M., Ritchie, L., Carter, P. D., Parry, D., & Koziol‐McLain, J. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.5455 · Cited by 32 · see citing works
Counselling in general practice: Clients' perceptions of significant events and outcome
Booth, H., Cushway, D., & Newnes, C. (1997) · Counselling Psychology Quarterly · doi:10.1080/09515079708254170 · Cited by 25 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Elliott, R., & Timulak, L. (2005). Descriptive and interpretive approaches to qualitative research. In J. Miles, & P. Gilbert (Eds.), A handbook of research methods for clinical and health psychology, (pp. 147-160). New York, NY: Oxford University Press.
Cited by
Sorted by citations
Lindegaard, T., Wasteson, E., Demetry, Y., Andersson, G., Richards, D., & Shahnavaz, S. (2022) · Internet Interventions · doi:10.1016/j.invent.2022.100533 · Cited by 30 · see citing works
“Indeed, participants highlighted the value and relevance of the content for them, for instance, increasing selfefficacy (Richards et al., 2018).”
BackgroundEnrique, Á., Mooney, O., Salamanca-Sanabria, A., Lee, C. T., Farrell, S., & Richards, D. (2020) · JMIR Formative Research · doi:10.2196/20167 · Cited by 29 · see citing works
Weisel, K. K., Zarski, A., Berger, T., Krieger, T., Moser, C. T., Schaub, M. P., Görlich, D., Berking, M., & Ebert, D. D. (2020) · Journal of Medical Internet Research · doi:10.2196/16450 · Cited by 26 · see citing works
Wisman, M. A., Emmelkamp, J., Dekker, J., & Christ, C. (2022) · Internet Interventions · doi:10.1016/j.invent.2022.100596 · Cited by 26 · see citing works
Jardine, J., Earley, C., Richards, D., Timulák, L., Palacios, J. E., Duffy, D. J., Tierney, K., & Doherty, G. J. (2020) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3313831.3376254 · Cited by 22 · see citing works
Nadal, C., Earley, C., Enrique, Á., Viganò, N., Sas, C., Richards, D., & Doherty, G. J. (2021) · Contemporary Clinical Trials · doi:10.1016/j.cct.2021.106323 · Cited by 17 · see citing works
Burke, J., Richards, D., & Timulak, L. (2019) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465818000504 · Cited by 14 · see citing works
Self-citationPatient experience of supported computerized CBT in an inner-city IAPT service: a qualitative study
Perera-Delcourt, R. P., & Sharkey, G. (2019) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x18000284 · Cited by 14 · see citing works
Eilert, N., Timulak, L., Duffy, D., Earley, C., Enrique, A., Kennedy, P., McCormack, C., Palacios, J., Wogan, R., & Richards, D. (2022) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2619 · Cited by 11 · see citing works
Castro, Ó., Salamanca-Sanabria, A., Alattas, A., Teepe, G. W., Leidenberger, K., Fleisch, E., Car, L. T., Müller‐Riemenschneider, F., & Kowatsch, T. (2024) · Archives of Public Health · doi:10.1186/s13690-024-01424-z · Cited by 10 · see citing works
Akkol‐Solakoglu, S., & Hevey, D. (2024) · Journal of Health Psychology · doi:10.1177/13591053241272243 · Cited by 3 · see citing works
Online programs for depression
Batterham, P. J., Calear, A. L., & Kurz, E. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-817933-8.00012-8
Timulák, L., Griffin, L., Healy, P., O'Brien, S., Rice, C., Ke, Q., Kearney, A., Byrne, G., Connon, G., Ruane, S., et al. (2026) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2026.2749791
- Authors
- Richards, D., Dowling, M., O'Brien, E., Viganò, N., & Timulak, L.
- Affiliations
- Trinity College Dublin (IE)
- E‐mental Health Research Group School of Psychology University of Dublin Trinity College Dublin Dublin Ireland
- Corresponding author
- Richards, Derek
- Venue
- Counselling and Psychotherapy Research
- Publisher
- Wiley
- Published
- 2017-09-13
- Volume
- 18
- Issue
- 1
- Pages
- 35-48
- ISSN
- 1473-3145 (ISSN-L)
- 1746-1405
- OpenAlex
- W2754914849
- Cited by
- 13
- References
- 47
- Citations by year
- 2026: 1 · 2024: 2 · 2022: 2 · 2021: 3 · 2020: 3 · 2019: 1 · 2018: 1
- FWCI
- 1.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Counselling and Psychotherapy Research (publishedVersion)
- Arrow@dit (Dublin Institute of Technology) (acceptedVersion)
- Trinity's Access to Research Output (TARA) (Trinity College Dublin) (submittedVersion, cc-by-nc-sa)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- depression, online intervention, cognitive behavioral therapy, therapeutic process, user experience, mindfulness, coping strategies, self-efficacy, platform usability
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
