(PS10-B36) Dropping out of an Internet-based Intervention (GROw) for Prolonged Grief Disorder: A Qualitative Study

The advance and development of ICTs has greatly facilitated the dissemination of evidence-based psychological treatments, allowing a greater number of people to benefit from it. There is an increasing number of Internet-delivered cognitive-behavioral therapies (iCBT) that address a wide range of psychological disorders showing effective results compared to control groups and traditional CBT formats, resulting in a cost-effective way to reach more people in need and overcoming geographical barriers. Despite all its advantages, low adherence and high dropout rates are one of the most common problems associated with iCBT and research is lacking to address this concerning issue. The aim of the present work is to explore the subjective experience of participants after dropping out a randomized feasibility study of an iCBT (GROw) for people with Prolonged Grief Disorder (PGD), compared with a face-to-face intervention for PGD. To this end, a qualitative analysis carried out with 9 participants (4 from the GROw group and 5 from the face-to-face videoconferencing group) who dropped out of the study. The Consensual Qualitative Research (CQR) (Hill et al., 2005) guidelines were followed. An independent researcher contacted the participants after they dropped out by a telephone interview. After conducting the interviews, two researchers independently analyzed the transcripts of the call. The conclusions reached by each independent investigator were discussed with a third judge who was an expert in the field of iCBTs. A series of domains, categories and illustrative ideas were established, which were then classified as general (if they applied to all participants), typical (if they applied to at least half of the participants) or variant (if they applied to less than half of the participants) categories using a crossover analysis. The results showed that the participants of the GROw group highlighted the lack of time, the need for more therapeutic support and the need to avoid the intense emotions that arose during the treatment as the main reasons that motivated their abandonment. Regarding the face-to-face videoconference group, they also stated that the problems were related to the lack of time and the need to avoid the emotions that arose during the treatment. The proposed improvement strategies for the GROw group included getting help on demand and having weekly follow-up video-conferencing calls. The face-to-face videoconferencing group also proposed having videoconferencing meetings instead of just phone calls and the possibility of choosing the treatment model as improvement strategies. Additional reasons given for dropout were starting another treatment, loss of contact, and familiarity with the profession. The reported results of the present qualitative study are relevant not only to improve the GROw program, but also to other iCBT programs, being important aspects to consider to improve adherence to online programs and to help expand knowledge in this field given the growing number of studies focused on internet-delivered treatments.