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Short abstract

Studying users’ engagement with internet based cognitive behavioral therapy (ICBT) through home visits gives valuable insights about reception, use and reluctance. In this paper the notion of ontonorms is used, to scrutinize how people living with anxiety and depression engage in iCBT from home.

Long abstract

Mental wellbeing is under pressure. There is a need for high-quality services to support mental thriving. The potential of internet-based cognitive therapy (iCBT) claims to have potential to reach many people at home in need of services but is still not fully unleashed. Based on home visits, this paper examines patient reservations, collaboration and reluctance while engaging in iCBT from home. We know that many people drop out of existing internet-based iCBT services because the services do not meet their requested need for help. To enlighten this, we debate ethnographic case studies gathered from thirteen home visits with patients receiving therapy for anxiety or depression. To address our informants’ values and engagements, we unfold three stories about what makes patients withdraw their engagement. We call these stories: entrapment, cynicism, and impatience. Correspondingly, we seek to understand what makes program cessation, and we argue that ethnographic studies and the notion of ontonorms help promote interface development in iCBT. Thus, we contribute to STS with what happens when users’ requests, interfaces and care contexts do not fit. This feeds into a debate about interface development and how to manage iCBT as an innovative and ethical practice. We discuss patients’ engagement with the iCBT platform, and we discuss how user interfaces and internet-based care services may be developed through ethnographic work and home visits.