Iluczyk, Dominika; (2025) The Acceptability and Feasibility of Internet-Based Psychodynamic Psychotherapy for University Students with Low Mood and a Review of Experiences of Therapists Who Guide Online Interventions. Doctoral thesis (D.Clin.Psy), UCL (University College London).

Text edited_version_Thesis_submission_volume1_Iluczyk.pdf - Accepted Version Access restricted to UCL open access staff until 1 October 2026. Download (5MB)

Abstract

Aims: There is an increase in the mental health needs of university students in the UK. This study follows from previous research examining the utility of Internet-Based Psychodynamic Psychotherapy (iPDT) in adolescents, although not university students. In the present study the acceptability and feasibility of an adapted therapist guided intervention for university students with low mood was examined. One of the adaptations was not including weekly synchronous written chat sessions with a Therapeutic Support Worker. The aims of the study were to 1) assess feasibility of the intervention via recruitment and retention rates of participants and therapeutic support workers, adherence including engagement with the intervention, and reporting of adverse events, 2) examine acceptability of the adapted intervention in a new target population, 3) explore preliminary indicators of effectiveness of the adapted intervention, and 4) explore factors that could influence treatment response. Method: A single-arm feasibility and acceptability study was conducted. Consultations were held to adapt the intervention for an adult university student population. University students completed an online intervention with 8 modules over 10 weeks. Participants completed weekly outcome measure as well as worksheets/exercises in each module of the intervention. They received asynchronous text-based feedback via an online platform on worksheets/exercises from allocated Therapeutic Support Workers, who were final year postgraduate students completing a psychodynamically oriented course. Therapeutic Support Workers received weekly group supervision. 88 Results: There was preliminary evidence that the intervention was acceptable. Additionally, there was preliminary evidence that despite removal of synchronous therapeutic contact, the intervention could be feasible in terms of and outcome measure completion, Therapeutic Support Worker retention, and participant engagement, which can support planning for future studies. However, it is not possible to ascertain feasibility of recruitment in the present study and further research is needed. No significant adverse events occurred during the study. Exploratory data analyses showed that participants reported statistically significantly lower depression scores at week 10 compared to baseline. This appeared stable at 3-month follow up. There was no statistically significant change to anxiety scores over time. Baseline overall defensive functioning and attachment styles were not predictive of Week 10 depression scores. There were no statically significant changes in dependency, and self-criticism did not differ between baseline, Week 10 and 3-month follow-up. Self-reported working alliance significantly strengthened over time in this guided online intervention. Conclusion: To the authors’ knowledge, this is the first study to examine the acceptability and feasibility of this therapist-guided iPDT intervention adapted for an adult university student population without synchronous text-based chat sessions from Therapeutic Support Workers. The results of the study indicate evidence of acceptability of the intervention, feasibility of delivery, and preliminary indicators of effectiveness regarding low mood but not anxiety. However, future studies are needed to examine the feasibility of recruitment of participants. The results warrant a further larger scale study of this iPDT intervention for this population. Suggestions are made for future studies to address methodological issues and to compare iPDT with and without synchronous chat sessions and to explore the impact of university-related stressors on outcomes. Methodological recommendations include a large-scale trial with a shorter window between expression of interest and enrolment in the study.

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