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SilverCloud Health: Online Mental Health and Wellbeing Platform
Published in Oleksandr Sverdlov, Joris van Dam, Digital Therapeutics, 2023
Derek Richards, Angel Enrique, Jorge Palacios, Nora Eilert, Daniel Duffy, Gavin Doherty, Jacinta Jardine, Noemi Vigano, Karen Tierney
The National Health Service (NHS) in the UK rolled out a nationwide initiative in 2008 to increase reach and access to psychological interventions for individuals with common mental health disorders, such as depression and anxiety. This initiative is called Improving Access to Psychological Therapies (IAPT), and it employs a stepped-care model that matches treatment intensity with the severity of symptom presentation. For those with mild to moderate symptoms of depression and anxiety, IAPT offers low-intensity interventions (e.g., internet-delivered interventions, guided self-help bibliotherapy) that require less therapist time. Within this setting, SilverCloud is now routinely used in 70% of IAPT services nationally.
A cognitive behavioural approach
Published in Myra Hunter, Melanie Smith, Managing Hot Flushes and Night Sweats, 2020
In the UK, recognition of CBT’s effectiveness is demonstrated by its inclusion in the National Institute for Health and Clinical Excellence (NICE) guidelines for several health issues (name changed from Clinical to Care Excellence in 2013). The NICE guidelines are essentially clinical parameters for good practice for both mental and physical health issues based on the best available evidence. This has, in turn, led to the development and implementation of the Improving Access to Psychological Therapies (IAPT) programme within the National Health Service (NHS) (Department of Health 2008). IAPT was developed to deliver low- and high-intensity CBT interventions for people with mild or moderate-to-severe depression and anxiety, in addition to medication or as a stand-alone therapy. The programme was initially aimed at people of working age, but is now available to all adults and, increasingly, to people with health problems and long-term conditions (NHS England 2016).
Therapeutic interventions
Published in Alison Brodrick, Emma Williamson, Listening to Women After Childbirth, 2020
Alison Brodrick, Emma Williamson
To address the need for greater access to NICE recommended psychological therapies for depression and anxiety disorders in the general population the Improving Access to Psychological Therapies (IAPT) programme has existed since 2007, predominantly with treatment based on cognitive behavioural therapy (CBT) principles (Clark, 2011). Further recommendations have stipulated that support should be tailored to the perinatal context (Department of Health, 2013). Despite this, there is criticism that much of what is offered by IAPT is still too prescriptive and not tailored to the needs of postpartum women with little opportunity to explore associated issues such as relationship issues post-birth, and women finding it process driven and impersonal (Millett et al, 2018). It is important to remember that IAPT services predominately work with mild to moderate anxiety and depression in the general population. For the treatment of PTSD relating specifically to birth trauma, it is unlikely that the provision of services available locally through IAPT would be able to provide the type of specialist support and treatment required.
A collaborative brief engagement with medically unexplained sexual and other persistent physical symptoms: a realist service evaluation
Published in Sexual and Relationship Therapy, 2020
Jean S. Penman, Erica Cook, Gurch Randhawa
The service population was also compared to the cohort within the geographical area showing demographic similarities attending NHS Well-being Services. Improving Access to Psychological Therapies (IAPT, UK) who oversee well-being services are now commissioned by the Government of England and Wales to work with “medically unexplained” symptom sufferers co-morbid with anxiety and depression. These service interventions are in the early stages of implementation and evaluation. However, outcomes using CBT interventions for MUS/uPPS in the pilot stage were not yet showing consistency. The request from Cognitive Behavioural therapists involved in the pilot study at the time was for more training on engaging with heterogenous MUS presentations and the support of specialist supervision (De Lusignan et al., 2013).
Integrating psychotherapy and psychopharmacology: psychedelic-assisted psychotherapy and other combined treatments
Published in Expert Review of Clinical Pharmacology, 2020
Kyle T. Greenway, Nicolas Garel, Lisa Jerome, Allison A. Feduccia
Evidence-based psychotherapies like Cognitive Behavioral Therapy (CBT) are generally accepted to be equivalently efficacious for depressive disorders as antidepressants, except for persistent depressive disorder [67]. Psychotherapy offers advantages in comparison to medication; harms and side effects are less common [68], quality of life (as opposed to symptomatology) may be more improved [69], and many patients prefer psychotherapy [70]. For some conditions, like specific phobia, psychotherapy is superior to all other treatments [27]. Unfortunately, the availability of psychotherapy is often lacking [71], partly because of greater upfront costs and the (generally false) perception of policy-makers that it is not cost-effective [71,72]. There are nevertheless notable counterexamples, such as the highly successful Improving Access to Psychological Therapies program in the United Kingdom [73,74], which demonstrates that providing psychotherapy at a population level is feasible. An additional difficulty with psychotherapy is that the treatment requires greater patient commitment than medications, in terms of appointments and active efforts to engage, which can be challenging for ill patients who often suffer from, for example, impaired cognition or low motivation [75]. Benefits of psychotherapy, like antidepressants, typically appear after several weeks of treatment [66,67,76], but are more likely to persist post-treatment [77].
Applying gender-based analysis plus to Employee Assistance Programs: A Canadian perspective
Published in Journal of Workplace Behavioral Health, 2020
Mary Bartram, Jelena Atanackovic, Vivien Runnels, Ivy Lynn Bourgeault, Chantal Fournier, Nikolina Kovacina, Alain Contant, Louis MacDonald, Nancy Porteous, Ariane Renaud
Third, outcome data could be strengthened, both in general and with specific assessment of outcomes by gender and other identity factors (Csiernik, 2011). Follow-up surveys with a sub-sample of clients asking about satisfaction with services and improvements in emotional well-being and job performance are helpful, but weaker measures of mental health outcomes than standardized preservice and postservice measures of mental health symptoms, addictions, and workforce factors with all EAP clients (Jacobson et al., 2011). Routine measurement is gaining ground in psychotherapy services in Canada, where new publicly funded programs are adopting the session-by-session approach to outcome monitoring used in the United Kingdom’s Improving Access to Psychological Therapies (IAPT) program (Anderssen, 2018; CAMH, 2017). For example, IAPT clients fill out the GAD-7 (General Anxiety Disorder 7) for anxiety symptoms and PHQ-9 (Patient Health Questionnaire-9) before every session, allowing the program to report recovery rates by gender and other identity factors at a national level (Community and Mental Health Team, 2016; Kroenke, Spitzer, & Williams, 2001; Spitzer, Kroenke, Williams, & Löwe, 2006).