Table 2
Themes | Subthemes | Examples of quotes | Codes |
|---|---|---|---|
Active agents of CBT principles | Concrete CBT-strategies | “I guess the most important thing is thinking about the consequences. Like thinking about the long-term consequences of skipping school for example, now I can understand why it’s not so nice doing certain things even if it is a relief there and then when you do it. I had not realised that.. like.. before.. that.. yeah.. that it may not be so good for you in the long run”. Participant [Evelinaa] | Exposure Behavioural activation Long-term consequences Sleep restriction Affect-regulation Worrying-time Avoidance strategies |
Active approach during and after treatment | “Well I cannot say that the anxiety for doing things has, like disappeared, the things I used to get anxious about still makes me anxious, like I have to work with it actively. Not giving up. Keep going.” Participant [Clara] | Applying it in real life Continuous work Deliberate practice Active reflection Taking time Doing home-work Don’t give up | |
Experience of insight | “Those texts said so much about yourself, things I did not know about, you know, like they gave me new perspectives on how I felt and why I felt the way I felt, I knew I was feeling bad, but not why, so I just kept going, and then I learned a lot about why, that there was a reason behind it, like it was not my fault and that this is how things can be, and like this is what you can do to improve it.” Participant [Alice] | Aha-moments Finding an explanation Understanding triggers Thoughts and emotions are manageable Eye-opener Faith in treatment | |
Passive agents of CBT principles | Vague general strategies | “I learned about attention.. like.. sure you can like work with your issues, but you shouldn’t put too much energy into things that you cannot change anyway.” Participant [Jacob] | Vague CBT-principles Learning about what works for oneself Changed attitude to oneself Less controlled by symptoms |
Passive or reactive approach | “It’s not something I really use, but more like, if you start feeling worse again you can go back and check the material, like maybe trying something out again.” Participant [Amelia] | Intuitive knowledge Implicit knowledge Using CBT when feeling worse Life continues Shrugging |