Current Projects


The Effectiveness & Cost-Effectiveness of Internet-Delivered Interventions for Depression and Anxiety Disorders in the Improving Access to Psychological Therapies Programme D-IAPT.

For many years now, the UK IAPT services have been using SilverCloud to deliver low-intensity online delivered cognitive-behavioural therapy (CBT) to clients.  Data reported nationally through this service demonstrates that SilverCloud interventions perform very well with 70% of clients showing reliable improvements in their symptoms after treatment.  The current trial seeks to establish very robustly and independently the effectiveness of online CBT as a treatment for depression and anxiety.  It also seeks to show that providing this service is cost-effective for the National Health Service.

Trial registration: ISRCTN91967124
Published protocol


Assessing the efficacy and acceptability of an internet-delivered intervention for resilience among college students: A pilot randomized control trial

A pilot randomised controlled trial including three groups: 1) an intervention group with human support; 2) an intervention group with automated support; and 3) a waiting list control group. The intervention, Space for Resilience, is based on positive psychology and consists of seven modules, delivered over a period of eight weeks. Primary outcomes measures will include the Connor-Davidson Resilience Scale (CD-RISC) and the Pemberton Happiness Index (PHI). Secondary outcomes measures will include the Brief Resilience Scale (BRS), the Patient Health Questionnaire – 4 items (PHQ-4), the Rosenberg Self-Esteem Scale (RSES), and the Perceived Stress Scale – 4 items (PSS-4). Acceptability will be examined using the Satisfaction with Treatment (SAT) questionnaire. Analysis will be conducted on an intention-to-treat basis.

Trial registration: ISRCTN11866034
Published  protocol


In Project Talia, we are exploring how we can best leverage AI to help improve the effectiveness of important mental health services. This partnership with Microsoft Labs Cambridge and SilverCloud Health aims to jointly explore how AI can be used to enhance SilverCloud Health’s digital mental health services that deliver cognitive-behavioral treatment (CBT) programs to a large and growing number of people in need of effective care. Using probabilistic machine learning frameworks, the aim is to identify new routes for personalizing treatments and improving patient engagement and clinical outcomes.


Recent Events


Internet-Delivered Cognitive Behavior Therapy as a Prequel to Face-To-Face Therapy for Depression and Anxiety: A Naturalistic Observation

Online CBT has been mostly used with people in the mild-moderate symptom range.  Although this is changing and the question that this study was interested in examining was whether we could use the Silvercloud interventions as part of a treatment package offered to clients who were assessed as severely depressed or anxious and waiting for face-to-face treatment. The study also facilitated us taking a look at the important construct of therapeutic alliance online and the perception of the clinical staff of the usability and acceptability of using a digital intervention as part of a package of care for their clients.

Main outcomes paper


Development and evaluation of internet-supported treatment for recently arrived children and adolescents with psychiatric problems.

The overarching aim of this research is to develop and test methods for effective screening and assessment of mental and somatic health among recently arrived immigrant children and adolescents as well as develop effective internet-delivered cognitive behavioural therapy (ICBT) interventions targeted towards common mental health problems in these groups such as anxiety, depression and post-traumatic stress. The research project is a collaboration between groups in Linköping, Stockholm, Östersund, and Dublin and will be organized in seven different work packages (WP) over a period of six years. These WPs will include development and pilot testing of three different ICBT programs, two targeted towards adolescents speaking Arabic and Dari, and the third targeted towards Arabic-speaking children aged 8-12 years and their parents. The programs targeted towards adolescents will be evaluated quantitatively first in a pilot study and secondly in a state-of-the-art randomized controlled trial whereas the program targeted towards children and their parents will be evaluated in a pilot study only. We will also conduct qualitative interviews with participants from these programs to complement the quantitative evaluation. This project aims to further the understanding regarding how to effectively assess and treat mental health problems in this vulnerable population, thus giving these young people increased well-being and a better chance of successful integration into society. 




Chronic illnesses can have profound effects on well being, functional capacity, and quality of life. Psychological comorbidities with an LTC can further contribute to the distress that is caused by these symptoms.

The current study uses a mixed-methods, feasibility design to examine the outcomes for people with LTCs of the SilverCloud online CBT interventions on scores of depression, anxiety, functioning, health-related quality of life for people who are accessing the national IAPT services.


Patients (n = 35) will be invited to use the supported intervention over an 8-week period. Participants will indicate consent and complete screening measures online before beginning the programme. They will then be referred to a supporter from within Berkshire NHS Foundation Trust. Primary outcome measures will be the Insomnia Severity Index (ISI) and sleep efficiency (SE) as calculated by the programme’s in-built sleep diary. Secondary outcome measures will be the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and the Work and Social Adjustment Scale (WSAS) as part of the minimum data set administered routinely by this IAPT site. All measures will be administered at baseline and weekly thereafter.









This study aimed at evaluating the efficacy of a culturally adapted and internet-delivered cognitive behavioural therapy (iCBT) through a randomised controlled trial (RCT) and with 3-months follow-up. The programme consisted of 7-modules. Two hundred and fourteen Colombian college students with depressive symptoms were randomly assigned to either the treatment group (n= 107) or a waiting list control group (n=107). Participants received weekly support from a trained supporter. The primary outcome was symptoms of depression as measured by the Patient Health Questionnaire (PHQ-9) and the secondary outcomes were anxiety symptoms assessed by the Generalised Anxiety Disorder questionnaire (GAD-7).

Trial registration: NCT03062215
Published protocol
Paper on cultural adaptation methodology
Main outcomes from an efficacy trial



This trial implemented Silverclouds interventions for depression, anxiety and stress in a University student population. The aim of the study was to see how well it could be implemented and also assess outcomes. An interesting feature of this trial is the ability of the user to choose which programme they wish to use – a patient preference was included after participants learned their scores on the psychometric measures we used to assess their symptoms on depression, anxiety and stress levels.

Published protocol
Main outcomes paper