Using computerised CBT to prevent mental health problems: a systematic review and a case study of Xanthis

20 November 2009


Amy McKeown has presented her work on using computerised cognitive behavioural therapy (cCBT) preventatively at two international conferences recently. The work, done in collaboration with Dr Henry Potts, was based on her prize-winning MSc Health Informatics dissertation at CHIME. McKeown is now an honorary researcher in the department.

Work to date includes a systematic review on cCBT for anxiety and depression in preventative and sub-clinical contexts. McKeown also collated and analysed empirical data about the use of a cCBT package, developed by her own start-up company Xanthis, in occupational health settings. Xanthis is a health content and technology company, developing products and delivering consultancy associated with psychological and emotional conditions. The company's focus is on using technology to help individuals become aware of and learn how to treat the psychological and emotional aspects of health, and understanding how these impact physical health and happiness.

Anxiety and depression are a leading cause of morbidity. Prevention and early treatment are effective, but are difficult to deliver in traditional forms to large populations. Internet-delivered approaches, like cCBT, appear promising as a cost-effective way of reaching populations for sensitive and stigmatised conditions. However, there are challenges to achieving this within a viable financial model. The literature in this area is heterogeneous, but outcomes are generally positive. Attrition rates remain high in Internet-based spontaneous self-help. Xanthis is in use in three large, UK, public sector organisations: Dyfed-Powys Police, Cardiff University and Oxford University. Its use is tied into occupational health/human resources policies. User numbers peaked after launch in all three organisations before settling at 5-10% staff per year. Users find the tool a useful support and like that it is confidential, accessible, increases knowledge and understanding about problems, and links to sources of help. However, there have been problems associated with the implementation and launch of the tool. Different organisations have sought to use Xanthis in different ways and how the tool was promoted internally has been critical. Commercialisation has been constrained by the resources typically devoted to occupational health. The financing and implementation of sub-clinical cCBT packages must be researched, including determining which are suitable for use in different user populations and circumstances.

This research was first presented on video at Medicine 2.0: Social Networking and Web 2.0 Applications in Medicine and Health, in Toronto, Canada, in September: you can watch the video here and the abstract and presentation are available on UCL Eprints. In October, McKeown was in Amsterdam for the inaugural International E-Mental Health Summit 2009, Amsterdam, with two presentations, again available on Eprints. One was an oral presentation on the review (Eprints link) and the other was a poster presentation on real-world case studies using Xanthis (Eprints link). With the latter, McKeown was also invited to talk about the work at the 4th ISRII (International Society for Research on Internet Interventions) sub-meeting.

McKeown and Potts are now seeking funding to further research in this area.

Contact: Henry Potts