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BABCP Response - NICE Consultation January 2022

NHS Talking Therapies Under a Cloud

SilverCloud is a computerised CBT programme, which according to the manufacturers supports ‘80%’ of the NHS services. A year ago, I complained to the Advertising Standards Authority (ASA) over its’ claim of, ‘up to 70% clinical recovery rates’, citing my independent evidence, Scott (2018), that only the tip of the iceberg recover.  The matter was passed to the Irish ASAI, under whose jurisdiction it actually falls, and they informed me  (April 27th 2023 ) that the advertised claim has since changed from “up to 70% clinical recovery” to “up to 65% users achieve clinically significant improvement”. For whatever reason there has been a watering down of SilverCloud’s claim. They no longer want to talk about recovery, a concept that most people can easily understand. The ASAI are continuing to address the matter. Unfortunately NHS Talking Therapies, are it seems answerable to no one and there is no indication that they are abandoning their absurd claim of a 50% recovery rate.

The claim that 65% achieve clinically significant improvement, has a scientific aura about it for a member of the public, but with no idea as to what it means in real world terms. They might consider that as ‘77% of volunteers agreed that volunteering improved their mental health and wellbeing’, National Council for Voluntary Organisations survey 2019, this was actually a better investment.  The implication of SilverCloud’s claim is that it is the use of their product that has brought about the ‘significant improvement’ but this has not been demonstrated. The said improvement could represent regression to the mean, patients presenting at their worst and becoming a bit better with time. Equally it could represent the client’s wish to please the therapist and/or to feel that they have not wasted their time. The claim of ‘significant improvement’ because of usage of the product is not evidence-based and is simply a marketing ploy.

NHS Talking Therapies have produced no evidence that its’ therapists using SilverCloud make any added difference to their clients over and above that of those who didn’t use it. see SilverClouds Space for Depression programme   NICE Guidance ‘Space from depression for treating adults with depression’ Medtech innovation briefing published May 7th 2020. Strangely the NICE IAPT Expert Panel concluded that the case for adoption is ‘partially supported’ despite in the body of report noting lower depression scores, at the end of treatment for the clients of therapists who did not use the computer assisted CBT. An example of spin and conflict of interest.

Dr Mike Scott

 

 

 

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