The impact of a national transition of treatment platform on the acceptance of internet-delivered cognitive behavioral therapy: A longitudinal study among Norwegian therapists

Background Therapists' acceptance of internet-delivered cognitive behavioral therapy (iCBT) is critical for successful and sustained implementation. However, little is known about how acceptance is affected by changes in delivery platforms. Objective To investigate how therapists' acceptance of iCBT changes during a national transition to a new delivery platform. Methods During a national change in delivery platform, 46 therapists (69% of the national population; N = 67) providing iCBT in Norwegian specialist health services, completed questionnaires at five time points over 18 months. The study applied an extended Technology Acceptance Model (TAM) which accounted for both patients and therapists as users of iCBT. Measures included TAM constructs, individual characteristics and place of employment. Multilevel models assessed changes in acceptance over time and baseline variance at therapist and organizational levels. Results Overall acceptance of iCBT was high at baseline and remained largely stable throughout the transition. Therapist perception of patients' ease of use increased significantly over time and was clearly distinguished from their perception of their own user experience. Notably, therapists' acceptance of the new platform was high even before they had gained hands-on user experience. Conclusion Among experienced iCBT therapists', acceptance appears resilient to disruptions caused by changes in treatment platforms. Acceptance of a new platform is not dependent on positive user experience alone and may be affected by efforts that influence therapists' expectations before implementation. Therapists' perceptions of their patients' user experience are likely important for their acceptance but remain poorly understood.