Digital CBT For Young People With Anxiety and Low Mood: Cohort Study With Propensity Score Methods
In the UK approximately 20% of 8-to-16-year-olds and 23% of 17-to-19-year-olds have a mental health condition with low mood/depression the most common. Difficulties like these can get worse and lead to problems continuing into adulthood if they are not treated quickly and effectively. Despite this, many young people cannot access appropriate support because UK child and adolescent mental health services (CAMHS) have long waiting lists and can often only see the most unwell.
Digital interventions may help to tackle this problem by reaching more young people. One online programme is SilverCloud by Amwell. Previously only available for adults, SilverCloud now includes three interventions for young people aged 13-to-18-years. Each intervention, based on Cognitive Behavioural Therapy (CBT), helps individuals to understand their thoughts, feelings and behaviours. The interventions are made up of 6-to-8 online modules with some practitioner support. One intervention is for low mood/depression, one is for anxiety and the remaining one is for both combined. The SilverCloud interventions are delivered across various services in the UK. One such service is NorthPoint Wellbeing, a charitable organisation providing mental health support to young people across West Yorkshire. Not all young people in the area are however able to access the interventions. This is because how much money is spent on making a treatment available depends on how strong the current evidence is for its effectiveness.
In 2023 the National Institute for Health and Care Excellence (NICE), the body that recommends
treatments for delivery in England’s NHS, conditionally recommended the SilverCloud interventions for young people. However NICE needs more evidence about how well the interventions work. Particularly, whether they are better at treating low mood/depression and/or anxiety than the usual care offered. We will analyse a 12-month dataset from NorthPoint which includes data from around 1,000 young people, including both those who have accessed SilverCloud and those who have accessed usual care.
We aim to:
- Compare the effects of SilverCloud on low mood/depression and anxiety symptoms to usual care at 8-weeks post-referral
- Compare the number of young people across the two groups who go on to need further support for low mood/depression and/or anxiety at 8-weeks post-referral
- Estimate the number of young people who use SilverCloud when offered it and how much.
We will set up 2 Expert Reference Groups (ERGs): One group made up of around 8 young people and the other of around 8 parents/carers. Both groups will include people from different backgrounds. The groups will guide the research, particularly by helping us to plan and analyse the data and advising on the best ways to share our results broadly.
Through our work we will provide further information to NICE to help them to judge whether a full
recommendation should be made for using the SilverCloud interventions within the NHS for teens with low mood/depression, anxiety, or both.
Study duration:
01/10/2026 – 30/09/2027
The project is led by Dr Lucy Tindall, Research Fellow, University of York