Data project comparing different NHS therapy approaches

Talking and digital therapies can help people manage their problems by changing the way they think and behave. NHS Talking Therapies services offer talking or digital therapies to people with depression or anxiety. But we don’t know how well different ways of providing talking or digital therapies works for different people.

Randomised controlled trials (RCTs) are often used for comparing different treatments. Randomised refers to allocating treatment to each person at random. This helps provide the best evidence of how well different treatments work. But many people who have therapy in ‘real-world’ NHS settings do not take part in RCTs. This limits what RCTs can tell us about normal NHS care.

Although RCTs are the gold standard for estimating causal treatment effects, they have limitations for informing treatment allocation and clinical guidelines; also, due to finite resources, more cost-efficient vehicles are needed to inform evidence-based decision-making. Rather than doing an RCT, this study is using real world data, which has its strengths. Unlike RCT’s, real world data looks at treatment as usual i.e data that is already collected as part of routine NHS care. Furthermore, we will be studying if treatment outcomes are impacted by differences between people – such as different ethnicities or experiences social deprivation. We will also involve NHS staff and patients to understand challenges to giving iCBT. The project could help inform evidence-based decision-making with a clear direction to patient benefit.

One other importance is the lived experience involvement: we will be involving people in aspects of the research which have seldom been done before. It is vital to explore how lived experience involvement can be made as meaningful and as accessible as possible in different types of research.

Forming a group of 14 people with lived experience of anxiety, depression, and different forms of talking or digital therapies provided within NHS Talking Therapies; for example, individual, group, or internet delivered CBT for depression or anxiety, or EMDR or trauma-focussed CBT for PTSD. The group will be involved in the following ways:

• help develop the study design and research questions;
• receive training, development opportunities and support throughout their time on the project;
• Interpret and make sense of study results, drawing on lived experience to contextualise the findings;
• develop ways to explain our study design and results to different audiences to ensure everyone can access them;
• Opportunity to co-author on a paper to describe our lived experience-centred approach to this work.

One key area that the LEAP will be trained to co-develop is the directed acyclic graphs (DAG). DAGs visually represent how different variables impact one another. For instance, how different demographics might impact someone’s treatment outcomes. Find out more here.

Check out this info video here – https://www.youtube.com/shorts/4r6snqj0gnY

We will link to the University of Sheffield’s webpage once it is live. For now please email [email protected] if you would like anymore info.