Psychological Treatments

Main location of work: Oxford but the treatments developed are tested nationally

This Theme aims to improve patient outcomes by developing new effective and efficient psychological interventions, including digital interventions, that precisely target core psychological mechanisms of mental health disorders or poor recovery from physical illness

Many people with significant mental health problems, or comorbid mental health and physical conditions, currently cannot access effective psychological treatments or face long waits. This Theme will continue its internationally-leading role in developing powerful psychological interventions. This will include blended digital interventions and automated virtual reality therapies, which can be accessed by patients from their homes at convenient times. Staff time is decreased and access increased, while effectiveness is maintained.

Building on the excellent track record of achievements as part of the current BRC [Precision Psychological Therapies Theme], the focus is on developing new treatments that will directly benefit patients and can be disseminated into the NHS or through other appropriate channels such as schools or charities.

Five areas will be the focus of the work with the aims of:

1) Developing and evaluating novel blended digital and automated VR treatments

2) Developing and evaluating novel psychological prevention and early intervention programmes

3) Developing novel interventions for complex mental disorders and comorbid physical and mental health problems

4) Using the results of clinical trials to further refine and personalise the treatments.

5) Implementing the novel interventions via the NHS, schools or charities.

1) Developing novel blended digital and automated VR treatments

This builds on highly effective therapist-assisted online treatments for social anxiety and PTSD and automated virtual reality (VR) interventions for anxiety disorders and  and psychosis developed by the Theme, as well as the demonstration of effective digital CBT for insomnia and consequent benefits on other mental health outcomes. Collaborations with service users will lead to further digital and VR interventions that are more efficient and at least as effective as face-to-face therapy. Brief interventions for transdiagnostic factors of poor mental health (eg rumination and worry) will also be developed. Early phase trials will be conducted followed by externally funded efficacy clinical trials of the new interventions.

2) Developing and evaluating novel psychological prevention and early intervention programmes

Building on the results of prospective and experimental studies we will develop and evaluate novel interventions for the prevention and early intervention of mental disorders following stressful events such as events involving threat to life or bullying. This approach will for example test interventions to prevent the transition to psychosis in young people or depression and PTSD in health professionals.

3) Developing novel interventions for complex mental disorders and comorbid physical and mental health problems

Psychological factors that impede recovery will be identified and targeted psychological interventions will be developed for patients with complex mental health problems. For those with comorbid chronic physical and mental health conditions, treatment targets will be identified.

4) Using the results of the clinical trials to further refine and personalise the treatments

Detailed analyses of the clinical trials will aim to identify processes of change and factors that affect treatment outcome. This will facilitate refinement of interventions with increased personalisation.

5) Implementing the novel interventions via the NHS, schools or charities

With an aim to maximise access, the interventions will be disseminated in the UK and internationally in collaboration with NHS services, charities and schools. This work will investigate the most effective ways of implementation.

Given the nature of the work, service user input and PPIEP is formally included in all studies.  Close working is undertaken with the McPin Foundation.  Patients are recruited from diverse backgrounds, and work undertaken with community leaders and charities to engage people who may be sceptical about psychological approaches. The work is conducted involving a variety of professionals (e.g., CBT therapists, teachers, midwives, nurses) and self-referrals are encouraged.

The treatments are tested across the UK, including in Cumbria, Lincolnshire, Bristol, Manchester, Newcastle, Birmingham, Blackpool, Wales, and Northern Ireland.

Work to date in the current BRC has allowed the substantial increase in the number of investigators working in this area at the cutting edge of the development of psychological interventions for treatment and prevention. The Theme has successfully committed to supporting pilot studies and mentoring for applicants for Fellowships which will build capacity in treatment innovation.  Plans for the future include continued support and mentoring for the current Fellowship holders plus funding new PhD students and Research Fellows who will become the next generation of researchers.