Beating the Blues was decommissioned and replaced with the Silvercloud package for comorbid depression and anxiety from 1st December 2022.
Review found that Silvercloud was rated higher with minimal technical issues and a more modern and usable platform. An additional benefit is that in addition to the Silvercloud comorbid depression and anxiety package, which is the direct replacement for Beating the Blues. There are also 3 additional packages made available for depression and anxiety. These include Depression, Anxiety and Generalised Anxiety Disorder. This will allow greater treatment specificity when required.
Silvercloud have also opened up a number of other packages. Each package contains modules based on cognitive behavioural therapy (CBT) or acceptance and commitment therapy (ACT), mindfulness and positive psychology (Please note chronic pain and chronic heart conditions programmes are based on ACT) covering the following conditions:-
Who to refer
Comorbid depression and anxiety (direct replacement for Beating the Blues)
Depression
Anxiety
Generalised anxiety disorder
Social anxiety
Health anxiety
OCD
Panic
Phobia
Perinatal well-being
Anxiety/depression associated with chronic pain
Anxiety/depression associated with diabetes
Anxiety/depression associated with lung conditions
Anxiety/depression associated with rheumatoid arthritis
Anxiety/depression associated with chronic heart conditions
Anxiety/depression associated with breast cancer.
The above packages are suitable for patients presenting with mild/moderate symptoms of depression and/or anxiety who are age 16 or older and they are able to read and understand English.
Who not to refer
Exclusion criteria are:
Patients with active suicidal ideation
Patients with severe and enduring mental health disorders (e.g. bipolar disorder, psychosis)
Patients with significant cognitive impairment
Patients with a primary alcohol / substance misuse issue
Patient must be able to complete their reviews from within the UK.
How to refer
Referrals can be made either via SCI-Gateway by selecting Computerised Cognitive Behavioural Therapy as the specialty or by completing the Tayside cCBT referral form. Please send completed forms by mail to the address below or by email to TAY.taysideccbt@nhs.scot.
If referring by SCI-Gateway it is essential to indicate the primary clinical condition listed above for which treatment is being sought. It is also essential that you include an up-to-date contact number and email address as an account cannot be set up without this.
After referral
After the referral is received, the NHS Tayside cCBT coordinator will contact your patient by telephone within 5 working days to provide them with additional information and register them on Silvercloud. Your patient will then be sent an email with a link to activate their account. They will be asked to create a secure username and password, read the support agreement and complete the questionnaires. After these steps they will be able to get started with Silvercloud and have the option of downloading an app to access the programme.
Home technical user requirements
Patients completing the programme in their home will require the following:
Desktop computer, laptop, tablet, or smartphone, with speakers or earphones
Internet connection (data usage may apply if using on a mobile network)
Reviews
Approximately every 4 weeks the user will be asked to take part in a “review” on an agreed date with the Tayside cCBT Co-ordinator, these are carried out in the format of an email. These must be completed whilst the user is in the UK. During a review the user will be asked to complete questionnaires and share any comments that they have made over the course of completing the Silvercloud modules. The cCBT co-ordinator will then provide written feedback and additional advice that will appear on the users Homepage and the Messages page. The feedback and advice provided will not be clinical in any nature, but will offer encouragement and support. If the user requires clinical support at any stage throughout the online treatment they should contact an appropriate clinician involved in their care, such as you as their referrer or their GP.
Suicidal thoughts
At the start of treatment and during a review, the patient will complete a questionnaire that includes asking if they have had thoughts of harming themselves. If they answer that they have, they will complete additional questions relating to the frequency and level of intent to act upon such thoughts as well as any protective factors. The NHS Tayside cCBT co-ordinator will inform the referrer and/or the users GP, or other clinician of this information. If they are completing the course outside of standard working hours it is recommended they contact NHS 24 to discuss these feelings. The Tayside cCBT co-ordinator will then inform the referrer and/or the users GP, or other clinician the next working day.
Further information on SilverCloud digital therapies platform
Silvercloud provides private and secure access anywhere, anytime to a range of evidence-based, online cCBT packages that are each tailored for different clinical conditions. Each package contains modules that teach users techniques to reduce symptoms of stress, anxiety, low mood or depression associated with their own specific condition.
Based on cognitive behavioural therapy (CBT) or acceptance and commitment therapy (ACT), mindfulness and positive psychology, Silvercloud is interactive and flexible. The program can be run on a PC, laptop, mobile phone or tablet device with an internet connection. This form of treatment is recommended by NICE and SIGN and can be accessed by patients with minimum delay.
In Scotland over 20,000 referrals for cCBT are received each year. It has been shown to be an effective and acceptable treatment with up-take and drop-out rates being comparable to face to face psychological treatment. It is suitable for patients aged 16 and above.
NHS Tayside RefGuide
