Bell Deborah
Department of Clinical Psychology, Newcastle University, Newcastle upon Tyne, UK.
J Eval Clin Pract. 2025 Feb;31(1):e70022. doi: 10.1111/jep.70022.
NICE guidelines recommend offering computerised Cognitive Behavioural Therapy (cCBT) to young people with mild mental health issues to ensure early treatment access and reduce service demand. Emerging evidence suggests cCBT reduces symptoms, but further evaluation is needed. SilverCloud is a recommended digital CBT programme.
Evaluate a pilot trial of SilverCloud in CAMHS at a local NHS Foundation Trust.
(1) Symptomology: Is there a change in depression or anxiety symptoms after using the intervention? (measured by outcome scores); (2) Adoption: What was young people's engagement with SilverCloud? (measured by time spent on the platform and uptake); (3) Satisfaction: How satisfied were young people with SilverCloud? (measured by module feedback ratings and a questionnaire).
The SilverCloud intervention for young people was evaluated over 9 months. Reductions in symptoms of generalised anxiety disorder (GAD) and low mood were measured using the Revised Children's Anxiety and Depression Scale (RCADS), GAD, and Major Depressive Disorder (MDD) subscales. Adoption was measured by time spent on SilverCloud and intervention uptake. Satisfaction was measured by module feedback ratings and a questionnaire.
Ninety-one people were offered SilverCloud, 77% started, 46% completed it and 27% disengaged. Thirty-two participants completed SilverCloud during the evaluation (12 CYP and 20 parents). No statistically significant reduction was found in any subscale. Satisfaction was varied; 94% rated the intervention favourably, but no participants reported behaviour changes due to the intervention.
This evaluation suggests tentative pessimism regarding SilverCloud's benefits. However, due to significant challenges and limitations, further analysis is recommended. Recommendations were given for local services.
英国国家卫生与临床优化研究所（NICE）指南建议为有轻度心理健康问题的年轻人提供计算机化认知行为疗法（cCBT），以确保早期获得治疗并减少服务需求。新出现的证据表明cCBT可减轻症状，但仍需进一步评估。SilverCloud是一个推荐的数字认知行为疗法项目。
评估在当地国民保健服务基金会信托机构的儿童与青少年心理健康服务（CAMHS）中对SilverCloud进行的一项试点试验。
（1）症状学：使用该干预措施后抑郁或焦虑症状是否有变化？（通过结果得分衡量）；（2）采用情况：年轻人对SilverCloud的参与度如何？（通过在平台上花费的时间和接受程度衡量）；（3）满意度：年轻人对SilverCloud的满意度如何？（通过模块反馈评分和问卷调查衡量）。
对针对年轻人的SilverCloud干预措施进行了为期9个月的评估。使用修订后的儿童焦虑与抑郁量表（RCADS）、广泛性焦虑障碍（GAD）和重度抑郁症（MDD）子量表来衡量广泛性焦虑障碍和情绪低落症状的减轻情况。通过在SilverCloud上花费的时间和干预措施的接受程度来衡量采用情况。通过模块反馈评分和问卷调查来衡量满意度。
91人获得了SilverCloud服务，7�%开始使用，46%完成了该服务，27%退出。在评估期间，32名参与者完成了SilverCloud服务（12名儿童与青少年及20名家长）。在任何子量表中均未发现有统计学意义的降低。满意度各不相同；94%对该干预措施给予好评，但没有参与者报告因该干预措施而导致行为改变。
该评估表明对SilverCloud的益处持初步的悲观看法。然而，由于存在重大挑战和局限性，建议进行进一步分析。并为当地服务提供了建议。
