This is the bizarre mantra from NHS Talking Therapies digital partner, SilverCloud. The latter platform is based in Ireland and until recently it boasted ‘up to a 70% clinical recovery rate’. I protested to the Irish Advertising Standards that this was fraudulent, and Silver Cloud have since withdrawn any claim as to recovery. I explained to the ISAA that recovery has a clear meaning to a member of the public, as back to their old self or best functioning. As SiverCloud studies have never demonstrated achievement of this metric, it was highly misleading. Its’ new vanguard claim is ‘up to 65% of users achieve clinically significant improvement’. But I wouldn’t change my internet provider if the would be provider claimed an ‘up to particular speed’, I would smell a rat.
The term ‘clinically significant improvement’ only has meaning if the population being addressed is clearly specified. The mnemonic PICOT is recommended by the NHS and NICE to establish the credibility of an intervention. The ‘P’ stands for population, established with a ‘gold standard’ procedure. But in none of the studies cited by SilverCloud has the ‘population’ been crystallised using a standardised diagnostic interview nor has outcome , the “O” been determined by a blind independent assessor using a ‘gold standard’ interview. The cited SilverCloud studies lack any credibility.
It is disingenuous of SilverCloud to now claim ‘up to 80% of participants show improvement in depression and anxiety symptoms’. Once again we have the advertising gimmick of ‘up to’. With no specification of who the ‘participants’ are with regards to the P of PICOT. The platform has not used a credible attention placebo to determine whether any identified changes are any more than regression to the mean. Similarly stating ‘93% users satisfaction’ is no more compelling than restaurant owners saying 93% of customers said they were satisfied when asked, leaving the premises.
Why does NHS Talking Therapies associate itself with SilverCloud? It offers the alluring prospect of wide dissemination of a service at minimal cost. Quite simply it is fixated on a fantasy, such a state of mind is a recipe for abuse. The time is long overdue for NHS Talking Therapies and NHS Managers to be properly regulated.
Dr Mike Scott
424 replies on ““We can’t tell you what proportion recover, we can only tell you what proportion clinically significantly improve””
I’ve been through this multiple times as patient and every time they’ve heavily spun (to put it cautiously) the impact, my choices, or both on the discharge letter. They also stop sending their beloved questionnaires (“are you thinking about yourself” etc) if you terminate the therapy early, which those who are negatively impacted presumably would.
There are some slick clever marketing people in these companies busily making as much profit as possible, it feels so desperately at odds with what mental health care should be.
Hi Mike – I just would like to say how admirable this page is. I am a psych grad by background and have worked in IAPT services so have seen first hand what you are speaking out about! Thank you for speaking out – I tried too whilst I was there but was not listened to. Please keep advocating!
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Fang Jifan은 거래 시장의 번잡함을 무시했습니다.
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Hu Kaishan이 주도권을 잡고 미친 듯이 돌진했습니다.
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마차는 여관에 정차했고 이미 누군가가 여관에서 나와 그를 정중하게 맞이하고 있었다.
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폐하가 내금을 기꺼이 꺼내면 다른 문제를 논의할 수 있습니다.
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어린 후배가 지금 그의 머리 위에 타고 있다.
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철갑선에 소식이 전해진 후 Fang Jifan은 안도의 한숨을 쉬었습니다.
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선비 복장을 한 무유는 얼굴이 창백해지더니 곧바로 머리를 껴안고 바닥에 엎드렸다.
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Zhu Houzhao는 IQ가 낮은 것이 아니라 EQ가 낮을 뿐이며 여전히 이 사실을 이해하고 있습니다.
토토 미니 게임
Fang Jifan은 고개를 끄덕이고 Zhu Houzhao의 일상을 이해하고 고개를 끄덕였습니다. “오.”
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장빈이 이런 말을 했을 때, 그것은 절제된 표현인 것 같았다.
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홍지황제는 이 문장을 알고 한동안 샤오징의 마음을 차갑게 만들었다.
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그는 눈을 살짝 가늘게 떴고, 그의 눈 사이로 의심의 흔적이 스쳐지나갔다.
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