A qualitative examination of psychology graduate students' experiences with guided Internet-delivered cognitive behaviour therapy

• This study explored students’ perceptions of training in guided ICBT.
• Students reported significant benefits from training in guided ICBT.
• Asynchronous emails with clients give students time to reflect and seek supervision.
• Students apply skills learned in guided ICBT to later face-to-face clinical work.
• Students identified factors that enhanced and challenged the learning experience.

Guided Internet-delivered cognitive behaviour therapy (ICBT) is efficacious for the treatment of a variety of clinical disorders (Spek et al., 2007), yet minimal research has investigated training students in guided ICBT. To contribute to the training literature, through qualitative interviews, this study explored how ICBT was perceived by student therapists (n = 12) trained in guided ICBT. Additionally, facilitators and challenges encountered by students learning guided ICBT were examined. Qualitative analysis revealed that students perceived training to enhance their professional skills in guided ICBT such as how to gain informed consent, address emergencies, and facilitate communication over the Internet. Students described guided ICBT as beneficial for novice therapists learning cognitive behavior therapy as asynchronous communication allowed them to reflect on their clinical emails and seek supervision. Further, students perceived guided ICBT as an important skill for future practice and an avenue to improve patient access to mental health care. Specific facilitators of learning guided ICBT included having access to formal and peer supervision as well as technical assistance, ICBT modules, a functional web application, and detailed policies and procedures for the practice of guided ICBT. Challenges in delivering guided ICBT were also identified by participants such as finding time to learn the approach given other academic commitments, working with non-responsive clients, addressing multiple complex topics over email, and communicating through asynchronous emails. Based on the feedback collected from participants, recommendations for training in guided ICBT are offered along with future research directions.