ENACT: Exploiting social Networks to Augment Cognitive behavioural Therapy

这项名为ENACT的医疗保健合作项目旨在利用在线社交网络（OSN）平台、社交电脑游戏和移动技术的吸引力，提高计算机化认知行为疗法（CCBT）干预措施的接受程度、依从性和完成率。最近的研究表明，许多常见的心理健康状况，如抑郁、焦虑和失眠，都可以通过CBT成功治疗，CBT是一种治疗方式，针对维持或加剧心理症状的思维方式和行为习惯。改善获得心理治疗的机会现在是NHS的一项明确政策；这一政策的组成部分是计算机化CBT （CCBT）的更大可及性。然而，虽然CCBT项目的有效性、有效性和成本效益已得到全面证明，但在用户接受、参与和完成方面仍存在挑战。作为一种基于计算机的交互式活动，CCBT的感知价值和用户参与将受到其他形式的交互式通信和基于计算机的媒体共同因素的影响。事实上，我们认为现有的CCBT项目的一个主要缺陷是它们只是复制了面对面CBT的结构，而没有反映人们目前使用新兴的在线和社交技术的方式。现有的CCBT项目通常包括被动的、每周一次的、一小时的治疗疗程，使用者与治疗师或其他治疗使用者之间没有社会联系，也很少或根本没有向使用者提供关于其基本日常作业任务表现的反馈。相反，在线社交技术似乎非常善于吸引用户的注意和经常使用，通常用户每天都会多次参与其中，具有很强的互动性，并且主要基于社交联系。ENACT项目的主要假设是，复制在线社交媒体互动结构的CCBT项目比复制传统一对一治疗课程结构的CCBT项目在促进用户接受和参与方面更有效。为了检验利用在线社交技术加强CCBT的效果，ENACT课程将专注于开发和加强用于治疗失眠的CCBT“一揽子”（CCBT- i）。最终应用程序的用户将1)能够与该服务的其他用户进行保密互动并获得支持，2)能够通过在线社交网络和移动电话应用程序报告日常活动的完成情况，3)以吸引人的方式收到关于设定和实现目标的反馈，以及4)通常会以反映其在线社交技术使用情况的方式支持他们完成治疗包。这很方便地融入了他们的日常生活方式。ENACT是对卫生部最近强调将CCBT作为改善获得有效心理治疗途径的一种手段的及时回应，同时需要继续为失眠症患者提供有效替代通常不适当的催眠药物的方法。

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.