According to the study, clients face a range of difficulties while engaging in ICBT, which can be broadly categorized into skill-specific challenges and generic challenges. The research highlights that clients who actively share their difficulties are generally more engaged with the therapy, completing more lessons and communicating more frequently with their therapists. This finding underscores the importance of encouraging clients to openly discuss their challenges.
Skill-Specific Challenges
The study identifies several skill-specific challenges that clients encounter during ICBT:
- Cycle of Symptoms: Clients often struggle with identifying their symptoms and understanding their triggers. Initial challenges include difficulties in pinpointing the starting point of their symptom cycle.
- Thought Challenging: Clients find it challenging to identify specific unhelpful thoughts and come up with alternative, helpful thoughts. This is often due to a lack of belief in the alternative thoughts or difficulties in taking action based on them.
- Graded Exposure: Clients face difficulties in identifying target behaviors for exposure and breaking them down into manageable steps. Emotional barriers, such as fear and anxiety, also pose significant challenges.
Generic Challenges
In addition to skill-specific challenges, clients report several generic challenges that affect their engagement across all lessons:
- Limited Time: Clients frequently mention that they do not have enough time to practice the skills, which impacts their ability to complete homework assignments.
- Emotionally Draining: Many clients find the content emotionally taxing, particularly when reflecting on their symptoms and experiences.
- Forgetting to Use Skills: Clients often forget to apply the skills in real-life situations, which reduces the effectiveness of the therapy.
Practical Recommendations for Practitioners
Based on the findings, here are some practical recommendations for practitioners to enhance their ICBT practices:
- Encourage Open Communication: Actively encourage clients to share their difficulties. This can be done through regular check-ins and by making it clear that discussing challenges is a crucial part of the therapeutic process.
- Normalize Emotional Responses: Inform clients that it is normal to find some aspects of therapy emotionally draining and provide strategies to manage these feelings.
- Time Management: Help clients develop time management skills to better integrate therapy tasks into their daily routines. Emphasize the importance of consistent practice for skill acquisition.
- Tailored Support: Provide tailored support based on the specific challenges that clients report. For example, offer additional resources or alternative strategies for clients struggling with thought challenging or graded exposure.
By implementing these strategies, practitioners can better support their clients in overcoming the challenges associated with ICBT, leading to improved engagement and therapeutic outcomes.
To read the original research paper, please follow this link: Understanding Client Difficulties in Transdiagnostic Internet-Delivered Cognitive Behaviour Therapy: A Qualitative Analysis of Homework Reflections.
