Strengths and limitations
First, the sample size is relatively small. However, we included patients from all general practices that participated in the feasibility trial. This allowed us to report the experiences of patients from different locations and cover the potentially influencing structural differences in one or more practices. Furthermore, our sample, which was comprised of individuals with mild to moderate symptom severity and mostly lacked current mental health treatment (either psychological/psychiatric or psychopharmacological) seems very relevant to an intervention study in primary care in which this patient profile predominates [Second, we relied on participants’ self-reported intentions and practices, which always carries the risk of social desirability that can bias the findings, particularly after the patients had received the intervention. However, we tried to minimize the limitations of self-reports by firmly reassuring the participants of the confidential nature of their participation and encouraging them to express their opinions and thoughts honestly.Third, the interviews were rather short. Telephone interviews are typically, and on average, shorter than those conducted face-to-face – an observation that usually results from participants speaking for less time. However, we reverted to a viable strategy for reducing this tendency by (1) reducing the number of themes covered compared to what we had planned initially and (2) providing a highly structured interview guide [Fourth, experiences from the participants were mostly positive and there may be a lack of more critical perspectives in our sample. Our sampling strategy was to include all patients in the intervention group. Thus, we did not distinguish between positive and negative cases. However, of the 23 participants in the intervention group, three patients did not participate in the interviews. It can be assumed that those who were not interested in participating were more likely to have had negative experiences with video consultation and did not want to participate further in the study. To validate the general feasibility and benefit of this treatment model, future studies should consider this aspect.Finally, as our trial was completed shortly before the COVID-19 pandemic began, our results were unaffected by the changing conditions of health-service delivery created by the pandemic. However, isolation due to social distancing and repeated lockdowns is a tremendous threat to the mental health of many people for the foreseeable future [