TY  - JOUR
AU  - Thapar, Serena
AU  - Nguyen, Megan
AU  - Khan, Bilal Noreen
AU  - Fanaieyan, Roz
AU  - Kishimoto, Vanessa
AU  - Liu, Rebecca
AU  - Bolea-Alamañac, Blanca
AU  - Leon-Carlyle, Marisa
AU  - O’Riordan, Anne
AU  - Keresteci, Maggie
AU  - Bhattacharyya, Onil
PY  - 2024
DA  - 2024/2/19
TI  - Patient and Therapist Perceptions of a Publicly Funded Internet-Based Cognitive Behavioral Therapy (iCBT) Program for Ontario Adults During the COVID-19 Pandemic: Qualitative Study
JO  - JMIR Form Res
SP  - e50113
VL  - 8
KW  - depression
KW  - anxiety
KW  - cognitive behavioral therapy
KW  - digital health
KW  - internet-delivered cognitive behavioral therapy
KW  - iCBT
KW  - CBT
KW  - implementation
KW  - facilitators
KW  - barriers
KW  - interviews
KW  - qualitative
AB  - Background: To address the anticipated rise in mental health symptoms experienced at the population level during the COVID-19 pandemic, the Ontario government provided 2 therapist-assisted internet-delivered cognitive behavioral therapy (iCBT) programs to adults free of charge at the point of service. Objective: The study aims to explore the facilitators of and barriers to implementing iCBT at the population level in Ontario, Canada, from the perspective of patients and therapists to better understand how therapist-assisted iCBT programs can be effectively implemented at the population level and inform strategies for enhancing service delivery and integration into the health care system. Methods: Using a convenience sampling methodology, semistructured interviews were conducted with 10 therapists who delivered iCBT and 20 patients who received iCBT through either of the publicly funded programs to explore their perspectives of the program. Interview data were analyzed using inductive thematic analysis to generate themes. Results: Six salient themes were identified. Facilitators included the therapist-assisted nature of the program; the ease of registration and the lack of cost; and the feasibility of completing the psychoeducational modules given the online and self-paced nature of the program. Barriers included challenges with the online remote modality for developing the therapeutic alliance; the program’s generalized nature, which limited customization to individual needs; and a lack of formal integration between the iCBT program and the health care system. Conclusions: Although the program was generally well-received by patients and therapists due to its accessibility and feasibility, the digital format of the program presented both benefits and unique challenges. Strategies for improving the quality of service delivery include opportunities for synchronous communication between therapists and patients, options for increased customization, and the formal integration of iCBT into a broader stepped-care model that centralizes patient referrals between care providers and promotes continuity of care. 
SN  - 2561-326X
UR  - https://formative.jmir.org/2024/1/e50113
UR  - https://doi.org/10.2196/50113
UR  - http://www.ncbi.nlm.nih.gov/pubmed/38373027
DO  - 10.2196/50113
ID  - info:doi/10.2196/50113
ER  -