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

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice Pub Date : 2025-02-10 DOI:10.1111/jep.70022

Deborah Bell

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引用次数: 0

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.

Abstract Image

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计算机化认知行为治疗项目在当地儿童和青少年心理健康服务中的试验评价

基本原理NICE指南建议为有轻微心理健康问题的年轻人提供计算机化认知行为疗法（cCBT），以确保早期治疗并减少服务需求。新出现的证据表明，cCBT可以减轻症状，但需要进一步评估。SilverCloud是一个推荐的数字CBT程序。目的评估银云在当地NHS基金会信托的CAMHS中的试点试验。目的(1)症状学：使用干预后抑郁或焦虑症状是否有改变？（以结果分数衡量）；(2)采用：年轻人对银云的参与程度如何？（通过在平台上花费的时间和接受度来衡量）；(3)满意度：年轻人对银云的满意度如何？（通过模块反馈评级和问卷调查来衡量）。方法对银云对青少年的干预进行为期9个月的评价。使用修订儿童焦虑和抑郁量表（RCADS）、广泛性焦虑症（GAD）和重度抑郁症（MDD）亚量表测量广泛性焦虑症（GAD）和情绪低落症状的减轻程度。采用是通过在SilverCloud上花费的时间和干预措施的吸收来衡量的。满意度是通过模块反馈评级和问卷调查来衡量的。结果91人接受了SilverCloud服务，77%的人开始，46%的人完成，27%的人不参与。32名参与者在评估期间完成了SilverCloud（12名CYP和20名家长）。在任何分量表中均未发现统计学上显著的减少。满意程度各不相同；94%的人认为干预是好的，但没有参与者报告由于干预而导致的行为改变。结论对SilverCloud的效益初步持悲观态度。然而，由于重大的挑战和限制，建议进一步分析。对当地服务提出了建议。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of evaluation in clinical practice 医学-卫生保健

CiteScore

4.80

自引率

4.20%

发文量

143

审稿时长

3-8 weeks

期刊介绍： The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.