Critical Review on Factors That Influence Continuous Engagement Towards CCBT

Zainul Akramin Mohd Drus, Dalbir Singh, Mohd Rosmadi Mokhtar, Rusdi Abd Rashid


Substance abuse is an epidemic that spreads among adults, adolescents and even children in Malaysia. Substance abuse is categorized as a mental disorder, whereby, Cognitive Behavioural Therapy (CBT) is an approach that provides face to face physiological therapy for patients could resolve this issue. Computerized Cognitive Behavioural Therapy (CCBT) is a progression of information technology that is provided for patients encounter substance abuse. CCBT is a computerized therapy conducted at patient’s own pace. Ensuring patient’s continuous engagement towards CCBT becomes an issue. Patients that experience early gains, loss of interest and improvement symptom would sign up for alternative services that eventually causes disengagement and dropout from CCBT program. Interface design for CCBT is known as one of the important elements that effects patient’s engagement along CCBT program. Therefore, in this study, influential factors regarding CCBT’s interface design was investigated, whereby, five prominent models was reviewed. Content analysis methodology was employed to discover influential factors regarding CCBT’s interface design. Four influential factors was discovered namely engagement, dropout, culture and interface. These factors are known to ensure patient’s continuous engagement towards CCBT program. CCBT’s interface design plays a vital role in delivering the therapy program. Indirectly, CCBT’s interface design plays an important role to ensure patient’s continuous engagement till the completion of CCBT program. Therefore, these factors would guide researcher, service provider, developers and clinicians in designing engaging interface for CCBT.


CCBT, continuous engagement, influential factors, interface design, substance abuse

Full Text:



Andersson, G., & Cuijpers, P. (2009). Internet-Based and Other Computerized Psychological Treatments for Adult Depression: a Meta-Analysis. Cognitive Behaviour Therapy, 38(4), 196–205.

Andrews, G. (2010). Utility of Computerised Cognitive-Behavioural Therapy for Depression. British Journal of Psychiatry, 196(4), 257–258.

Attfield, S., Kazai, G., Lalmas, M., & Piwowarski, B. (2011). Towards a Science of User Engagement (Position Paper). WSDM Workshop on User Modelling for Web Applications. Retrieved from

Barazzone, N., Cavanagh, K., & Richards, D. (2012). Computerized Cognitive Behavioural Therapy and The Therapeutic Alliance: A Qualitative Enquiry. British Journal of Clinical Psychology, 51(4), 396–417.

Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive Therapy of Depression. The Guilford Press.

Cavanagh, K., & Millings, A. (2013). Increasing Engagement With Computerised Cognitive Behavioural Therapies. ICST Transactions on Ambient Systems, 13(2), e3.

Chiauzzi, E., & Gammon, J. (2012). Recovery 2.0: Substance Abuse Treatment in a Technological World. Inflexxion. Retrieved from

Giordani, B., Novak, B., Sikorskii, A., Bangirana, P., Nakasujja, N., Winn, B. M., & Boivin, M. J. (2015). Designing and Evaluating Brain Powered Games for Cognitive Training and Rehabilitation in At-Risk African Children. Global Mental Health, 2, e6.

Heimgärtner, R. (2013). Intercultural User Interface Design - Culture-Centered HCI Design - Cross-Cultural User Interface Design: Different Terminology or Different Approaches? Lecture Notes in Computer Science (Including Subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics), 8013 LNCS(PART 2), 62–71.

Jaeggi, S. M., Buschkuehl, M., Jonides, J., & Shah, P. (2011). Short- and Long-Term Benefits of Cognitive Training. Proceedings of the National Academy of Sciences of the United States of America, 108(25), 10081–10086.

Jeon, M., Riener, A., Lee, J.-H., Schuett, J., & Walker, B. N. (2012). Cross-Cultural Differences in the Use of In-Vehicle Technologies and Vehicle Area Network Services: Austria, USA, and South Korea. Proceedings of the 4th International Conference on Automotive User Interfaces and Interactive Vehicular Applications, (October 2015), 163–170.

Kobak, K. a, Greist, R., Jacobi, D. M., Levy-Mack, H., & Greist, J. H. (2015). Computer-Assisted Cognitive Behavior Therapy for Obsessive-Compulsive Disorder: A Randomized Trial on The Impact of Lay vs. Professional coaching. Annals of General Psychiatry, 14(1), 1–8.

Marks, I., & Cavanagh, K. (2009). Computer-Aided Psychological Treatments: Evolving Issues. Annual Review of Clinical Psychology, 5, 121–141.

McLellana, A. T., Kemp, J., Brooks, A., & Carisea, D. (2008). Improving Public Addiction Treatment Through Performance Contracting: The Delaware Experiment, 87(3), 296–308.

Mokhtar, S. A., & Anuar, S. M. S. (2015). Learning Application for Malaysian Sign Language: Content Design, User Interface and Usability. In IMCOM ’15 Proceedings of the 9th International Conference on Ubiquitous Information Management and Communication Article No. 27. ACM New York, NY, USA.

O‘Brien, H. L., & Toms, E. G. (2008). What is User Engagement ? A Conceptual Framework for Defining User Engagement with Technology. Journal of the American Society for Information Science & Technology, 59(6), 1–37.

Reynolds, J., Griffiths, K. M., Cunningham, J. A., Bennett, K., & Bennett, A. (2015). Clinical Practice Models for the Use of E-Mental Health Resources in Primary Health Care by Health Professionals and Peer Workers: A Conceptual Framework. JMIR Mental Health, 2(1), e6.

Saidin, N., Singh, D., & Drus, Z. A. M. (2017). Culture Centered Design : Reviews on Cultural Factors Influencing Interface design Elements. Pertanika Journal of Scholarly Research Reviews, 3(1), 42–54.

Sarsam, S. M., & Al-Samarraie, H. (2018). Towards incorporating personality into the design of an interface: a method for facilitating users’ interaction with the display. User Modeling and User-Adapted Interaction, 28(1), 75–96.

Shepherd, M., Fleming, T., Lucassen, M., Stasiak, K., Lambie, I., & Merry, S. N. (2015). The Design and Relevance of a Computerized Gamified Depression Therapy Program for Indigenous Māori Adolescents. JMIR Serious Games, 3(1), e1.

Wolpe, J. (1958). Behavior Therapy by Reciprocal Inhibition. Stanford, CA: Stanford University Press.


  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

The Pertanika Journal of Scholarly Research Reviews, (e-ISSN: 2462-2028, ISSN: 2636-9141) published by Universiti Putra Malaysia Press