Achieving mental health priorities: How PsychologyOnline can help

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.

• We will lead 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 and so on.

• We will 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.

• We will offer 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, director of business development at PsychologyOnline, would be pleased to discuss further with service providers how a partnership with PsychologyOnline can help them meet their targets. Contact us on 01954 230 066 or visit www.psychologyonline.co.uk.

How to treat PTSD: CBT can help says PsychologyOnline's Sarah Bateup

How to treat PTSD (post-traumatic stress disorder) was an unexpected part of a live BBC radio discussion featuring PsychologyOnline’s clinical lead Sarah Bateup.

Appearing alongside author Nigel Cooper in BBC Radio Cambridgeshire’s Chat Room feature, Sarah discussed how cognitive behaviour therapy (CBT) is an effective treatment for PTSD, a form of anxiety that can trigger nightmares, flashbacks, insomnia, guilt and feelings of isolation and/or anger.

In Mr Cooper’s new book Sophia, the lead character (Sophia) uses CBT to help recover from a traumatic event. CBT helps to break down negative cycles of thought and gives patients strategies and tools to deal with the situations that cause them distress.

Sarah commented: “When someone has experienced a significant trauma, it’s not unusual that you have some emotional distress. We have an animalistic instinct to hide ourselves away when we’re unwell, physically or mentally… when someone is unwell for a long period of time, this normal reaction becomes abnormal, and that’s where therapy can help.

“When we’re emotionally distressed, we often move away from the things that are important. It’s a normal knee-jerk reaction… if someone is suffering from depression or anxiety they tend to avoid things and move away from loving relationships, their hobbies or a working life they cherish.

“That comes back to bite you, because the things that we love are the things that make us feel happy and fulfilled.”

Other topics tackled in the Chat Room included the creative mind, and whether artistic or musical people are more prone to mental health conditions than analytical or scientifically minded-individuals.

Sarah added: “Our human minds can be quite creative. We can write great books, be great musicians and do great things. It’s hypothetical, but maybe if you don’t use a gifted, creative mind and put it to good use, it gets up to tricks. Our minds can create our own suffering and create distress in ourselves and other people too.

“What sets us apart as human beings is that we have a thinking mind that can zoom off into the future or look back on the past and reflect on it. Animals tend to live in the present, this moment.”

Sarah uses her experience as a BABCP therapist with more than 27,000 hours of CBT to oversee clinical governance at PsychologyOnline. She is passionate about the role technology can play in increasing access to psychological therapy and an advocate of PsychologyOnline’s unique text-based approach.

You can hear Sarah’s radio appearance until 29 January via BBC Radio Cambridgeshire’s listen again service; scroll the timeline about two hours into the programme. For more information on PsychologyOnline, please visit our website.

New Year, New You: Focus on values for a happy 2014

Sarah Bateup, clinical lead at PsychologyOnline, says true happiness comes from aligning our behaviours with our values

Welcome to 2014 and the “New Year, new you” frenzy. This is a time of year when many of us think about how we can improve ourselves and get fitter, thinner and happier. Have you ever caught yourself saying: “I’ll be a better person if I gave up chocolate?” Or, “I’ll be happier when I drop a dress size?”

Stop and ask yourself, deep down, whether those things are truly important. If you died tomorrow, what would you like people to say about you? Would you like these things written on your headstone?...

   “Here lies Ann. She did not eat chocolate.”

   “Here lies Jane. She was a size 10.”

Most of us would not wish to be remembered in this way. The New Year is a chance to think about what you would want to be remembered for and what you want your life to mean.

We all have a different idea of what is truly important in our lives. Some people will think about loving relationships, friendship and being a good parent. Others will consider things like being creative, making a difference, or spirituality.

Cognitive behavioural therapists call these concepts, values. Our values can motivate us to make meaningful changes in our lives. Values are different to goals, in that we cannot just tick the box when we have done them. If you value being a loving partner, for example, it is not a one off action. A value is an ongoing process.

We can choose whether our actions and behaviour move us towards our values. Have you noticed how it makes you feel when you are not behaving in accordance with what you value? If you value being creative and you stop using your imagination because you are too busy – how do you feel? If you value being a loving partner and you stop making time for them, how do you feel?

You may notice that when we divert from our values we tend to experience emotions like guilt, sadness and distress.

So what are your values? Here is a list of some common domains;

• Intimate relationship
• Friendship
• Parenting
• Family
• Employment
• Spirituality
• Creativity
• Health
• Culture
• Nature/animals/environment
• Sport/activity
• Education/learning
• Exploration/travel

Choose the ones that mean the most to you and ask yourself, how you are doing in these areas of your life? What mark would you give yourself out of 10 and how does that make you feel? Choose one value that you would like to work on.

What would you be willing to do, this week, to move towards your value? Try and keep in mind why you are willing to do this. As baseball coach Yogi Berra famously said: “If you don’t know where you are going, you’ll end up someplace else.”