Cognitive Behaviour Therapy for Depression and Anxiety
Results of Blues Begone Research – Part 1
Welcome to the first part of the results for cognitive behaviour therapy for depression and anxiety program Blues Begone. This the fourth article in a series about the Blues Begone User Experience.
Interviews indicated that participants had found the Blues Begone programme easy to use and appeared to have become engaged with their self-help activity. Six individuals reported improvements to their physical and/or emotional well-being including improved sleeping patterns, decision-making and general mood.
Five master themes emerged from the analysis of transcripts and can be summarised as follows:
Cognitive Behaviour Therapy for Depression and Anxiety:
The psychological state, individual characteristics and expectations of the participant at the outset of their self-help activity.
Cognitive Behaviour Therapy for Depression and Anxiety: Client theory of change
Within the theme of Psychological Position, the importance of participants’ own “theory of change” emerged, with participants clear as to why a self-help activity might suit their needs at this particular time, and why the Blues Begone programme in particular could be of help. For Teresa, having reflected on her personality and coping style, the programme’s CBT framework was an attraction:
“The difference you know with this particular self-help
programme was that it did…make you…focus very specifically
on problems and analyse them which I am…I’m a bit lazy about
doing” (Teresa, 2. 38-41)
Similarly, Caroline commented:
“I have had a little CBT before, erm and I always spend an hour a day on the computer, so the whole thing seemed to be something that would…have advantages for me… it ticked the boxes” (Caroline, 1. 14-17and 35)
Caroline’s comment above highlights the importance of the format as well as the content of self-help activity. In choosing to do the Blues Begone programme, most participants viewed being able work at home as having advantages: firstly, using a computer at home offered a degree of privacy to the “client”. Jane in particular felt that this would suit her, being aware of her particular symptoms of depression:
“I withdraw when I’m depressed, I don’t like talking…I think that it (BBG) is private; if you’re…yes, there isn’t anybody there, it just is…you’re on your own and it’s private” (Jane, 2. 3-4, 17-18)
Secondly, using a computerised format at home offered flexibility with the opportunity for users to choose when they did the programme, fitting it in with other life commitments. As Tessa explained:
“(Using the computer) felt private, more intimate and being able to do it when I wanted; I used to do it early in the morning when no one else was up. And you know that felt you know, very comfortable for me” (Teresa, 4. 43-46)
Cognitive Behaviour Therapy for Depression and Anxiety: Novelty and hope
It is interesting to note that five of the seven participants interviewed had had previous experience of face to face therapy. Whilst such experiences were described as being largely positive, all were now choosing to try a different approach. Analysis of the text seemed to suggest that a different type of therapy might offer participants new possibilities and hope. As Jane commented:
“I suppose there was another aspect to it of actually thinking you know people say they just want the magic wand, so (laughs) you know, maybe that somehow something might happen that was a different tack from face to face therapy” (Jane, 2. 27-31).
Cognitive Behaviour Therapy for Depression and Anxiety: “Down but not out”
Whilst participants appeared “down”, their reported day to day activities indicated that they were not yet “out”; that is whilst psychological functioning appeared to be impaired to varying degrees, all participants demonstrated sufficient levels of personal agency to indicate that they were not completely overwhelmed by their psychological problems.
Analysis revealed a group of individuals who were actively seeking help of some form or other in order to address their issues, and indeed it seemed that some participants had chosen a self-help programme to be active in their treatment. For Caroline, the passivity of waiting for treatment at a GP’s surgery seemed depressing in itself:
“I don’t like going to GP’s surgeries! (Laughs). I mean I really hate it. I just have memories of sitting there for hours and waiting and waiting with all these miserable looking people” (Caroline, 2. 17-20)
Cognitive Behaviour Therapy for Depression and Anxiety: Personal characteristics
Further to the largely active stance of participants, it was noticeable that participants demonstrated personal characteristics such as openness to new experience, curiosity, resourcefulness and a positive attitude to self-help. They reported a readiness to take on board new information and ideas but also a tendency to “see through” things that they had started.
Overall participants showed a desire for further understanding of themselves and their current psychological state. They seemed to place an emphasis on wanting to know, understand and learn techniques to alleviate their distress. The following comment made by Monica encapsulates well this particular sub-theme:
“I thought I must learn something from it and it’s going to open
me up to maybe some new ideas and some other things that
maybe I wouldn’t have otherwise considered. So let’s just give
this a try and see what it teaches me…” (Monica, 2. 22-25)