Negative effects in internet-based interventions for depression: a qualitative content analysis
Open accessAbstract
An increasing number of studies is proving the efficacy of Internet-based interventions (IBI) for treating depression. While the focus of most studies is thereby lying on the potential of IBI to alleviate emotional distress and enhance well-being, few studies are investigating possible negative effects that might be encountered by participants. The current study was therefore exploring self-reported negative effects of participants undergoing a cognitive-behavioral IBI targeting mild to moderate depression over 6 weeks. Data from the client pool of a German insurance company (n = 814, 68% female) revealed that 8.6% of the participants reported the experience of negative effects. Qualitative content analysis yielded two broad categories and five subcategories for the nature of participants' experiences of negative effects: participant-related negative effects (insight and symptom) and program-related negative effects (online format, contact, and implementation). By using both, qualitative and quantitative methods, results did not only shed light on the characteristics of negative effects but analyses also found that working alliance was a predictor for the experience of negative effects. Monitoring the occurrences of negative effects as well as working alliance throughout treatment was considered essential to help prevent negative effects and attrition among participants undergoing IBI for depression.
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Monitoring adverse effects is an effective strategy for preventing them and reducing dropout rates in web-based interventions.
“Monitoring adverse effects is an effective strategy for preventing them and reducing dropout rates in web-based interventions (Fenski et al., 2021).”
From Internet-based self-administered intervention to reduce anxiety and depression symptomatology and improve well-being in 7 countries: protocol of a randomized control trial (2024) · cites this paper as Fenski et al., 2021
The Conclusions say monitoring negative effects throughout treatment might help prevent dropout in internet-based interventions for depression. The Discussion recommends monitoring so clinicians can respond promptly, but the paper does not establish that monitoring effectively prevents adverse effects or reduces dropout rates. (LLM, conf=0.89)
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“Monitoring adverse effects is an effective strategy for preventing them and reducing dropout rates in web-based interventions (Fenski et al., 2021).”
Background
- Authors
- Fenski, F., Rozental, A., Heinrich, M., Knaevelsrud, C., Zagorscak, P., & Boettcher, J.
- Affiliations
- Freie Universität Berlin (DE)
- Uppsala University (SE)
- Psychologische Hochschule Berlin (DE)
- Corresponding author
- Fenski, Friederike
- ORCID
- Venue
- Internet Interventions
- Publisher
- Elsevier BV
- Published
- 2021-12
- Volume
- 26
- Pages
- 100469
- ISSN
- 2214-7829 (ISSN-L)
- PMC
- PMC8564554
- OpenAlex
- W3207415829
- Cited by
- 28
- References
- 47
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 6 · 2023: 8 · 2022: 2
- FWCI
- 3.59
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Internet Interventions (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Uppsala University Publications (Uppsala University) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Refubium (Universitätsbibliothek der Freien Universität Berlin) (submittedVersion, cc-by-nc-nd)
- Universitätsbibliothek der FU Berlin Hochschulschriftenstelle u. Dokumentenserver
- 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 › Social Psychology › Mental Health Treatment and Access
- Keywords
- online intervention, depression, adverse outcomes, cognitive behavioral therapy, therapeutic relationship, attrition, online therapy, participant experiences, mild to moderate depression
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