A survey of web-based mental health selfhelp programs Ken Weingardt, Ph.D. National Director, Web Services Office of Mental Health Services Veterans Health Administration U.S. Department of Veterans Affairs Washington, DC Investigator Center for Health Care Evaluation VA Palo Alto Health Care System Stanford University Palo Alto, CA 1
OMHS Web Services Agenda Provider-facing resources Patient-facing resources Web-Based Self-help: Computerized CBT VA/DoD Integrated Mental Health Strategy New Programs for Veterans in 2012 The Road Ahead: Patient Education Management System 2
OMHS Web Services The web services group is part of the Mental Health Informatics Section in the VHA Office of Mental Health Services (VACO-10P4M) Our mission is to use internet and emerging technologies to support the delivery of evidence-based, recovery-oriented, mental health services to Veterans and their families. OMHS Web Services designs, develops and implements three types of resources: (2) Provider-facing resources including intranet and SharePoint sites, webbased CE courses and online communities of practice (3) Veteran-facing resources including websites for information and education, screening tools, and web-based self-help programs (4) Innovative technology applications for both Veterans and staff, including mobile apps and social media. 3
OMHS Web Services Name Position Location Steve Baumgartner New Media Producer Enterprise, AL Mike Conran New Media Producer Salt Lake City, UT Kellie Condon, Psy.D. National Coordinator, My Recovery Plan Santa Maria, CA Carolyn Greene, Ph.D. Program Manager Palo Alto, CA Kevin Lai, M.S. New Media Producer Palo Alto, CA Ali Lott, M.S. Health Science Specialist Palo Alto, CA Peter Shore, Psy.D. Program Manager Portland, OR Ken Weingardt, Ph.D. Director Palo Alto, CA 4
vaww.mentalhealth.va.gov 5
Online Communities of Practice 6
Online Courseware for Continuing Education 7
www.mentalhealth.va.gov 8
www.mentalhealth.va.gov 9
www.myhealth.va.gov 10
www.myhealth.va.gov 11
Online self-help programs Marks, Cavanaugh & Gega (2007) Hands-on Help: Computer-Aided Psychotherapy (CP) Bennett-Levy, Richards, Farrand et al. (2010). Oxford Guide to Low Intensity CBT interventions 12
http://www.beatingtheblues.co.uk/ 13
Cavanagh, K., Shapiro, D. A., Van Den Berg, S., Swain, S., Barkham, M., & Proudfoot, J. (2006). The effectiveness of computerized cognitive behavioural therapy in routine care. The British Journal of Clinical Psychology / The British Psychological Society, 45, 499-514. Cavanagh, K., Shapiro, D. A., Van Den Berg, S., Swain, S., Barkham, M., & Proudfoot, J. (2009). The acceptability of computer-aided cognitive behavioural therapy: a pragmatic study. Cognitive behaviour therapy, 38, 235-46. Proudfoot, J., Ryden, C., Everitt, B., Shapiro, D. a, Goldberg, D., Mann, A., et al. (2004). Clinical efficacy of computerised cognitive-behavioural therapy for anxiety and depression in primary care: Randomised controlled trial. The British Journal of Psychiatry: The Journal of Mental Science, 185, 46-54. Kaltenthaler, E., Sutcliffe, P., Parry, G., Beverley, C., Rees, a, & Ferriter, M. (2008). The acceptability to patients of computerized cognitive behaviour therapy for depression: a systematic review. Psychological medicine, 38(11), 1521-30. 14
15
Marks, I. M., Mataix-Cols, D., Kenwright, M., Cameron, R., Hirsch, S., & Gega, L. (2003). Pragmatic evaluation of computer-aided self-help for anxiety and depression. The British Journal of Psychiatry, 183, 57. Gega, L., Marks, I., & Mataix-Cols, D. (2004). Computer-aided CBT self-help for anxiety and depressive disorder: Experience of a London clinic and future directions. Journal of Clinical Psychology/In Session, 60, 147-157. Marks, I. M., Kenwright, M., McDonough, M., Whittaker, M., & Mataix-Cols, D. (2004). Saving clinicians time by delegating routine aspects of therapy to a computer: A randomized controlled trial in phobia/panic disorder. Psychological Medicine, 34, 9-18. 16
NHS Stepped Care Model 17
18
19
20
21
Christensen, H., Griffiths, K. M., Korten, A. E., Brittliffe, K., & Groves, C. (2004). A comparison of changes in anxiety and depression symptoms of spontaneous users and trial participants of a cognitive behavior therapy website. Journal of Medical Internet Research, 6, 1-14. Internet Healthcare Coalition. Christensen, H., Griffiths, K. M., & Korten, A. (2002). Web-based cognitive behavior therapy: Analysis of site usage and changes in depression and anxiety scores. Journal of Medical Internet Research, 4, 1-11. Internet Healthcare Coalition. Christensen, H., Griffiths, K. M., & Jorm, A. F. (2004). Delivering interventions for depression by using the internet: Randomised controlled trial. BMJ (Clinical Research Ed.), 328, 265. Christensen, H., Griffiths, K., Groves, C., & Korten, A. (2006). Free range users and one hit wonders: Community users of an internet-based cognitive behaviour therapy program. The Australian and New Zealand Journal of Psychiatry, 40, 59-62. Christensen, H., Leach, L. S., Barney, L., Mackinnon, A. J., & Griffiths, K. M. (2006). The effect of web based depression interventions on self reported help seeking: Randomised controlled trial BMC Psychiatry, 6, 13. 22
23
VA/DoD Integrated Mental Health Strategy 24
25
26
27
28
29
30
31
32
Building Strong Relationships with Your Children Reintegrating into the family system after separations. Promoting positive parent-child interactions Limit setting and discipline during transitions. Helping children cope with common post-deployment (and anytime) issues, Taking Care of Yourself as a Parent Regulating your own emotions while parenting. Managing your stress level during stressful times. Parenting in the Face of Personal Challenges Balancing work and home life demands as a military member. Parenting while coping with your own emotional upheaval. Helping children deal with your physical injury or disability. 33
The Road Ahead 34
Patient Education Management System Veteran-Facing Learning Management System (LMS), much like TMS for VA employees. Will make highly interactive, media rich courseware available to Veterans on My HealtheVet. Administrative functions allow clinicians to assign relevant courses and monitor progress. *Removes dependency on OI&T. Programs built to the industry standard (SCORM 2004) can be deployed with minimal technical rework
PEMS allows diverse stakeholders to contribute content MIRECCS NCPTSD DCoE Veterans PEMS CoE s Active Duty University Partners Other DoD Commercial Partners 36
PEMS supports Modular Content Development
Questions? Ken Weingardt, Ph.D. Ken.weingardt@va.gov 650-493-5000, ext 2-22846