PhD Reflections, E-therapies, Older Adults, NHS Mental Health Services and IAPT

My project concerned the delivery of psycho-therapeutic interventions for mild to moderate stress, anxiety and depression via digital platforms known as e-therapies. More specifically, it concerned the use of
e-therapies by older adults, a sector of the population hitherto neglected both in the design of e-therapies and in research of this nature. The primary aim of the work was to explore ways in which the user interface of an e-therapy could be enhanced to improve usability for and promote acceptability by older adults, and hence improve access to this mode of therapy for this particular service user group. Secondary aims were to examine whether perceived usability is associated with other factors that influence the delivery of therapy such as credibility, pre-expectancy and the therapeutic relationship. Phase one, comprising two surveys and a meta-analysis, mapped the landscape of contemporary e-therapy use within NHS England in order to determine: what e-therapies are used; what evidence exists for them; and whether they are suitable for older adults. Findings indicated that e-therapies used in the NHS are broadly effective, but they are less effective with age, and there is a dearth of research on their use in older adults. Following on from this, phase two, comprising three empirical studies, investigated: the relationship between usability and expectancies and acceptability of e-therapies, in older adults. Findings indicated that the perceived therapeutic relationship older adults formed with the e-therapy was related to the e-therapy’s usability, suggesting that usability is an important factor in e-therapy design that requires further research attention.

My PhD research has enabled me to influence or participate in a number of projects relating to the NHS’s digital implementation strategy such as:

  • Being part of NHS England’s Digital Innovation and Adoption in Psychological Therapies Expert Reference Group.
  • Contributing towards the Topol review through an NHS Topol review Workshop.
  • Helping the NICE IAPT assessment programme to gain a better understanding of the current digital therapy landscape in IAPT and the NHS through publication.
  • Assessing a number of the health apps for the NHS App library via Our Mobile Health’s evaluation framework.

Being part of CATCH has given me the opportunity to be involved in a number of projects such as “AVACHAT” an artificially intelligent virtual agent developed using co-design to support the self-management in individuals with complex physical comorbidities. It has also given me the opportunity to be involved in a winning NewMinds funding bid to develop an AI Empathy Agent as a Co-Investigator (COI). Finally working as part of THAW has equipped me with an array of additional skills that will assist me in future projects.

I’m extremely proud to have passed my PhD.  As a Dyslexic I found the process of writing difficult but never gave up. I hope my success will inspire others with learning difficulties to do the same. It’s also been fantastic to see my work aiding decision making regarding digital mental health therapies at both NICE and NHS England. I am currently working a twelve-month contract at University Hospitals Birmingham working on their health data system. In the near future I hope to bridge my work within the hospital with innovation and research to build digital interventions that I believe could be potential game changers within the NHS.

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