The Serenity Programme

A brief introduction ...

What is it, how it worksSteve Cottrell, June 2013

SERENE.ME.UK/HELPERS/

#SERENITYPROGRAM

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SERENE.ME.UK/HELPERS

#SERENITYPROGRAM

SERENITY.PROGRAMME

Guided Online Self-help

For Generalised Anxiety Disorder, (GAD) Phobias and Panic Disorder

What is it?

Human ContactInteractive ProgrammeSelf AssessmentTelephone Support

A unique, theoretically

integrative blended learning

approach to treatment of

stress and anxiety disorders

A blend of face-to-face

contact alongside an

interactive Internet

programme and telephone

support ...

Assessment

Begins with a two-hour

semi-structured assessment

Bespoke template-driven

documentation, assessment

using CORE-OM, HADS (or

GAD-7) & PHQ-9

35 Interactive Assessment Tools, Including ...

GAD-7 (Generalised Anxiety)

PHQ-9 (Depression)

WSAS (Work Adjustment)

PEQ (User Satisfaction)

PHQ-15 (Somatisation)

IES-R (Trauma)

PDSS (Panic Disorder)

OCI (OCD)

AUDIT (Alcohol Use)

The Programme 1• Introduction

2• Understanding Anxiety

3• Becoming Different - Goal setting

4• Behaviour, Emotions, Sensations, Thoughts

5• Relaxation

6• Difficult Thoughts

7• Difficult Feelings

8• Solving Problems

9• Staying Well

Presented in an attractive

interactive workbook (in depth

programme) and online

multimedia format (brief

psychoeducational

programme)

Assistive technology for

people with dyslexia, visual

impairment, physical or

reading difficulties

Assessment meeting

Modules 1 and 2 Support call

Module 3 Goal setting meeting Module 4

Support call Module 5 Support call

Module 6 Module 7

Module 8

Module 9

Support call

Support call Support call

Final meeting

The Programme

Takes most people at least

three months to complete ...

Workbooks

Password protected

interactive workbooks , users

download & keep to form a

comprehensive client-held record

Use on your PC or print and

complete by hand (average

reading age of 11 years)

With more than 60 tasks and

exercises

Benefits - to the user

Increased choice

Increased confidentiality

Range of options: Internet,

CD, paper, USB drive

Infrequent contact, longer

term approach (CDM model)

Reduced need to travel

Time flexibility - night shift

workers, carers, single parents

User involvement during

design process, CQI

Benefits - to the service

Prevents wasteful ‘admit >

treat> discharge > readmit’ cycle

Equity - services for

agoraphobia, social phobia,

avoidant and fearful, single

mothers, young men, people with

disabilities

No inherent geographical

boundary problems

100% increase in throughput

Benefits - to the Wider Community

Materials shared, reducing

familial transmission of harm

Use of model alone or as

adjunctive treatment - EAP,

CFS, MUS, anxiety in COPD and

MI etc.

Less paper, less travel, less

cost, less waste, less pollution -

more efficient use of time!

Evaluation

Interview with researcher,

repeated measures (DASS,

CORE-OM, HADS, PHQ-9)

Studies with Beneficiaries

of ‘Want 2 Work’ programme

John Moore’s University

Student Stress Study

Ongoing NHS Study

Awards

Awards from WaMH in PC

WIsH (2006)

RCN (2008)

BJN (2008)

Best Nurse-led Project 2010

In RCN ‘Top 30’ UK Health

Modernisation Projects 2011

(TBA)

The Serenity Programme

Outcome evaluation in BCUHB

Early results ...

'...it was good for changing thought

patterns...' JC, Abergele

'...the website was compelling and

encouraging...' KJ, Rhyl

'... navigation was easy...' CM, Colwyn Bay

'...programme gives great insight and

understanding to anxiety and the reasons why it is

happening...' CR, Rhyl

'...layout was very user-friendly...' CA, Rhyl

'...really liked the points of interest, helpful hints, and breakdown of what

was wrong and how I could deal with it...' RW,

Colwyn Bay

'..it’s absolutely super, I’m really, really very

impressed with it, it’s a wonderful thing to

have...' AD, Denbigh

'...instantly appealed as it immediately seemed

to address my problems...' JT, Rhyl

'...not loads of medical jargon, so could

understand what was being said...' SW, Rhyl

'...I liked the gentle approach...' SP, Rhyl

'...it’s good to know someone else

understands how I feel...' SW, Rhyl

'...think the programme is good and should be rolled out to others...'

HR, Prestatyn

Mixed-methods quasi-experimental study - semi-structured interview and repeated measures using HADS, PHQ-9 and CORE-OM

Anxiety scores showed an average reduction of 31% over 3 months

Mean baseline score = 16, SD = 3.48, CI = 1.53 | Mean 3-month score = 11, SD = 3.54, CI = 1.55, t-test (2-tailed) p<0.0002

Normal 0 - 7 | Mild 8 - 10 | Moderate 11 - 14 | Severe 15 - 21

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 200

5

10

15

20

25

HADS - Anxiety Scores, 3 month interval, p<0.0002

Client

Depression scores showed an average reduction of 52% over 3 months

Normal 0 - 7 | Mild 8 - 10 | Moderate 11 - 14 | Severe 15 - 21

Mean baseline score = 10, SD = 4.51, CI = 1.98 | Mean 3-month score = 5, SD = 4.11, CI = 1.80, t-test (2-tailed) p<0.0001

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 200

5

10

15

20

25

HADS - Depression scores, 3 month interval, p<0.0001

Client

The Serenity Programme

Internet usage data ...The first seven months

1,821 visitors stayed forbetween 3 & 30 minutes

357 visitors stayed formore than 30 minutes

Thanks for Listening!

Questions?

Thanks for Listening!

Questions?