Computer Assisted Cognitive Behavior Therapy (Ccbt) for Bangladeshi Population

Abstract

Computer assisted Cognitive Behavior Therapy (CCBT) is a relatively new form of treatment in the world. The present research was aimed at developing a CCBT package for Bangladeshi population. Another purpose was to observe the impact of such an intervention as well as the perception of participants toward this kind of service. An explorative-sequential mixed method design was selected to achieve this end. The entire research was divided in two phases – development phase and test-and-review phase. The first phase was qualitative in nature which had three sub-phases – symptoms review, reviewing existing CBT practices and development of the web page. Using secondary data collection method and archival review, a total of 35 participants’ description of depression, 15 case reports and 20 case logs were collected. Data was analyzed following qualitative thematic content analysis. A total of five categories, ten themes and 26 sub-themes were identified as clustered in a thematic relationship representing depression within a portrayal. The Problem rating form was created from the mostly coded symptoms of depression. Similarly, the reported CBT practices were summarized and represented in a timeline, few categories and two models. The summarized results helped in the development of the content of web page. The web page had ten sessions, each session contained PPT, case examples, psycho-education materials, exercise, homework and feedback of homework. In the second phase of the research, a one group pre-posttest design was adopted. The web page was administered to 15 participants with mild to severe level of depression. The impact of CCBT and participants’ attitudes toward the service were assessed by using Depression Scale, problem rating form, feeling rating form and evaluation form. Statistical analysis showed the session completion rates and drop-out rates of the present program as 46.7% and 40%. Session completion rates were higher for participants with moderate depression (66.7%), whereas only 33.3% of mildly and 33.3% of severely depressed participants completed the package. Result also found a general decrease in theCCBT FOR DEPRESSION VI mean scores of depression scale from baseline (M = 118.07; SD = 11.823) to fifth (M =102.67; SD =19.346) and final session (M = 90.83; SD =17.414). The Friedman test showed a significant decrease in depressive symptoms before and after the treatment [χ2 (2, N = 9) = 15.80, p = .000]. The result also indicated a significant difference between the baseline and fifth session (z = -2.524, p = .012) as well as between the baseline and last session (z = - 3.062, p = .002). In terms of participants’ attitudes toward the service, mean score indicated gradual increases in the participants’ perceived benefits as the session progresses from first (M = 7.53; SD = .516) to ninth session (M = 9.00; SD = .000). The differences were also significant (χ2 = 22.656, p = .004) regarding the perceived benefits. Participants reported higher level of satisfaction as the session progressed from first (M = 7.80; SD = .414) to ninth session (M = 9.00; SD = .000) and the differences were significant [χ2 (8, N = 12) = 22.154, p = .005]. Both qualitative and quantitative findings affirmed that computer assisted cognitive behavior therapy can be used successfully to treat symptoms of depression.