RE-EDITT and Compass
Resource for Electronic Development of Interventions for Talking Therapies in Long-Term Conditions (RE-EDITT) is developing online Cognitive Behavioural Therapy (CBT) treatment for anxiety and depression in people with long-term conditions.
The project is led by a group of Clinical Health Psychology researchers at King’s College London, based at Guy’s Hospital: Professor Rona Moss-Morris, Dr Joanna Hudson, Dr Katherine Rimes and Dr Katrin Hulme. Research shows that around 30% of people with a physical long-term condition (LTC) also experience mental health problems. Research into online tools has found them to be an effective way of delivering CBT, which is the National Institute for Health and Care Excellence (NICE) recommended treatment for mental health conditions including anxiety and depression, to a wider group of patients.
Caring for your mental health during long-term physical treatment is vital, but what happens when you enter remission? Penny shares how the RE-EDIT tool Compass helped her recognise the importance of her own mental wellbeing on the road after remission.
There are existing tools for delivering online CBT. However, these are not as effective as they could be for those with LTCs because the context of the LTC and lived experience of the patient is often not taken into consideration. The impact of the LTC and factors involved in the psychological adjustment of living with a long-term illness may require specialist support different to that offered for primary mental health issues.
The team reviewed literature on understanding psychological adjustment and distress in LTCs, to tailor current evidence-based CBT treatments for anxiety and depression to be more specific to people with LTCs. Input from an expert advisory panel of people with LTCs and psychologists specialising in treatment for people with LTCs is informing key elements of the project. For example, there have been meetings with the panel to discuss terminology, design and accessibility of the website; now known as Compass, content and implementation options.
To create the website and hosting platform, the team is working with SPIKA, a technical agency which focuses on writing software solutions to create engagement, build relationships, enhance wellbeing and boost performance. The initial programme has been designed as suitable for a range of different LTCs, addressing anxiety and/or depression in the context of having any LTC. Following the initial version, tailored programmes for specific patient populations can be ‘cloned’, for example developing a version of Compass specifically targeted at those with Multiple Sclerosis (MS).
The project works with colleagues across King’s Health Partners, the Southwark Improving Access to Psychological Therapies (IAPT) service and Guy's and St Thomas' psychology services. This ensures that the product is informed by clinical experience, responds to the needs of our patients, and that we can trial implementation in a front-line setting.
In the next phase of Compass development, the programme will be trialed in two local services: Southwark IAPT service and the Congenital Heart Disease service at St Thomas’ Hospital. We will explore how to best implement Compass in healthcare services and conduct extensive evaluation, including gathering feedback from both healthcare professionals and patients, in order to improve the programme moving forward.
The project aims to build a clear pathway for patients to enter treatment by linking with mind and body partners including Integrating Mental & Physical healthcare: Research, Training & Services (IMPARTS), IAPT, clinical health psychology and liaison psychiatry.
Read a blog about the project by Professor Rona Moss-Morris, Health Psychology Section, Institute of Psychiatry, Psychology & Neuroscience, King’s College London.
If you know someone with a LTC and depression and/or anxiety registered with a Southwark GP, they can refer themselves to Southwark IAPT. The Southwark IAPT team can then speak with the patient to discuss what psychological therapy options are available to them.