Delivering an outcomes focused cCBT Service Key learnings Collette Bird, Senior Product Marketing Manager 18th September 2015.

Introduction Understanding the challenges and benefits of delivering cCBT Identifying effective practices Real-life outcomes and experiences

INTRODUCTION Global healthcare technology company. Online therapeutic solution, 10+ years of clinical and academic research. Focus on bringing best to market through key strategic partnerships including Berkshire Healthcare, Wiley, Kings College and Trinity College Dublin.

WHAT we offer? EFFECTIVENESS, CARE, REACH SilverCloud Solution Broad library of programmes Developed with world leading clinical and academic partners Flexible online platform Secure, anonymous, supportive, accessible 24/7 Professional services Consultation, implementation, customisation & engagement SilverCloud Solution

SilverCloud Programme suite Space from Anxiety Space from OCD Space from Health Anxiety Space from Social Anxiety Space from GAD Space from Panic Space from Phobia Space from Depression Space from Depression & Anxiety Space from Stress Berkshire Talking Therapies developed the clinical content across the anxiety and depression suite to ensure IAPT step 2 suitability

Understanding the challenges and benefits of delivering cCBT

The Challenges Getting PWPs on board Reticence around new ways of working/change. Staff percpetion of online therapy Time for PWPs to get familiar with the programme The Challenges Processes & procedures for online working - how will it fit into current pathways - developing new care pathways

Sense of Ownership - Important for head of service to own it. Promote it - understand the benefits and cascade it down through service Buy in from senior management Understanding the product is key! Understand clinical content on the platform Know the best way to adapt it for clients Allocate dedicated time -setup processes and guidance PWPs know exactly how it will be used Consider targets Key Learnings Training – Look at content, buddy up training Practice describing it to clients

The Benefits ✓ Flexible, helps to manage case loads Increased capacity PWPs can hold signifcantly higher case loads Flexible, helps to manage case loads Asynchronous online support e.g. can deal with unexpected risk Time saving Online session 15 minutes, guided self help takes 30 mins. Integration of PEQ questionnaires, integration with client record providers The Benefits It works! Clinically effective Good recovery rates. 50-60% Proven in RCTs Access Maintain steady access rates Improve access - self referrals, GP referral ✓

The Benefits Good content Based on PWP curriculum so nothing unfamiliar Can be tailored to individual e.g. sleep, employment difficulties

The Benefits Very transparent You can see what clients have done and what they haven’t done! The Benefits

User Benefits X3 engagement Flexible, accessible, convenient Online accessible 24x7. Helps overcome psychological and physical barriers of accessing services Effective Empowering – interactive, engaging content. Personalisation of programme increases success. Clinically proven RCTs Supportive Supporter guidance increases. Access to programme and tools for 1 year to maintain recovery and wellbeing X3 engagement

Effective practices Top tips to drive engagement

Top tips to encourage good engagement Offer it appropriately Have confidence in the product -clinical product backed by research - you know it will be effective! Explain exactly what it will involve - get client feedback on how they feel about it Explain it is based on CBT – and explain what CBT is Let them know that the more they put into it the more they will get out of it Run through the modules/techniques – make it relevant to the individual Check that they think it will be helpful!

Top tips to encourage good engagement Set clear expectations Around progress. Explain your DNA procedure – e.g. missed online review is the same as a missed appointment Explain about online reviews Be flexible. Include phone contact if needed, for example until they are comfortable with online reviews Explain how many reviews you offer on average, that their progress will be monitored through their activity, feedback and the questionnaires Explain the reason for questionnaires

Real-life outcomes and experiences

IOW - GP referral Simple referral process GP assesses patient suitability for online CBT GP provides the patient with a leaflet – explaining what it is and how to sign-up Patient signs-up via a SilverCloud designed website. They are automatically assigned an IAPT PWP

IOW GP referral - benefits “The results from the programme have seen recovery rates above 60% for those who have completed treatment.” Increase access points and reduce the steps to entry for online therapy Provides anonymity - access mental health services through confidential doctor-patient relationship Support and guidance - from IAPT trained Psychological Wellbeing Practitioners throughout the programme 50 % of online clients are GP referrals

Talking Therapies Berkshire - Service Outcome Data Number of clients on SilverCloud Around 40% of all step 2 clients Recovery Rate Average 57% Engagement Rate Only marginally lower than that of Guided Self Help PWPs can hold significantly higher caseloads

Talking Therapies Berkshire - Service Outcome Data

Client Feedback For me the best part of SilverCloud is the fact that I can do it at my own pace, which gives me a greater sense of control and achievement. After just a few months on the program, I am feeling significantly better than any amount of antidepressant has ever made me feel. It was particularly interesting to learn how thoughts, feelings and behaviours are all linked. The mindfulness exercises have helped me to understand my body a bit more and I am able to identify any unhelpful thoughts before they become a problem. Overall I would recommend Talking Therapies as they have been a massive help to me and my wellbeing.

Questions Collette.Bird@SilverCloudHealth.com www.SilverCloudHealth.com