Evaluation of a Trial of Computerised Cognitive Behavioural Therapy Programme Within Local Child and Adolescent Mental Health Services

对地方儿童和青少年心理健康服务中计算机化认知行为疗法项目试验的评估

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Abstract

RATIONALE: NICE guidelines recommend offering computerised Cognitive Behavioural Therapy (cCBT) to young people with mild mental health issues to ensure early treatment access and reduce service demand. Emerging evidence suggests cCBT reduces symptoms, but further evaluation is needed. SilverCloud is a recommended digital CBT programme. AIMS: Evaluate a pilot trial of SilverCloud in CAMHS at a local NHS Foundation Trust. OBJECTIVES: (1) Symptomology: Is there a change in depression or anxiety symptoms after using the intervention? (measured by outcome scores); (2) Adoption: What was young people's engagement with SilverCloud? (measured by time spent on the platform and uptake); (3) Satisfaction: How satisfied were young people with SilverCloud? (measured by module feedback ratings and a questionnaire). METHODS: The SilverCloud intervention for young people was evaluated over 9 months. Reductions in symptoms of generalised anxiety disorder (GAD) and low mood were measured using the Revised Children's Anxiety and Depression Scale (RCADS), GAD, and Major Depressive Disorder (MDD) subscales. Adoption was measured by time spent on SilverCloud and intervention uptake. Satisfaction was measured by module feedback ratings and a questionnaire. RESULTS: Ninety-one people were offered SilverCloud, 77% started, 46% completed it and 27% disengaged. Thirty-two participants completed SilverCloud during the evaluation (12 CYP and 20 parents). No statistically significant reduction was found in any subscale. Satisfaction was varied; 94% rated the intervention favourably, but no participants reported behaviour changes due to the intervention. CONCLUSION: This evaluation suggests tentative pessimism regarding SilverCloud's benefits. However, due to significant challenges and limitations, further analysis is recommended. Recommendations were given for local services.

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