Theme 3, task subtheme descriptions and supporting quotes
| Theme, percentage of sample endorsed (n) and description | Supporting quotes |
| Theme 3: task 100%, (19) | |
| Activity-based task, 100% (19) | |
| 3.1. Personalisation, 95% (18) The level at which a client is able to tailor the therapeutic task to their individual needs. A non-personalised digital intervention was reported to negatively impact engagement. The PWP in blended-therapy can play an important role in making a generic intervention (ie, computerised CBT) as more personalised. | P12, high-range WAI-SF-C Score: “I think it’s a bit more personalised, because I would say while the E-Compared is good, it is still, it is to an extent generic, because it can’t kind of know every single person that’s watching the video, so whereas the therapists can kind of get an idea of you, your story, your journey, what’s maybe led you to kind of this maybe relapse, or for you to be feeling the way you are, and you can’t maybe get that from a computer…Whereas if I’m hearing it from the person, I’m going to take a bit more notice, but then if I’m just hearing it from the computer, where it will say that to everyone watching the video“. |
| 3.2. Usefulness, 95% (18) A useful task was defined as one that promotes new learning, reflection and is effective in creating desired change in the client’s life. | P4, medium-range WAI-S-C score: “But like the modules themselves, feelings-wise they were often quite helpful for clarifying stuff. Like I usually came out the other end feeling better or more kind of composed…it would kind of shape how I was seeing things. So like if I, you know learnt about thought distortions, I’d kind of go in with that knowledge and be able to kind of talk about it…” |
| 3.3. Complementary, 84% (16) The ability to experience complementary tasks in face-to-face therapy and on the digital platform as continuous and cohesive, as opposed to stilted and disjoint. Knowing what to expect from the respective components of blended therapy was reported to help the client optimise the benefits sought from different components of therapy. | P16, medium working alliance: “I was finding it really hard to leave the house so that whole thought of going to therapy was quite difficult in the very beginning, so it did take me a couple of sessions to really start talking to (therapist) and opening up but because I had this online support I found it easier to open up to (therapist) so maybe instead of you know, two sessions it would have taken four or five”. |
| Responsive support task, 100% (19) | |
| 3.4. Accountability, 79% (15) The availability of a figure of authority that the client can (positively) feel responsible towards, as a means of garnering motivation to work on therapeutic activities. For the process of accountability to positively impact the client’s motivation, a PWP is required to demonstrate their knowledge of the client’s progress and provide feedback accordingly. | P19, medium-range WAI-S-C score: “ Well, to me, I saw it like homework, you've got to get it done otherwise you get into trouble, not that I would have got in trouble, but do you know what I mean, you're sort of motivated that way. And there is the other, the embarrassment of going in and saying 'oh yeah, I didn't do the modules' and then you feel really about that big and you know, someone's trying to help you and you haven't bothered to do your bit kind of thing. So that was a motivation in itself”. |
| 3.5. Guidance, 89% (17) The provision of guidance and reassurance on the therapeutic tasks by a PWP. The PWP’s intuition, expertise, interpretation and foresight is especially considered as helpful in addressing salient issues that would not have otherwise been communicated by the client. | P10, high-range WAI-SF-C score: “When you speak to your therapist, obviously she’s had a lot of different scenarios with a lot of different people, she’s got the experience and the know-how, and then obviously how I’m looking at it thinking the module’s really working like this, she then says, ‘That’s really brilliant, but to then add onto that and to support you, how about if you think about that?” |
| 3.6. Expression of feelings 100% (19) The client’s expressed need to speak to another human being, in order to communicate issues that are pertinent to their treatment journey. In order for the client to optimally benefit, clients require the PWP to dedicate a sufficient amount of time for the activity. The amount of time required by each person appears to vary in relation to pretherapy expectations and symptom severity. | P14, WAI-SF-C score unavailable: “I think it’s nice to have someone to talk to. It’s kind of, I think it’s important for me to express my feelings like in a private situation. Because sometimes I have, kind of I live with my partner but, you know, some(times), you can’t talk to her”. |
PWP, psychological well-being practitioner; WAI-SF-C, Working Alliance Inventory Short Form-Client.