ENACT: Exploiting social Networks to Augment Cognitive behavioural Therapy

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The work in this Healthcare Partnerships project - termed ENACT - aims to improve the uptake, adherence and completion rates of those referred to Computerised Cognitive Behavioural Therapy (CCBT) interventions using the engaging power of online social network (OSN) platforms, social computer games and mobile technology. Recent research has demonstrated that many common mental health conditions, such as depression, anxiety and insomnia, can be treated successfully with CBT, a form of therapy that addresses styles of thinking and behavioural habits that maintain or exacerbate psychological symptoms. Improving access to psychological therapy is now an explicit NHS policy; integral to this policy is the greater accessibility of computerised CBT (CCBT). However, while the efficacy, effectiveness and cost-effectiveness of CCBT programmes have been comprehensively demonstrated, there remain challenges in terms of user uptake, engagement and completion.As an interactive computer-based activity, the perceived value of, and user engagement with, CCBT will be influenced by factors common to other forms of interactive communications and computer-based media. Indeed, we believe that a major deficiency of existing CCBT programmes is that they merely replicate the structure of face-to-face CBT and do not reflect the way people currently use emerging online and social technologies. Existing CCBT programmes typically consist of passive, weekly, hour-long therapy sessions, with no social contact between the user and either a therapist or fellow treatment users, and also little or no feedback provided to the user on their performance of essential daily homework tasks. Conversely, online social technologies, which appear to be very good at engendering user uptake and regular use, are typically engaged with by users a number of times daily, are very interactive, and are based primarily on social contact.The primary hypothesis of the ENACT project is that CCBT programmes which replicate the interactive structure of online social media will be more effective at engendering user uptake and engagement than CCBT programmes that replicate the structure of traditional one-to-one therapy sessions. In order to examine the effects of enhancing CCBT with elements of online social technology, ENACT will concentrate on the development and enhancement of a CCBT 'package' for the treatment of insomnia(CCBT-I). Users of the final application will 1) be able to interact confidentially with and receive support from other users of the service, 2) be able report completion of daily activities via Online Social Networking and mobile phone applications, 3) receive feedback in an engaging manner on targets set and met, and 4) will generally be supported in their completion of the treatment package in a manner that reflects their usage of online social technology, and which fits conveniently into their daily liefstyle. ENACT is a timely response to the recent emphasis placed, by the DoH, on CCBT as a means of achieving improved access to effective psychological therapies,combined with a continuing need to offer patients with insomnia effective alternatives to often inappropriate hypnotic medication.