Exploring Patients' Experiences in a Blended Transdiagnostic Group Treatment: Qualitative Study.

Abstract

Background: Emotional disorders (EDs) are the most prevalent mental disorders worldwide. Health services face significant difficulties in attending to the high demand and applying evidence-based psychological treatments. Combining the transdiagnostic approach with the group and blended formats could help the accessibility of treatment for ED. It is important to assess the feasibility and acceptability of new interventions from a qualitative perspective.

Objective: This study aimed to explore the experiences and opinions of patients with ED who have received transdiagnostic cognitive behavioral therapy treatment in a group and blended format.

Methods: Two subsamples of participants were included: those who completed the intervention (n=18) and those who did not (n=4). The completers' subsample participated in focus groups, which were transcribed verbatim and subsequently analyzed using a consensus qualitative research methodology. The noncompleters subsample completed a brief online questionnaire. Key themes identified by 2 independent researchers were described and used as complementary to focus group findings. Results were reported following the COREQ (Consolidated Criteria for Reporting Qualitative Research) guidelines.

Results: After analyzing the focus group interviews using the consensus qualitative research method, 8 domains (or topic areas) were identified, namely experience with the online platform, configuration of the blended intervention, therapeutic content, experience with the group sessions via videoconference, role of the therapists, overall assessment of the blended treatment, elements that help maintain adherence, and suggestions for improvement. Overall, participants reported benefits from this type of intervention, expressed satisfaction with the treatment, and highlighted the perceived improvement and usefulness of what they learned. They also noted the good usability of the platform and the possibility of establishing a good therapeutic alliance in this format. Participants also pointed out unfavorable aspects and offered suggestions on possible areas for improvement. For noncompleters, various reasons for dropping out were identified: lack of treatment efficacy, intervention-related stress, difficulty in applying learned strategies, low involvement, lack of motivation, time constraints, or need for different types of help. Strategies to enhance adherence to treatment were also identified, such as changes in the format and configuration of the sessions, allowing more time to discuss individual problems or reducing the number of homework assignments.

Conclusions: These qualitative results support the feasibility, acceptability, and clinical utility of a blended group transdiagnostic intervention for the treatment of ED. This novel format could be a scalable and well-valued option within mental health services, although it can still be further optimized based on the results of this study.