Return to Research on the dissemination of psychological treatments

Scalable treatment

Scalable psychological treatment

The need for scalable psychological treatments

The overarching goal of this line of work is to determine whether complex therapist-delivered psychological treatments can be modified to make them suitable for delivery on a large scale without a major reduction in their effectiveness. We believe that developments of this type are essential if psychological treatments are to be made readily available (see figure below from Fairburn and Patel, 2014). In particular, we believe that the way forward lies in the development and promotion of "programme-led" forms of treatment in which the intervention is delivered by the programme itself rather than by a therapist. In other words, these therapist-free interventions involve self-help; that is, sufferers treating themselves.

There are self-help versions of many of the evidence-based psychological treatments and some have good evidence to support them. Overcoming Binge Eating is a leading example: in essence, it is a self-help version of CBT-E. Until recently, these self-help programmes have been delivered in the form of self-help books but increasingly they are being delivered via the Internet (eTherapy). The two forms of delivery - via printed material or the Internet - have their pros and cons. What is particularly attractive about the online mode of delivery is the fact that the intervention can be personalised to match the characteristics of the individual and his or her specific problems, something that cannot be achieved with a one-size-fits-all self-help book. In addition, the intervention can be designed to change in response to the user's progress.

To develop personalised (“tailored”) interventions of this type requires an intimate knowledge of the problem being addressed and the treatment concerned. With respect to eating disorders, CREDO has both. Accordingly CREDO is developing an online version of CBT-E (CBTe).