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.”

PM at G8 Dementia Summit welcomes work by PsychologyOnline

When Prime Minister David Cameron spoke at the G8 Dementia Summit recently about the global challenge of dementia he also talked of seeing a glimmer of hope in tackling this condition.

He said: “It doesn’t matter whether you’re in London or Los Angeles, in rural India or urban Japan - this disease steals lives; it wrecks families; it breaks hearts and that is why all of us here are so utterly determined to beat it.”

He talked of the hope of creating a treatment and also of progress in developing for tools for early detection.

“I see it in the extraordinary work of UK life sciences companies, like Ixico, Cambridge Cognition, PsychologyOnline and Proteome Sciences, working with others to develop new tests for Alzheimer’s Disease.”

Barnaby Perks, CEO of PsychologyOnline welcomed this high profile support for work in this area.

“The NHS is one of the most respected health institutions in the world.  If it is prepared to be a ‘smart purchaser’ and work with innovative companies such as those mentioned in David Cameron’s speech then this will fast track developments in this area.”

PsychologyOnline provides text-based cognitive behaviour therapy (CBT) to treat anxiety and depression, conditions that are common in dementia sufferers and their carers.

CBT is used widely in NHS mental health services, as a NICE-recommended treatment.  The therapy aims to help people manage their problems by changing the way they think and feel about certain situations or events.  Such is the demand for this type of therapy that there can often be a long wait to see a therapist.

One of the reasons, PsychologyOnline was developed originally by two NHS psychologists was to enable more effective use of resources. It provides instant-messaging based CBT with a therapist via a secure internet consulting room, so neither the therapist or the service user needs to travel.

Barnaby says results for the treatment of depression and other conditions are very promising, with patients needing 40% fewer sessions than would be expected with face-to-face therapy to recover.

“From our work with the Clinical Commissioning Groups (CCGs) in Surrey, where we provide therapy on prescription, we’ve seen that people of all ages are prepared to use the internet to access treatment.  The ability to have therapy in your own home makes it particularly suitable for those who find it difficult to travel for appointments or who already spend too much of their time waiting in hospitals.

“We are currently provide an accessible treatment path for carers of people with dementia and other diseases, who would not otherwise find time to focus on their own health. We also see considerable potential for CBT delivered in this way to support people in the early stages of dementia and are working with experts in this field to explore this further.

“If the NHS was to commission a study in this area then we would be able to devote more resource to this area of research. This type of support would lend further credibility to this approach and support early adoption of beneficial treatment. “

PsychologyOnline one of Observer's 16 leading Tech Start-Ups

PsychologyOnline has been identified as one of Cambridge’s 16 leading technology-based startups in the Observer’s Tech Monthly supplement.

Cambridge is a world-leading centre for the development of technology and life science firms; the city has long been accepted as a hub for pioneering new companies and a place where brilliant academic minds can turn their innovative ideas into reality. PsychologyOnline is located on the outskirts of the city to tap into networks of existing expertise as Barnaby Perks, chief executive at PsychologyOnline, explains:

“Cambridge has the right environment and support networks, including lawyers, accountants and non-executive directors. When I looked at the skills we needed, the software development skills, the clinical management skills, here was the best place and all the best people were here."

Other firms featured in the article include Crowdsurfer, a website which allows users to search for alternative finance options such as peer-to-peer lending and Darktrace, a cyber security firm launched this year which provides technology to companies to allow them to monitor threats to their computer networks.

PsychologyOnline was co-founded in 2011 by Barnaby Perks and two chartered psychologists, Sue Wright and Nadine Field. Having worked in the NHS in England and witnessed first hand the scarcity of therapists, they started the company in a bid to make top quality cognitive behavioural therapy easily accessible to all.

Therapy from PsychologyOnline is available on the NHS across Surrey and to private individuals across the UK and overseas via Thinkwell. It helps people suffering from a wide range of mental health conditions, including depression, anxiety, phobia and stress-related problems.

PsychologyOnline’s in house developers have created a secure messaging system to allow service users and therapists to write short, confidential messages to each other during sessions, which last up to an hour at a time. All users need is a computer, laptop, tablet or smartphone and a stable internet connection.

"This way patients are comfortable,” Barnaby explains. “They can have therapy at home at a time that suits them. The results show the system has higher recovery rates and takes fewer sessions than face-to-face therapy for patients to get better.”

You can read more about the 16 leading Cambridge tech startups here and for more information on PsychologyOnline, please visit our website: www.psychologyonline.co.uk.

Trott shows 'stress-related illness' happens to the best of us

Jonathan Trott is not the first world-class cricketer to return home from the intense spotlight of the Ashes tour with a stress-related illness. The nature of the game - a team sport played by individuals – and the type of personality required to excel, risks the mental health of many of its players.

The big question is whether the sports associations are doing enough to support players at all levels within the game.

According to Telegraph journalist Steve James, himself a former cricketer, there is still a culture of secrecy within the sport when it comes to mental illness. Indeed the word ‘depression’ was rarely mentioned in the numerous media interviews.

Writing in the paper on Monday 25th November, James says that sport should be grateful for the bravery of cricketers such as Marcus Trescothick, Darren Cousins and Tim Ambrose who have all spoken publicly about their mental health over recent years.

The courage it takes to do this or to show any indication of weakness within such a macho sport was self-evident from the comments that Aussie player David Warner made a few days earlier about Trott having ‘scared eyes’.

The type of training given to the physical body should be extended to ensuring the health of the mind.

Cognitive Behaviour Therapy (CBT) is well proven to be effective in ‘retraining’ the mind to allow an individual to consider the world from a better perspective. It helps create a tool kit of coping mechanisms for the pressures of life.

PsychologyOnline’s approach to CBT is particularly effective and it is available wherever you are, 24x 7, all that is required is a computer and an internet connection.

However robust you are, intense ambition, long periods away from home, high pressure, high financial stakes, detachment from family are all risk elements that can adversely affect your mental health.

Perhaps now is the time to promote the concept of a ‘physio for the mind’ and use the pressures faced by our top sportspeople to show that although depression is something that can happen to the best of us, it can be effectively treated.

Re-thinking Psychological Therapy in a new NHS: PsychologyOnline attends New Savoy Partnership Conference

Improving the quality of mental healthcare while navigating a path through the new clinically-led commissioning framework is just one of the themes to be explored at the seventh annual ‘Psychological Therapies in the NHS’ conference, 28 and 29 November at the Mermaid Conference Centre in London.

PsychologyOnline will showcase its unique online therapy at the high-profile event, and in so doing will rub shoulders with leading mental healthcare policy-makers including the Care Minister Norman Lamb and Dr Geraldine Strathdee, NHS England’s head clinical director for mental health.

The two-day conference at the end of November, organised by the New Savoy Partnership, will investigate whether the coalition government’s Mental Health Strategy is working and whether more needs to be done to “join up” the way talking therapies are commissioned and accessed on the NHS.

In 2011, the government issued a “No health without mental health” pledge, and committed to improving access to psychological therapies by broadening the focus of IAPT (Improving Access to Psychological Therapies) initiative.

As a consequence, PsychologyOnline was commissioned earlier this year by the Surrey Mental Health CCG Collaboration as one of four therapy providers.

Surrey GPs referring patients to the innovative service say the evening appointments have been particularly popular with patients who work during the day or those who find it difficult to travel to meet a therapist face-to face.  It has also allowed more men, who are often embarrassed to seek help in person, to access the therapy they need, without taking time off work.

All that service users need to access online CBT is a computer, laptop, tablet or smartphone which is connected to the internet.  Therapy can begin within 24 hours of referral and can be undertaken from the comfort of home or wherever the patient feels most comfortable.

Barnaby Perks, chief executive at PsychologyOnline, is encouraging delegates to come along and meet the team and find out how online CBT could make therapy more accessible.

“At PsychologyOnline, we’re proud of our innovative way of delivering highly-effective therapy.  All our therapists are UK trained and accredited and our service has been proven to be effective in treating moderate to severe depression.

“PsychologyOnline’s therapy can treat a range of mental health conditions, including anxiety, stress-related disorders, phobia, obsessive compulsive disorder and postnatal depression.”

To find out more about PsychologyOnline, please visit www.psychologyonline.co.uk.

Technological Innovations in Mental Health: PsychologyOnline Exhibits at London Launch Event

PsychologyOnline’s innovative text-based approach to cognitive behavioural therapy will be on show at the Technical Innovations in Mental Health conference on 11 November 2013.

The symposium, held at the Royal College of Physicians in London, will highlight the latest technological advances in the field and consider how these advances could help transform the delivery of therapy to service users.

The event coincides with the launch of MindTech, the NHS National Institute for Health Research’s new initiative to promote the use of technologies for mental healthcare in England.

Cambridge-based PsychologyOnline provides a unique form of live online cognitive behavioural therapy via a text-based instant messaging system. All service users need is access to a computer, laptop, tablet or smartphone which is connected to the internet.

Therapy sessions can be held at flexible times, including evenings and weekends, from the comfort of home or wherever the patient feels most comfortable.

Surrey is one of the first areas to offer PsychologyOnline “on prescription” to service users in its five CCG areas. Therapy is also accessible to all via Thinkwell, the firm’s pay-for service.

Barnaby Perks, chief executive at PsychologyOnline, has welcomed the conference as an exciting chance to showcase the firm’s unique online therapy and is encouraging fellow delegates to come and meet the team.

He adds: “It is good to see the health sector embracing new developments in technologies in the mental health field.

“PsychologyOnline allows more flexibility in the way mental health services are delivered and is also a means to cope with the increased volume in demand that we’ve seen over recent years.

“There has been a growing acceptance of internet technologies for accessing services of all types and many NHS Trusts and commissioners are interested in how PsychologyOnline could work for their patients.”

Keynote speakers at the conference include Dr Geraldine Strathdee, the national clinical director of Mental Health for NHS England and Dr Louise Wood, the head of NHS Research Infrastructure and Growth at the Department of Health.

For more information please visit: www.psychologyonline.co.uk or MediLink

Military mental health: Join the discussion with Professor Jamie Hacker Hughes

While the physical rehabilitation of service personnel often features prominently in the headlines, the mental effects of war on serving or veteran soldiers is often less well publicised.

PsychologyOnline is hosting a webinar on 5^th November at 1.30pm discussing the impact that military conflict can have on the mind and the how online cognitive behavioural therapy can improve access to support both on and off the battlefield.

It will be led by prominent military psychologist Professor Jamie Hacker Hughes, who has spent 20 years in the military, first as an army officer and later as a military psychologist. He rose to become head of clinical psychology for the Ministry of Defence.

Prof Hacker Hughes will also explore the type of mental health conditions, such as depression, anxiety and post-traumatic stress disorder that affect serving personnel, reservists, veterans and their families and how they can be assessed and treated.

He will also outline some of the warning signs to allow the families of service personnel to spot when a mental health problem may be manifesting.

Click here for a preview of the webinar from Prof Hacker Hughes.  If you would like to book your place at the webinar, which will last for one hour, send your name, company and email address to info@psychologyonline.co.uk with “military webinar” in the subject field.

Role of online technology within IAPT

How to integrate online text-based CBT therapy within IAPT, was the topic of a presentation by Sarah Bateup, Clinical Lead for PsychologyOnline and lecturer at Exeter University, at the recent Recovery-Focused Conference organised by Bournemouth University and Dorset HealthCare University NHS Foundation Trust.

Sarah, who is a BABCP accredited therapist who has delivered over 27,000 hours of CBT, discussed her experiences gained with PsychologyOnline of integrating live synchronous, Internet-based text CBT into Step 3 IAPT services.

Prior to joining PsychologyOnline Sarah had worked with the South London and Maudsley NHS Trust where she was involved in training junior doctors how to deliver CBT within IAPT. So, she has a good knowledge of IAPT and support for therapy services. Before this Sarah was a manager of a primary care CBT service in the South West of England. 

Sarah comments, "I am very interested in seeing how technology can enhance therapy and learning. Increasingly we are seeing more learning being offered online and accessed remotely. CBT is very much based on people learning and therefore it fits well within this model.

"Interestingly the benefits of text-based therapy are maintained for a long time. I think this is partly the action of writing and reading that takes place during the session, which is very much how we are used to learning and creates a real change in the thought processes.

"Originally IAPT was designed to offer patient choice and PsychologyOnline's service supports this by making it easier to access therapy. For example, we have seen particularly good results for patients with anxiety disorders for whom arranging and attending a face-to-face session in itself creates stress."

The bi-annual Recovery-Focused Mental Health Conference was held on September 6th 2013 and was attended by mental health professionals, health commissioners, researchers and service users. The purpose of the conference is to disseminate information about new research, innovation, best practice, and inspirational developments in mental health.