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David Baxter

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The feasibility and effectiveness of Computer-Guided CBT (FearFighter) in a rural area
by Hayward L, MacGregor AD, Peck DF, Wilkes P.
Beh. Cogn Behav Psychother 2007 Apr;doi:10.1017/S

Evaluations of computer-guided CBT (CCBT) suggest that this is a promising approach to closing the gap between the demand for, and the supply of, CBT. However, additional studies are required that are conducted by researchers independent of the programme developers, and include a wider range of participants.

This independent study examined the viability of CCBT for panic and phobic anxiety in an unselected sample of referrals in remote and rural areas of Scotland.

Outcome was assessed by a wide range of outcome measures, completed before and after treatment, and at 4-month follow-up.

Participants experienced few difficulties in using the programme, and GPs and participants regarded CCBT as acceptable and useful. Major improvements were obtained, with several large effect sizes, which remained at follow-up.

It was concluded that computer-guided CBT can play a useful part in delivering CBT services in rural areas; and that self-help CBT may be the only treatment option available to some sufferers.

Note: Patients in England can now access the FearFighter program through the NHS. Contact your GP for more information.
 

David Baxter

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Computer-Guided CBT (FearFighter, Beating the Blues)

NHS to provide computerised CBT programs for anxiety, depression
Thursday, 29 March 2007

Computer-based therapy for milder, but more common mental health conditions such as depression and anxiety should be made available to any patients in England who could benefit from it from April, Health Secretary Patricia Hewitt said today.

Computerised Cognitive Behavioural Therapy (cCBT) delivers cognitive behavioural therapy - proven to be clinically effective - through a computer. Providing this therapy as a first-line treatment for people with anxiety and depression heralds a significant shift towards providing new services closer to people at home and in the community.

Over 2007/08, the establishment of cCBT in every Primary Care Trusts (PCT) in England will be an important building block in the delivery of comprehensive psychological therapy services.

The National Institute for Health and Clinical Excellence (NICE) has approved two computer-based programs for use by the NHS - Fear Fighter? for treating people who have phobias or suffer from panic attacks, and Beating the Blues? for treating people with mild to moderate depression. Such programs will enable therapy to be provided in a greater number of locations and settings, such as at home or in the library. People who receive these services will also benefit from the support of a mental health professional.

Launching cCBT Implementation Guidance that will help the NHS to deliver these innovative therapies to patients, ahead of her speech at the MIND annual conference in Bournemouth, Patricia Hewitt said:

"Mental health services have clearly improved substantially, but we want to offer patients even greater choice over how, when and where they are treated. Being able to access the right kind of therapy, instead of just being prescribed medication, is central to this vision for patients.
"On April 1st, we will reach the first milestone in our drive to provide choice - namely quicker access to computer based self-help services to stop mild mental health problems becoming worse.

"Clinical evidence confirms that counselling and therapy are just as effective as medication in helping to treat most cases of depression. The guidance being published today will give the NHS the information they need to provide these services.

"In addition to continuing to improve services for people with severe mental health problems, we are working to improve the mental wellbeing of society as a whole, and providing a real, twenty-first century service for people with common mental health needs such as anxiety and depression."​
Commenting on the announcement MIND Chief Executive Paul Farmer said:

"Computerised Cognitive Behavioural Therapy is an important addition to the range of treatment options available for people who suffer from mild depression or anxiety. It will bring therapy to the doorstep of users making it convenient and easy to access especially for people who live in remote locations. Its immediacy will benefit people who have been waiting months or even years to see a therapist."

"However, this method of delivery will not suit everyone. It is important that there is a choice of options."​
The effectiveness of cCBT was confirmed by Dr Peter Crouch, a GP and Forensic Medical Examiner at the Taw Hill Medical Practice in Swindon who stated:

"We have been using computerised Cognitive Behavioural Therapy for over three years and the feedback by our patients is extremely positive.
"Our patients have found that using "The Relief Series" and "Beating the Blues" has significantly helped them to better cope with anxiety, insomnia and stress. Using the system has amplified the ability of our award winning local psychology service in Wiltshire to provide tangible and practical help and psychological support to those who need it.

"Very few services are able to be delivered within a few minutes of a consultation and in the patient's own home. We have patients who have logged in from work, home and anywhere they can access the internet. As we have many patients who travel, some have logged in from halfway around the world to continue the programme of support."​
Last year, the Government announced the establishment of two improving access to psychological therapy (IAPT) demonstration sites in Doncaster and Newham. The programme's core purpose is to develop: evidence of the benefits of psychological therapies; service models on how evidence based services should be implemented nationwide; and incentives to enable the local NHS to deliver the new services.
 

sister-ray

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Re: Computer-Guided CBT (FearFighter, Beating the Blues)

Thanks for posting this David, I wasnt aware of these being available here, they may well be helpful to me with all the problems I have had getting therapy, so will contact my GP about them and see if they are available in my area, thanks again.
 

sister-ray

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Re: Computer-Guided CBT (FearFighter, Beating the Blues)

David,

As you know I was eager to try these courses and asked my GP who knew nothing about them. He has now written to me and its not good news, the article states they are available through the NHS and again they are not, certainly not in my area,, my GP said that they have a cost implication and the Primary Care Trust has not purchased these services which means I cannot access them, which is bad news for me and typical of things in this country, he says they "may" purchase them in due course, its all about funding, he has given his details to a contact at the courses so if things change they can refer me which he is quite happy to do but he has said it could be months. He has given me some other information about a online resource which as soon as Ive checked it out will post about it.
 
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David Baxter

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Re: Computer-Guided CBT (FearFighter, Beating the Blues)

Thank you for the update, TTE. That's unfortunate.
 

fazer

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I understood Beating The Blues was available direct from the USA ?
 

Daniel

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Just to clarify, the "Access Map" is in reference to getting Beating the Blues for "free" by having the NHS provide it.

Otherwise, their website says one can pay for the online service, which isn't cheap (about $500 in US dollars or ?295) plus a screening fee.

The same company, Ultrasis, offers something much cheaper (in possibly more ways than one) that is based on Beating the Blues and is $20 per module. A sample of their "Depression Relief" module gives basic info that one can get elsewhere from online articles, self-help books, etc:

Depression Relief - Demonstration - Wellness Shop (in this sample demo, the Back and Continue buttons aren't intended to work)
 

fazer

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Daniel, I live in the UK and BTB is availbale free for about 97% of the NHS at the mo, probably be 100% soon. I believe it free in the Netherlands ?

Does American health insurance give you free access to it ?
 

Ade

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Computer-based therapy for milder, but more common mental health conditions such as depression and anxiety should be made available to any patients in England who could benefit from it from April, Health Secretary Patricia Hewitt said today.

Is it just me but categorising some anxiety and depression as mild seems to imply that people who suffer form this is are subject to interpretation as to what impact on someone's life is regarded as mild.

As for the program I really think that what ever works is fine, if its free then even better:2thumbs:
 

Andy

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I haven't read this thread but from the quote I think it just means mild compared to a diagnosed MDD or GAD for example. Nobody suffers more or less. It's unique to the individual, but someone with a disorder that's higher on the severe spectrum may respond better to face to face type therapy.
 

David Baxter

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It's not entirely subjective, either. One can refer to the GAF, for example.
 

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