Self-esteem in new light: a qualitative study of experiences of internet-based cognitive behaviour therapy for low self-esteem in adolescents

BACKGROUND: Low self-esteem is common and can be impairing for adolescents. Treatments that primarily target low-esteem are lacking. Internet-delivered cognitive behaviour therapy (ICBT) is a treatment that can be used for adolescents but ICBT is yet to be evaluated for low self-esteem using qualitative methods. The aim of this study was to investigate experiences of participating in a novel ICBT treatment for adolescents suffering from low self-esteem. METHOD: Fifteen adolescent girls who had received ICBT consented to participate in a semi-structured qualitative telephone interview at post-treatment. Data were analysed and categorised using inductive Thematic Analysis. RESULTS: Four overarching themes were identified; (1) Increased awareness and agency in difficult situations, (2) Enhanced self-image, (3) Unique but not alone, and (4) Widened understanding and new perspectives. Participants reported positive changes in their thinking and behaviour, as well as helpful learning experiences in relation to themselves and their self-esteem. For instance, participants described a more self-accepting attitude, learned how to manage negative thoughts, and experienced an increased sense of connection to others. CONCLUSION: The results suggest that ICBT is experienced as helpful and will inform further use and development of ICBT for low self-esteem. Future studies should validate and further evaluate experiences of ICBT for low self-esteem in other settings and in particular for boys as the study only include female participants. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-023-05328-0.