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ThinkWell, CBT by instant messaging

How to achieve mental health priorities

By Michael Reilly of PsychologyOnline - 03 March 2014

Within its policy document ‘Closing the Gap - Priorities for Essential Change in Mental Health’ the Department of Health has identified 25 priorities for change that will improve access to effective treatment.

This is in support of the government’s 2011 “No Health without Mental Health” pledge which promises better access to psychological therapy, more effective and higher-quality treatments, and better support for those caring for a mentally ill friend or relative.

Online text-based cognitive behaviour therapy with highly qualified therapists, delivered through instant messaging, tackles many of these action points and NHS organisations working with PsychologyOnline have already seen benefits in addressing these priorities. We outline just a few:

• Establish clear waiting time limits for mental health services

One of the issues is a shortage of skilled therapists and PsychologyOnline overcomes this issue by maintaining a large, flexible database of highly qualified UK accredited psychotherapists so there is no waiting list for CBT. Therapy is not constricted to working hours or weekdays as online therapists are available at any time, including evenings and weekends, and therapy can begin within days of a GP referral.

Therapists and their patients communicate one-to-one through PsychologyOnline’s specially-developed secure online consultation room. All patients need is a computer, tablet or smartphone connected to the internet for therapy to begin.

• Leading an information revolution around mental health and wellbeing

PsychologyOnline is leading the information revolution in mental health. The secure web portal allows patients and therapists to access therapy and data about therapy, including transcripts and outcomes questionnaires from any internet connected device. This makes therapy an ongoing activity rather than a once-a-week intervention.

PsychologyOnline operates a strict system of clinical governance so quality of care and operating efficiency are closely monitored. The use of text allows the written therapy delivered by each CBT practitioner to be regularly reviewed by PsychologyOnline’s clinical management team to ensure it is of the highest quality.

The same highly qualified therapist is assigned to a client for the duration of the treatment to ensure continuity of care. The online format also allows regular assessment of progress through treatment so it is easy to extract metrics such as how many clients completed the course of treatment, client satisfaction, effectiveness of recovery etc.

• Tackle inequalities around access to mental health services

Being unable to travel to appointments, whether through disability or lack of transport, or not speaking English as a first language are examples of scenarios, which affect equality in accessing therapy.

PsychologyOnline matches the most appropriate therapist in their network to each individual patient. Many therapists have additional languages and are experienced in dealing with cultural nuances that may affect what a patient is prepared to disclose. Moreover, as the therapy can be delivered at home, there is no need to travel to appointments.

PsychologyOnline has also been recommended for use within the British Armed Forces by the former head of psychology at the Ministry of Defence. Prof. Jamie Hacker-Hughes believes online therapy, which can be accessed from military bases both home and abroad, could help serving personnel cope with the traumas of the battlefield and prevent negative cycles of thought leading to more serious conditions.

• The most effective services will get the most funding

Current PsychologyOnline contracts are showing recovery rates from moderate to severe depression of over 60%, achieved with 40% fewer sessions than would have been expected with traditional talking therapies. The act of answering a therapist’s questions by writing is extremely beneficial as it documents and saves the “light bulb”-type realisations that can bring rapid resolutions to problems but are so often lost between therapy sessions. Having this moment recorded in a transcript captures the breakthrough and allows it to be accessed again whenever required.

A 300 patient clinical trial by Bristol University, published in the Lancet, demonstrated the effectiveness of PsychologyOnline’s therapy for step three patients with depression. An average of just six sessions of instant messaging based CBT was needed for recovery compared to 10 – 12 sessions of face-to-face treatment. A follow up study at four and eight months showed the benefits were maintained.

• Carers will be better supported and more closely involved in decisions about mental health service provision

There is incredible potential for instant messaging based CBT to support people in the early stages of long term conditions and help their carers come to terms with the decline in their loved one. With increasing levels of chronic conditions, there is an exponential growth in mental illness associated with the effects of living with them. The ability to have therapy at home with PsychologyOnline makes it particularly suitable as an alternative for people who already spend a great deal of time at medical appointments. PsychologyOnline services can be tailored to meet the needs of specific population groups, such as dementia sufferers, their carers and family.

CBT gives patients tools and strategies to allow them to cope with the things that trigger negative thoughts, stress or anxiety. Many carers experience stress and depression, the ability to conveniently slot therapy into their day means online CBT is well placed to help carers come to terms and recover from their own mental health concerns.

• Better support to new mothers to minimise the risks and impacts of postnatal depression

Postnatal depression effects one in seven new mothers within the first few months of giving birth and often debilitating. The symptoms include low mood, anxious thoughts, insomnia, loss of appetite, nausea, headaches and are prolonged for three weeks or more.

CBT is an established treatment for postnatal depression and the way it is delivered by PsychologyOnline means it can easily fit into a new mum’s routine. An exhausted mum with a newborn has little free time and PsychologyOnline allows her to have therapy at home, with their baby, at any time of the day or night. There is no need to travel outdoors with all the baby paraphernalia.

Women with postnatal depression often respond quickly to the treatment and do not need many sessions of treatment to recover.

Michael Reilly, Business Development Director at PsychologyOnline would be pleased to discuss further with service providers how partnership with PsychologyOnline can help them to meet their targets.

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