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Open Access Study protocol

Expectations, experiences and attitudes of patients and primary care health professionals regarding online psychotherapeutic interventions for depression: protocol for a qualitative study

Jesús Montero-Marín12, José Miguel Carrasco3, Miquel Roca4, Antoni Serrano-Blanco5, Margalida Gili4, Fermin Mayoral6, Juan V Luciano5, Yolanda Lopez-del-Hoyo7, Barbara Olivan7, Francisco Collazo8, Ricardo Araya9, Rosa Baños1012, Cristina Botella1112 and Javier García-Campayo113*

Author Affiliations

1 Department of Psychiatry, University of Zaragoza, Zaragoza, Spain

2 Faculty of Health and Sports, University of Zaragoza, Huesca, Spain

3 Research Unit, Sociedad Española de Reumatología, Madrid, Spain

4 Institut Universitari d’Investigació en Ciències de la Salut (IUNICS), University of Balearic Islands, Palma de Mallorca, Spain

5 Parc Sanitari Sant Joan de Déu, and Fundación Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain

6 Psychiatric Service, University Hospital Carlos Haya, Malaga, Spain

7 Departamento de Psicología y Sociología, Universidad de Zaragoza, Zaragoza, Spain

8 Servei de Psiquiatria, Hospital Universitari Vall d’Hebron, Barcelona, Spain

9 Academic Unit of Psychiatry, School of Social and Community Medicine, University of Bristol, Bristol, UK

10 University of Valencia, Valencia, Spain

11 Jaume I University, Castellón, Spain

12 CIBER Pathophysiology of Obesity and Nutrition (CB06/03), Carlos III Institute of Health, Madrid, Spain

13 Psychiatry Service, Miguel Servet Hospital, Avda Gomez Laguna 52, 4D 50.009, Zaragoza, Spain

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BMC Psychiatry 2013, 13:64  doi:10.1186/1471-244X-13-64

Published: 20 February 2013



In the year 2020, depression will cause the second highest amount of disability worldwide. One quarter of the population will suffer from depression symptoms at some point in their lives. Mental health services in Western countries are overburdened. Therefore, cost-effective interventions that do not involve mental health services, such as online psychotherapy programs, have been proposed. These programs demonstrate satisfactory outcomes, but the completion rate for patients is low. Health professionals’ attitudes towards this type of psychotherapy are more negative than the attitudes of depressed patients themselves. The aim of this study is to describe the profile of depressed patients who would benefit most from online psychotherapy and to identify expectations, experiences, and attitudes about online psychotherapy among both patients and health professionals that can facilitate or hinder its effects.


A parallel qualitative design will be used in a randomised controlled trial on the efficiency of online psychotherapeutic treatment for depression. Through interviews and focus groups, the experiences of treated patients, their reasons for abandoning the program, the expectations of untreated patients, and the attitudes of health professionals will be examined. Questions will be asked about training in new technologies, opinions of online psychotherapy, adjustment to therapy within the daily routine, the virtual and anonymous relationship with the therapist, the process of online communication, information necessary to make progress in therapy, process of working with the program, motivations and attitudes about treatment, expected consequences, normalisation of this type of therapy in primary care, changes in the physician-patient relationship, and resources and risks. A thematic content analysis from the grounded theory for interviews and an analysis of the discursive positions of participants based on the sociological model for focus groups will be performed.


Knowledge of the expectations, experiences, and attitudes of both patients and medical personnel regarding online interventions for depression can facilitate the implementation of this new psychotherapeutic tool. This qualitative investigation will provide thorough knowledge of the perceptions, beliefs, and values of patients and clinicians, which will be very useful for understanding how to implement this intervention method for depression.

Depression; Online psychotherapy; Internet-based treatment; Protocol; Qualitative study