Clinicians’ attitudes towards, and use of, computerised cognitive behaviour therapy: a research portfolio

Abstract

BACKGROUND: Computerised Cognitive Behaviour Therapy (cCBT) is effective for a range of mental health difficulties but research indicates that the rate of uptake is low amongst clinicians. Most of the literature regarding cCBT tends to focus on evidence demonstrating its effectiveness or patient views of cCBT, but there is limited research looking at clinician or provider views.

AIMS: The systematic review and empirical research project aimed to examine staff attitudes towards cCBT. The empirical study also aimed to establish whether constructs of Normalisation Process Theory predicted clinicians’ a) self-reported attitudes towards cCBT and b) self-reported referral behaviour regarding cCBT.

METHODS: A systematic review of four electronic databases was conducted. Nineteen studies were identified for inclusion in the review and subjected to data extraction, quality assessment and narrative synthesis. For the empirical study, an online survey was completed by 246 individuals who provide psychological input to people in the UK. Stepwise regression was used to examine predictors of attitudes and referral rates.

RESULTS: Findings from the systematic review indicated that clinicians were generally of the view that cCBT is acceptable and effective to an extent. No firm conclusions could be drawn regarding the rate of use of cCBT by clinicians due to the heterogeneity between studies. Similarly, the empirical study found that clinicians reported both negative and positive attitudes towards cCBT. Fewer than half of respondents had ever referred a patient to cCBT and the rates of referral were typically low. Constructs of NPT were important predictors of both attitudes and self-reported referral rates.

CONCLUSIONS: The current findings indicate that clinicians exhibit mixed attitudes towards cCBT. The empirical study indicates that NPT may be a useful theory in predicting attitudes and behaviours toward healthcare interventions but additional research is required to establish whether this finding is replicable in areas beyond cCBT.