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Online mental health interventions can benefit people experiencing a range of psychological difficulties, but attrition is a major problem in real-world deployments. We discuss strategies to reduce attrition, and present SilverCloud, a platform designed to provide more engaging online experiences. The paper presents the results of a practice-based clinical study in which 45 clients and 6 therapists used an online Cognitive Behavioural Therapy programme for depression. Pre and post-treatment assessments, using the Beck Depression Inventory, indicate a statistically significant improvement in depressive symptoms, with a large effect size, for the moderate-to-severe clinical sub-sample receiving standalone online treatment (n=18). This group was the primary target for the intervention. A high level of engagement was also observed compared to a prior online intervention used within the same service. We discuss strategies for design in this area and consider how the quantitative and qualitative results contribute towards our understanding of engagement.
Doherty et al. (Sat,) studied this question.