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

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

3. 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.

4. 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

5. 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

6. Understanding the challenges and benefits of delivering cCBT

7. 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

8. 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

9. 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 ✓

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

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

12. 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

13. Effective practices
Top tips to drive engagement

14. 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!

15. 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

16. Real-life outcomes and experiences

17. 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

18. 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

19. 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

20. Talking Therapies Berkshire - Service Outcome Data

21. 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.

22. Questions Collette.Bird@SilverCloudHealth.com