The DOI matches its Crossref record; 32 of the 35 references it cites were found in a registry or an index.
Primary‐care patients’ expectations and experiences of online cognitive behavioural therapy for depression: a qualitative study
Open accessAbstract
Objective To explore expectations and experiences of online cognitive behavioural therapy (CBT) among primary‐care patients with depression, focusing on how this mode of delivery impacts upon the therapeutic experience. Design Qualitative study, using repeat semi‐structured interviews with patients before and after therapy. The study was conducted in parallel with a randomized controlled trial examining the effectiveness and cost‐effectiveness of online CBT for patients with depression. Participants Twenty‐four patients with depression recruited from five general practices in southwest England, who were offered up to 10 sessions of CBT, delivered via the internet by a psychologist. Results Most participants accessed the therapy from their home computer and found this to be a major advantage, in terms of convenience and fitting therapy into their daily routine, with any technical problems quickly resolved. Two key themes regarding expectations and experiences of online CBT were: developing a virtual relationship with a therapist, and the process of communicating thoughts and emotions via an online medium. Online CBT seems to be acceptable to, and experienced as helpful by, certain subgroups of patients with depression, particularly those who are familiar with computers, feel comfortable with writing their feelings down, enjoy the opportunities to review and reflect that written (or typed) communication offers are attracted to the ‘anonymity’ of an online therapeutic relationship and are open to the proactive requirements of CBT itself. However, on‐line CBT may feed into the vulnerability of depressed people to negative thoughts, given the absence of visual cues and the immediate response of face‐to‐face interaction. Conclusions Online CBT has the potential to enhance care for patients with depression who are open to engaging in ‘talking’ (or typing) therapies as part of their treatment. If online CBT is to be provided via the NHS, it is important to establish patient preferences regarding this mode of delivery and ensure that referral practices are appropriately targeted. The results of our main trial will provide evidence regarding the effectiveness and cost‐effectiveness of receiving therapy via this modality.
Overview
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
Verification
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?
The cited source says what the claim attributes to it.
In the citing paper
“This echoes previous research showing that some individuals are more comfortable self-disclosing to therapists via computer-mediated communication than face-to-face communication, as it reduces their fear of being judged [41].”
From User Experiences of Social Support From Companion Chatbots in Everyday Contexts: Thematic Analysis (2020) · cites this paper as [41]
In the citing paper
“Studies on the experiences of patients with online therapy also show that personal feedback and support are perceived as positive among patients, to optimally use the program and to keep them motivated [12-14].”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
An inventory for measuring depression
BECK, A. T. (1961) · Archives of General Psychiatry · doi:10.1001/archpsyc.1961.01710120031004 · Cited by 38,032
Basics of Qualitative Research
Ozanne, J. L., Strauss, A., & Corbin, J. M. (1992) · Journal of Marketing Research · doi:10.2307/3172751 · Cited by 17,852
(1990) · Cited by 11,110
Qualitative research in health care: Analysing qualitative data
Pope, C. (2000) · BMJ · doi:10.1136/bmj.320.7227.114 · Cited by 8,131
Gosby, J. R. (2000) · Journal of Advanced Nursing · doi:10.1046/j.1365-2648.2000.t01-7-01210.x · Cited by 2,001
Can You See the Real Me? Activation and Expression of the “True Self” on the Internet
Bargh, J. A., McKenna, K. Y. A., & Fitzsimons, G. M. (2002) · Journal of Social Issues · doi:10.1111/1540-4560.00247 · Cited by 1,301
Process evaluation in randomised controlled trials of complex interventions
Oakley, A., Strange, V., Bonell, C., Allen, E., & Stephenson, J. (2006) · BMJ · doi:10.1136/bmj.332.7538.413 · Cited by 1,247
Delivering interventions for depression by using the internet: randomised controlled trial
Christensen, H. (2004) · BMJ · doi:10.1136/bmj.37945.566632.ee · Cited by 928
Donovan, J., Little, P., Mills, N., Smith, M., Brindle, L., Jacoby, A., Peters, T., Frankel, S., Neal, D., & Hamdy, F. (2002) · BMJ · doi:10.1136/bmj.325.7367.766 · Cited by 533
Proudfoot, J., Ryden, C., Everitt, B., Shapiro, D. A., Goldberg, D., Mann, A., Tylee, A., Marks, I., & Gray, J. A. (2004) · British Journal of Psychiatry · doi:10.1192/bjp.185.1.46 · Cited by 516
Research works printed but not linked: 2
- National Institute for Clinical Excellence, 2004, Depression: Management of Depression in Primary and Secondary Care
- Lewis G, 1990, Manual of the Revised Clinical Interview Schedule (CIS‐R)
Cited by
Sorted by citations
Items 101–171 of 171
Barceló‐Soler, A., García‐Campayo, J., Araya, R., Doukani, A., Gili, M., García‐Palacios, A., Mayoral, F., & Montero‐Marín, J. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1024966 · Cited by 14
Can Cognitive Behaviour Therapy Be Beneficial for Heart Failure Patients?
Lundgren, J., Andersson, G., & Johansson, P. (2014) · Current Heart Failure Reports · doi:10.1007/s11897-014-0244-2 · Cited by 14
A narrative review of alliance formation and outcome in text-based telepsychotherapy.
Schwartzman, C. M., & Boswell, J. F. (2020) · Practice Innovations · doi:10.1037/pri0000120 · Cited by 16
Haller, E., Besson, N., & Watzke, B. (2019) · BMC Health Services Research · doi:10.1186/s12913-019-4495-1 · Cited by 13
Gautam, K., Aguilar, C., Paudel, K., Dhakal, M., Wickersham, J. A., Acharya, B., Sapkota, S., Deuba, K., & Shrestha, R. (2024) · JMIR Human Factors · doi:10.2196/56002 · Cited by 12
“This not only addresses the financial challenges faced by Nepali MSM but also alleviates the transportation struggles [35].”
BackgroundKothari, R., Egan, S. J., Wade, T. D., Andersson, G., & Shafran, R. (2016) · JMIR Research Protocols · doi:10.2196/resprot.6378 · Cited by 14
“Being able to process thoughts and feelings in written form and developing a virtual relationship with a therapist were shown to be important to mental health users when receiving CBT delivered online by a psychologist [23].”
BackgroundFreund, J., Buntrock, C., Braun, L., Thielecke, J., Baumeister, H., Berking, M., Ebert, D. D., & Titzler, I. (2022) · Internet Interventions · doi:10.1016/j.invent.2022.100566 · Cited by 11
“The flexible use of the training, an often reported benefit of IMIs for depression treatment (Gerhards et al., 2011; Holst et al., 2017; Beattie et al., 2009; Knowles et al., 2015; Bendelin et al., 2011), was found to be highly relevant for the majority of the interviewees.”
BackgroundResultDropout and completion in iCBT for university students: Insights from a thematic analysis
Koelen, J. A., de Koning, L., Nottage, M., Klein, A. M., der Heijde, C. M. V., Vonk, P., & Wiers, R. W. H. J. (2025) · Internet Interventions · doi:10.1016/j.invent.2025.100831 · Cited by 11
(2013) · doi:10.1093/fampra/cmt028 · Cited by 11
Professional care after deliberate self-harm: a qualitative study of young people’s experiences
Idenfors, H., Kullgren, G., & Renberg, E. S. (2015) · Patient Preference and Adherence · doi:10.2147/ppa.s76244 · Cited by 11
“Online treatment has already been successfully implemented, such as with internet psychotherapy,(37) where one of its advantages is the convenience of having access to online therapy from a home computer.(38) Other examples are email counseling that facilitates subsequent face-to-face counseling, as it gives more time…”
Online interactive suicide support services: quality and accessibility
Best, P., Foye, U., Taylor, B. J., Hazlett, D. E., & Manktelow, R. (2013) · Mental Health Review Journal · doi:10.1108/mhrj-03-2013-0009 · Cited by 10
“Quality of online mental health services Studies have generally shown positive results regarding online mental health service delivery (Christensen et al., 2004; Beattie et al., 2008; Mackinnon et al., 2008).”
BackgroundSalisbury, C., O’Cathain, A., Thomas, C., Edwards, L., Montgomery, A. A., Hollinghurst, S. P., Large, S., Nicholl, J. P., Pope, C. J., Rogers, A. E., et al. (2017) · Programme Grants for Applied Research · doi:10.3310/pgfar05010 · Cited by 9
“Internet programmes may require some level of basic training and web-based interventions were more accessible to patients who were familiar or comfortable with using the internet.(98,107) Less computer-literate users expressed concerns over being misunderstood(105) and older people reported fear.”
BackgroundInfluentialKorkmaz, B., & Şen, G. (2018) · Klinik Psikoloji Dergisi · doi:10.31828/kpd2602443829092018m000004 · Cited by 9
Efficacy of an Internet-based Intervention Targeted to Adolescents with Subthreshold Depression
Makarushka, M. M. (2011) · Scholars' Bank (University of Oregon) · Cited by 9
Antoniou, M., Estival, D., Lam‐Cassettari, C., Li, W., Dwyer, A., & Neto, A. D. A. (2022) · JMIR Formative Research · doi:10.2196/33036 · Cited by 17
“However, others have found the time delays created space to think, reflect, and communicate feelings without being disrupted by further questioning, as might occur in face-to-face sessions [20].”
BackgroundWatkins, D. C., Smith, L. C., Kerber, K., Kuebler, J., & Himle, J. A. (2011) · Journal of Telemedicine and Telecare · doi:10.1258/jtt.2011.110105 · Cited by 8
Students’ perceptions of an online mental health intervention: a qualitative interview study
Irish, M., Zeiler, M. D., Kuso, S., Musiat, P., Potterton, R., Wagner, G., Karwautz, A. F. K., Waldherr, K., & Schmidt, U. H. (2020) · Neuropsychiatrie · doi:10.1007/s40211-020-00383-5 · Cited by 9
O’Bree, B., Walton, C. C., Bendall, S., Wilson, M., Valentine, L., McEnery, C., D’Alfonso, S., Álvarez‐Jiménez, M., & Rice, S. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18062796 · Cited by 9
Ciuca, A., Berger, T., & Miclea, M. (2017) · Pragmatic Case Studies in Psychotherapy · doi:10.14713/pcsp.v13i3.2011 · Cited by 7
Ab Initio Molecular Dynamics with Quantum Monte Carlo
Luo, Y., & Sorella, S. (2015) · Frontiers in Materials · doi:10.3389/fmats.2015.00029 · Cited by 6
Waite, P. (2022) · Pilot and Feasibility Studies · doi:10.1186/s40814-022-01009-z · Cited by 6
Editorial : introducing Internet Interventions — A new Open Access Journal
Andersson, G., Riper, H., & Carlbring, P. (2014) · Internet Interventions · doi:10.1016/j.invent.2013.11.001 · Cited by 7
Du, E., Quayle, E., & Macleod, H. (2021) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x21000210 · Cited by 5
“It was guided by research on patients ’ experiences (Beattie et al ., 2009; Bennett et al ., 2008) to gain as much knowledge as possible and a better understanding of patients ’ perspectives and their satisfaction and acceptance of CCBT services.”
A questionnaire-based qualitative study of therapist views on computerized CBT
Newton, J., & Sundin, E. (2016) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x16000131 · Cited by 7
“These advantageous features were also reported in previous studies (Kenwright et al. 2005; Griffiths & Christensen, 2007; Beattie et al. 2009; Green & Iverson, 2009; Gerhards et al. 2011).”
MethodResultDemırcı, İ., Şar, A. H., & Manap, A. (2014) · International Journal of Psychology and Educational Studies · doi:10.17220/ijpes.2014.01.002 · Cited by 5
User Experiences and Perceptions of Internet Interventions for Depression
Drozd, F., Andersen, C. E., Haga, S. M., Slinning, K., & Bjørkli, C. A. (2017) · Advances in psychology, mental health, and behavioral studies (APMHBS) book series · doi:10.4018/978-1-5225-3241-5.ch002 · Cited by 5
Hillier, L. (2018) · Lancaster University · doi:10.17635/lancaster/thesis/406 · Cited by 5
Rapport Building in Written Crisis Services: Qualitative Content Analysis
Schwab‐Reese, L. M., Short, C., Jacobs, L., & Fingerman, M. (2024) · Journal of Medical Internet Research · doi:10.2196/42049 · Cited by 5
“In a parallel qualitative study, participants reported mixed perceptions of the experience [26].”
BackgroundHish, A. J., Nagy, G. A., Fang, C. M., Kelley, L., Nicchitta, C. V., Dzirasa, K., & Rosenthal, M. Z. (2020) · International journal of doctoral studies · doi:10.28945/4669 · Cited by 4
Prasartpornsirichoke, J., Pityaratstian, N., Poolvoralaks, C., Sermruttanawisith, N., Polpakdee, K., Pholphet, K., & Buathong, N. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1502406 · Cited by 9
“Online CBT fosters a virtual therapeutic relationship and facilitates the expression of thoughts and emotions (44).”
Odoh, L., & Aimiosior, O. (2024) · Health Open Research · doi:10.12688/healthopenres.13512.1 · Cited by 3
Bjornstad, G. J., Sonthalia, S., Rouse, B., Freeman, L., Hessami, N., Dunne, J. H., & Axford, N. (2024) · Campbell Systematic Reviews · doi:10.1002/cl2.1376 · Cited by 3
Patients' and Therapists' Views of Integrated Online CBT for Depression
Fox, F. E., Wiles, N., Kessler, D. A., Tallon, D., Thomas, L., Williams, C. J., Shafran, R., Lanham, P., & Turner, K. M. (2024) · Health Expectations · doi:10.1111/hex.70002 · Cited by 3
“These patients are likely to be comfortable expressing themselves via typing, value the opportunity to review and reflect on written transcripts and motivated to engage in the tasks required by the CBT approach [6].”
BackgroundResultInfluentialSelf-citationLy, K. H. (2015) · Linköping University Electronic Press eBooks · doi:10.3384/diss.diva-113996 · Cited by 3
Taylor, L. M. W., Waite, P., Halldorsson, B., Percy, R., Violato, M., & Creswell, C. (2019) · Trials · doi:10.1186/s13063-019-3295-6 · Cited by 5
Finazzi, E., MacLeod, E., & MacBeth, A. M. (2023) · PLoS ONE · doi:10.1371/journal.pone.0279263 · Cited by 4
“Other studies have explored service users experience across formats such as Computerized CBT [48], online CBT [49] and group interventions [24].”
BackgroundWilliams, M. P., Manjourides, J., Smith, L. H., Rainer, C., Hightow‐Weidman, L., & Haley, D. F. (2024) · Journal of Medical Internet Research · doi:10.2196/57619 · Cited by 2
University student experiences of digital mental health packages
Barnwell, A. M., & Patton, R. (2025) · Journal of Further and Higher Education · doi:10.1080/0309877x.2025.2451693 · Cited by 2
“A more established evidence-base exists for cCBT as an effective treatment for anxiety (Coull and Morris 2011), depression (Barazzone, Cavanagh, and Richards 2012; Beattie et al. 2009) and general distress (Twomey et al. 2014) within healthcare contexts.”
Erşahin, Z. (2016) · Research Explorer (The University of Manchester) · Cited by 2
Practice-informed guidance for undertaking remotely delivered mental health research
McCarthy, L., Teague, B., Rowe, K. J., Janes, K., Rhodes, T., Hackmann, C., Samad, L., & Wilson, J. (2021) · Nurse Researcher · doi:10.7748/nr.2021.e1770 · Cited by 2
Byrne, P. (2010) · The British Journal of Psychiatry · doi:10.1192/bjp.197.4.304 · Cited by 2
The Effectiveness of Horticultural Therapy Groups on Adults with a Diagnosis of Depression
Alston, L. Y. (2010) · Cited by 2
Gerhards, S. A. H. (2011) · Research Publications (Maastricht University) · doi:10.26481/dis.20110113sg · Cited by 2
Portable Assessment of Emotional Status and Support System
Yang, P.-C., Chang, C., Chen, Y., Chiang, J.-H., & Hung, G. C. (2014) · Lecture notes in computer science · doi:10.1007/978-3-319-06269-3_19 · Cited by 1
“To have a cordial talk with patients is critical in mobile application interaction [8].”
BackgroundAgathokleous, G. (2020) · Wolverhampton Intellectual Repository and E-Theses (University of Wolverhampton) · Cited by 1
Alternative interventions for young men's mental health.
McGale, N. (2011) · Arrow@dit (Dublin Institute of Technology) · Cited by 1
Atik, E., Schückes, M., & Apolinário-Hagen, J. (2022) · doi:10.2196/preprints.36806 · Cited by 1
Whitchurch, M., Humayun, S., & Robinson, O. C. (2022) · Research Square · doi:10.21203/rs.3.rs-1708568/v1 · Cited by 1
Biersack, K., Sattel, H. C., Schönweger, P., Kaspar, L., Lehnen, N., Gensichen, J. S., Henningsen, P., & the POKAL group (2023) · medRxiv · doi:10.1101/2023.12.27.23297265 · Cited by 1
Eid, L., Kenny, A., Jacobsen, P. C., Hsu, C.-W., & Yiend, J. (2024) · Research Square · doi:10.21203/rs.3.rs-5563578/v1 · Cited by 1
Friesen, L. N. (2012) · oURspace (University of Regina) · doi:10.82465/4580
CHILDREN AND PARENTS' EXPERIENCES WITH DISTANCE MENTAL HEALTH TREATMENT
Lingley‐Pottie, P. (2011)
Online therapy : client and counsellor experiences
Khan, S. (2014) · cIRcle (University of British Columbia) · doi:10.14288/1.0135566
“Online therapy also offers clients more ownership and control over the mode, frequency, and termination of their therapy sessions (Beattie et al., 2009; Hanley, 2012; Mallen, Jenkins, Vogel, & Day, 2010; Maples & Han, 2008).”
BackgroundYoung people's contact with healthcare before and after suicidal behaviour
Idenfors, H. (2016) · DiVA at Umeå University (Umeå University)
Holland, D. (2016) · ODU Digital Commons (Old Dominion University) · doi:10.25777/9m8h-gn42
Reiner, N. (2016)
Security for People with Mental Illness in Telehealth Systems: A ProposalPreprint
Jiang, H. (2020) · arXiv (Cornell University) · doi:10.48550/arxiv.2008.03406
“[14] Angela Beattie, Alison Shaw, Surinder Kaur, and David Kessler.”
BackgroundAdvantages, Limitations and People’s Attitudes toward Online Counseling
何, 珍. (2021) · Advances in Psychology · doi:10.12677/ap.2021.119246
Jain, S. (2021) · Advances in psychology, mental health, and behavioral studies (APMHBS) book series · doi:10.4018/978-1-7998-7991-6.ch014
van Dijke, A., Emmory-Lijde, G. R. M., & Deen, M. L. (2021) · doi:10.2196/preprints.34507
Nakao, S., Nakagawa, A., Oguchi, Y., Mitsuda, D., Kato, N., Nakagawa, Y., Tamura, N., Kudo, Y., Abe, T., Hiyama, M., et al. (2018) · doi:10.2196/preprints.10743
User Experiences and Perceptions of Internet Interventions for Depression
Drozd, F., Andersen, C. E., Haga, S. M., Slinning, K., & Bjørkli, C. A. (2019) · IGI Global eBooks · doi:10.4018/978-1-7998-2351-3.ch016
Fernández, O., Pérez, J. C., Fernández, S., Krause, M., Cáceres, C., & Espinosa-Duque, D. (2023) · Digital Health · doi:10.1177/20552076231203920
Biersack, K., Sattel, H. C., Schönweger, P., Kaspar, L., Lehnen, N., Gensichen, J. S., Henningsen, P., & the POKAL group (2025) · PLoS ONE · doi:10.1371/journal.pone.0293713 · Cited by 1
“Surprisingly, we only identified four publications directly researching patients’ expectations [36,56,93,94].”
Eid, L., Kenny, A., Taher, R., Jacobsen, P. C., Hsu, C.-W., & Yiend, J. (2025) · JMIR Human Factors · doi:10.2196/70181 · Cited by 2
“Most participants reported that the way the intervention was delivered fit their preferences and offered them flexibility and privacy, in line with the perceived advantages of internet-based interventions in previous studies [30,31].”
Lundén, C., Khalifa, N., Ramklint, M., Isaksson, J., Jernelöv, S., & Zetterqvist, V. (2025) · Psychiatry Research · doi:10.1016/j.psychres.2025.116815
Sjöström, M. (2014) · KTH Publication Database DiVA (KTH Royal Institute of Technology)
Jabeen, I., Shomik, M. S., Hossain, S., Ara, T., Manna, R. M., Islam, S. M. H., Akter, T., Usmani, N. G., Chandra, P., Ahamed, B., et al. (2026) · BMC Health Services Research · doi:10.1186/s12913-026-15109-6
“Evidence showed that using a home computer for therapy is useful for the patients, as they can fit therapy into their daily schedule at their convenience [45].”
Fournier, A., Rivest, M.-C., Price, J. A. B., & Hadjistavropoulos, H. D. (2026) · Revue québécoise de psychologie · doi:10.7202/1126758ar
Metadata
- Authors
- Beattie, A., Shaw, A., Kaur, S., & Kessler, D.
- Affiliations
- University of Bristol (GB)
- National Institute for Health and Care Research (GB)
- Venue
- Health Expectations
- Publisher
- Wiley
- Published
- 2009-02-27
- Volume
- 12
- Issue
- 1
- Pages
- 45-59
- ISSN
- 1369-6513 (ISSN-L)
- 1369-7625
- PMC
- PMC5060477
- OpenAlex
- W1981927499
- Cited by
- 170
- References
- 35
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 7 · 2023: 6 · 2022: 6 · 2021: 10 · 2020: 16 · 2019: 7 · 2018: 13 · 2017: 10 · 2016: 21 · 2015: 10 · 2014: 18 · 2013: 15 · 2012: 7
- FWCI
- 9.01
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Health Expectations (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Explore Bristol Research (publishedVersion)
- Funders
- National Institute for Health and Care Research (CL-2007-25-001)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- internet-based cognitive behavioral therapy, depression, primary care, patient expectations, patient experience, therapeutic relationship, anonymity, written communication, computer literacy, acceptability, face-to-face interaction
- MeSH terms
- Adult, Aged, Depression, England, Female, Humans, Interviews as Topic, Male, Middle Aged, Primary Health Care, Cognitive Behavioral Therapy, Patient Satisfaction, Internet, Young Adult
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
