An outcomes study of eTherapy for dual diagnosis using Breaking Free Online

Abstract

Purpose – In recent years there has been a proliferation of computer-based psychotherapeutic interventions for common mental health difficulties. Building on this, a small number of such interventions have now been developed to address substance dependence, one of which is Breaking Free Online (BFO). A new “eTherapy” self-help service, which was set up by the UK mental health charity Self-Help Services, has provided access to BFO to service users presenting with comorbid mental health and substance misuse difficulties. The purpose of this paper is to evaluate a range of clinical outcomes in the first cohort of service users accessing this dual diagnosis service. Design/methodology/approach – A number of standardised psychometric assessments were conducted with service users at baseline and post-treatment at discharge from the service. Outcome data were available for 47 service users out of an original cohort of 74. Findings – Statistically significant improvements were found in terms of measures of social functioning, depression, anxiety, alcohol and drug use and social anxiety. Clinically relevant gains were also identified, with fewer service users reaching threshold scores for depression and anxiety at post-treatment compared to baseline. Effect sizes also indicated that the identified improvements across the psychometric measures were robust and significant. Research limitations/implications – These findings provide further support for the clinical effectiveness of BFO, and also provide evidence that an eTherapy self-help service may be appropriate for some individuals presenting with dual diagnosis. Further research is underway with larger and alternative clinical populations to examine the effectiveness of BFO and also this novel eTherapy self-help approach. Originality/value – This paper has provided initial data to support effectiveness of a novel eTherapy service for dual diagnosis.

An Outcomes Evaluation of Computerized Treatment for Problem Drinking using Breaking Free Online

“…PHE is responsible for promoting the health and well-being of all citizens through preventative interventions, including the impact of alcohol. PHE currently includes alcohol consumption as one of the key behaviors determining health outcomes as outlined within its 'health and well-being framework' for 2014-2015(Public Health England, 2012. In terms of treatment of those individuals already affected by problem alcohol consumption, treatment and support can be accessed via standard NHS, third sector and private service provision including general practitioners, inpatient and outpatient detoxification and residential rehabilitation.…”

Using the “recovery” and “rehabilitation” paradigms to support desistance of substance-involved offenders: exploration of dual and multi-focus interventions

“…The BFO programme is appropriate for individuals with substance misuse difficulties, in addition to those who are dually diagnosed (e.g. Davies et al, 2015;Elison et al, 2014;Elison et al, 2015a). BFO is designed to support prisoners to strengthen their resilience and build their 'recovery capital' (Best & Laudet, 2010), through supporting prisoners to develop a range of coping skills and tools based on principals of CBT and mindfulness, and has been demonstrated as effective in a number of populations receiving support for substance misuse in community settings (Elison et al, 2014;Elison et al, 2015aElison et al, , 2015b.…”

“…Davies et al, 2015;Elison et al, 2014;Elison et al, 2015a). BFO is designed to support prisoners to strengthen their resilience and build their 'recovery capital' (Best & Laudet, 2010), through supporting prisoners to develop a range of coping skills and tools based on principals of CBT and mindfulness, and has been demonstrated as effective in a number of populations receiving support for substance misuse in community settings (Elison et al, 2014;Elison et al, 2015aElison et al, , 2015b. The BFO programme also encourages users to engage in mutual aid and other positive non-offending, non-substance using activities in order to facilitate the building of supportive social networks, which may facilitate the process of identity change for individuals using the programme (Best et al, 2008;Best et al, 2015).…”

A Qualitative Exploration of U.K. Prisoners’ Experiences of Substance Misuse and Mental Health Difficulties, and the Breaking Free Health and Justice Interventions

“…The programme has recently been introduced throughout a number of prisons in the North West of England, and is based on a programme previously developed for community settings, for which there is now a growing evidencebase Elison et al, 2013;Elison et al, 2014b;Elison et al, 2014a;Elison et al, 2015aElison et al, , 2015bHogan et al, 2015). The programme incorporates evidence-based techniques taken from cognitive-behavioural therapy (CBT) (Beck et al, 2001;Beck, 2011) alongside 'mindfulness' approaches (Marlatt et al, 2008;Marlatt et al, 2010), and is appropriate for individuals with substance misuse difficulties and those who are dually diagnosed Elison et al, 2013;Elison et al, 2014a;Elison et al, 2014b;Elison et al, 2015a).…”