{"id":3815,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/computerised-cognitive-behavioural-therapy-cbt\/"},"modified":"2026-07-20T11:49:39","modified_gmt":"2026-07-20T10:49:39","slug":"computerised-cognitive-behavioural-therapy-cbt","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/mentalhealthadult\/mentalhealthpsychologyotherservices\/computerised-cognitive-behavioural-therapy-cbt\/","title":{"rendered":"Computerised Cognitive Behavioural Therapy (cCBT)"},"content":{"rendered":"\n<h4 class=\"wp-block-heading\">cCBT and Psycho-educational Programmes<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">The Digital Psychological Intervention Team offer a range of highly effective computer-based treatment programmes for patients in Lothian.&nbsp; The programmes are based on cognitive behavioural therapy, mindfulness and positive psychology.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">These packages are interactive and very flexible, using internet enabled devices such as mobile phone, tablet or laptop. These CBT based products have been recommended by SIGN and NICE and can be delivered in a supported or unsupported format.&nbsp;<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Self-Referral cCBT<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><em>Self-guided programmes (unsupported) are self-referrals and can be accessed using the sign-up options below:<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><span style=\"text-decoration: underline\">Wellbeing Silvercloud modules: self-referral access<\/span><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/wellbeing.silvercloudhealth.com\/signup\/nhsscotland\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/wellbeing.silvercloudhealth.com\/signup\/nhsscotland\/<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>Access Code:<\/em><\/strong> Scotland2020<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Money Worries<\/li>\n\n\n\n<li>Positive Body Image<\/li>\n\n\n\n<li>Sleep<\/li>\n\n\n\n<li>Stress<\/li>\n\n\n\n<li>Resilience<\/li>\n\n\n\n<li>Challenging Times<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Please see the RefHelp <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/mentalhealthadult\/mentalhealthpsychologyotherservices\/computerised-cognitive-behavioural-therapy-cbt\/wellbeingselfreferrals\/\" target=\"_blank\" rel=\"noreferrer noopener\">Wellbeing self-referral page<\/a> for more detail.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><span style=\"text-decoration: underline\">Daylight and Sleepio<\/span><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u2018Daylight\u2019 <\/strong>is a program designed to help manage worry and anxiety, while<strong> \u2018Sleepio\u2019 <\/strong>targets insomnia\u2014both supporting effective self-management of mental health.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/anxietyselfreferraldaylight\/\" target=\"_blank\" rel=\"noreferrer noopener\">Anxiety self-referral \u2013 DAYLIGHT \u2013 RefHelp (nhslothian.scot)<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/insomniasleepio\/\" target=\"_blank\" rel=\"noreferrer noopener\">Insomnia \u2013 SLEEPIO \u2013 RefHelp (nhslothian.scot)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Clinical Referral cCBT<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><em>Supported \u2018Silvercloud\u2019 programmes are available through a clinical referral and include 3\u20134 reviews with a Wellbeing Worker, who provides online guidance at the review stage and support throughout the programme.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>** Please note \u2013 this is <u>not<\/u> a real time chat or instant messaging platform<\/em><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><span style=\"text-decoration: underline\">Silvercloud Programmes for Common Mental Problems<\/span><\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Depression and Anxiety<\/li>\n\n\n\n<li>Depression<\/li>\n\n\n\n<li>Generalised Anxiety Disorder (GAD)<\/li>\n\n\n\n<li>Social Anxiety<\/li>\n\n\n\n<li>Health Anxiety<\/li>\n\n\n\n<li>OCD<\/li>\n\n\n\n<li>Panic<\/li>\n\n\n\n<li>Phobia<\/li>\n\n\n\n<li>Perinatal.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Silvercloud Supported Programmes that focus on the mental health aspects of living with a long-term condition<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Chronic Heart Conditions<\/li>\n\n\n\n<li>Chronic Pain<\/li>\n\n\n\n<li>Depression and Anxiety in COPD<\/li>\n\n\n\n<li>Depression and Anxiety in Diabetes<\/li>\n\n\n\n<li>Depression and Anxiety in Rheumatoid Arthritis.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Email access is required for the programme:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Patients <strong>must<\/strong> have an <strong>email address<\/strong> and give <strong>explicit consent<\/strong> for it to be used to set up their SilverCloud account<\/li>\n\n\n\n<li>Once the referral is received, the Digital Interventions Team will create a SilverCloud account and provide immediate access to the programme.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Referrals are processed daily to ensure patients have quick and easy access to the digital treatment. Once a referral is received, patients are sent an activation email from SilverCloud. After activating their account, they gain immediate access to the SilverCloud programme.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">After Referral: What Happens Next<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Account Activation &amp; Engagement<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>SilverCloud sends automated email reminders prompting patients to activate their accounts<\/li>\n\n\n\n<li>At <strong>2 weeks<\/strong>, an NHS Lothian \u2018Administrator\u2019 will call patients who have not activated their account<\/li>\n\n\n\n<li>At <strong>4 weeks<\/strong>, an NHS Lothian \u2018Wellbeing Worker\u2019 will call patients who have not started the programme<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><u>Patient Support<\/u><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The Digital Interventions Team is available during working hours Monday to Friday 08:30am-4:30pm to help with:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Technical issues<\/li>\n\n\n\n<li>Access problems<\/li>\n\n\n\n<li>General queries<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><u>SilverCloud Suicide Risk Alerts<\/u><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">These are part of how the SilverCloud digital mental health platform flags and responds to signs that an individual using the service may be at risk of suicide and are above the threshold for patients with mild to moderate depression and anxiety.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>What suicide risk alerts are:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Automated risk screening:<\/strong> When a patient signs up and periodically while using SilverCloud, they complete standard questionnaires (e.g., PHQ-9 for depression). Certain responses on these tools especially indications of suicidal thoughts or intent can trigger a suicide risk alert.<\/li>\n\n\n\n<li><strong>Triggers for alerts:<\/strong> An alert can be generated if the patient indicates active suicidal thoughts, a higher level of intent to harm themselves, or other concerning risk scores.<\/li>\n\n\n\n<li><strong>Risk Alerts review:<\/strong> These alerts are received by the Digital Interventions team who inform the referrer\/GP.<\/li>\n\n\n\n<li><strong>Not an emergency service:<\/strong> SilverCloud itself isn\u2019t a crisis hotline \u2014 it\u2019s a therapeutic digital tool. If someone is in immediate danger, they should contact emergency services or crisis lines directly.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C.M. 20-7-26<\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p class=\"wp-block-paragraph\">This is the SilverCloud referral process:<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"976\" height=\"452\" src=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/cCBT-image1.png\" alt=\"Computerised Cognitive Behavioural Therapy\" class=\"wp-image-14759\" srcset=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/cCBT-image1.png 976w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/cCBT-image1-300x139.png 300w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/cCBT-image1-768x356.png 768w\" sizes=\"auto, (max-width: 976px) 100vw, 976px\" \/><figcaption class=\"wp-element-caption\"><span class=\"media-credit\">NHS Lothian<\/span> flowchart courtesy of NHS Lothian<\/figcaption><\/figure>\n<\/div>\n\n\n<h4 class=\"wp-block-heading\">Who to refer:<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Suitable for patients with<em>:<\/em><\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Mild to moderate<\/strong> depression and\/or anxiety, including phobias and panic disorder<\/li>\n\n\n\n<li><strong>Adults aged 18 or over<\/strong>, whether being treated with medication or not<\/li>\n\n\n\n<li>A willingness to take an active role in their recovery and use an online programme<\/li>\n\n\n\n<li>A minimum <strong>reading age of 10\u201311 years<\/strong>\n<ul class=\"wp-block-list\">\n<li>Much of the programme uses audio and video content, making it accessible for people with lower literacy levels<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Home User Technical Requirements<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Patients will need:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>An internet-enabled device (PC\/laptop, smartphone, or tablet)<\/li>\n\n\n\n<li>A stable internet connection<\/li>\n\n\n\n<li>An email address<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Who not to refer:<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">SilverCloud is <strong>not suitable<\/strong> for patients who:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Have <strong>active suicidal thoughts or plans<\/strong> \u2013 please refer to the appropriate service<\/li>\n\n\n\n<li>Are <strong>unable to read or write English<\/strong> (reading age below 10\u201311 years)<\/li>\n\n\n\n<li>Are in the <strong>acute phase of psychosis or mania<\/strong>, or have cognitive impairment (e.g., dementia)<\/li>\n\n\n\n<li>Are <strong>under 18 years old<\/strong><\/li>\n\n\n\n<li><strong>Do not have an email address.<\/strong><\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">How to refer:<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><span style=\"text-decoration: underline\">Via SCI Gateway<\/span><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Royal Edinburgh \u2192 General Psychiatry \u2192 Protocol: cCBT Referral<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Consent and Data Handling<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span style=\"text-decoration: underline\">Referrers must:<\/span><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Ask patients for their email address \u2013 avoid shared (work \/ family) email addresses<\/li>\n\n\n\n<li>Obtain explicit consent for the SilverCloud team to use this to contact them<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">This process is approved by the <strong>Lothian Caldicott Guardian<\/strong>.<br>Patients with consent will receive a unique SilverCloud access code by email.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><u>Without SCI Gateway Access<\/u><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Use the <a href=\"http:\/\/intranet.lothian.scot.nhs.uk\/Directory\/PsychologyServices\/services-provided\/DigitalInterventions\/Documents\/cCBT%20-%20Silvercloud%20-%20Standard%20Referral%20Form%202024.docx\" target=\"_blank\" rel=\"noreferrer noopener\">Silvercloud Referral Form<\/a><strong> a<\/strong>nd email it from an <strong>@nhs.scot.<\/strong> or <strong>@nhs.net<\/strong> address to: <strong><a href=\"mailto:loth.silvercloudcbt@nhs.scot\" target=\"_blank\" rel=\"noreferrer noopener\">loth.silvercloudcbt@nhs.scot<\/a><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Or send by post\/internal mail to:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Digital Interventions<br>CCBT Clinical Psychology<br>South Corridor<br>Western General Hospital<br>Crewe Road South<br>Edinburgh<br>EH4 2XU<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><u>Process following referral<\/u><\/strong><em><u><\/u><\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Referrals are processed daily ensuring quick and easy access to the digital treatment. Once received, patients are sent an activation email from SilverCloud. After activating their account, they can then gain immediate access to the programme.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Following referral, automated email reminders are sent to patients with prompts to activate their accounts. If the patient still does not respond, they are phoned at 2 weeks by an administrator; and if they have still not started the programme by 4 weeks, are called by an NHS Lothian \u2018Wellbeing Worker\u2019.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The Digital Interventions Team is available during working hours Monday to Friday 08:30am-4:30pm to help with:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Technical issues<\/li>\n\n\n\n<li>Access problems<\/li>\n\n\n\n<li>General queries.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">There is also a response made to suicidal thoughts and alerts, though these are infrequent. Please see <a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/cCBT-suicidal-thoughts-and-alerts-March-2023.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">more details on when the referrer is contacted if suicidal thoughts are expressed<\/a>.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/cCBT-Silvercloud-Standard-Referral-Form-2024.docx\" data-type=\"link\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/cCBT-Silvercloud-Standard-Referral-Form-2024.docx\" target=\"_blank\" rel=\"noreferrer noopener\">SilverCloud-Referral-Form.docx<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/SilverCloud-Patient-Information-Leaflet.pdf\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/SilverCloud-Patient-Information-Leaflet.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">SilverCloud-Patient-Information-Leaflet.pdf<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/cCBT-suicidal-thoughts-and-alerts-March-2023.pdf\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/cCBT-suicidal-thoughts-and-alerts-March-2023.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">cCBT-suicidal-thoughts-and-alerts-March-2023.pdf<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.bighealth.com\/\" target=\"_blank\" rel=\"noreferrer noopener\">Mental Health Solutions | Big Health<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Silvercloud-cCBT-how-to-refer-17-July-2026-final.pdf\">https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Silvercloud-cCBT-how-to-refer-17-July-2026-final.pdf<\/a><\/li>\n<\/ul>\n<\/div><\/div>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>cCBT and Psycho-educational Programmes The Digital Psychological Intervention Team offer a range of highly effective computer-based treatment programmes for patients in Lothian.&nbsp; The programmes are based on cognitive behavioural therapy, mindfulness and positive psychology. These packages are interactive and very flexible, using internet enabled devices such as mobile phone, tablet or laptop. These CBT based<\/p>\n","protected":false},"author":6,"featured_media":0,"parent":4130,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_searchwp_excluded":"","footnotes":""},"categories":[357],"class_list":["post-3815","page","type-page","status-publish","hentry","category-computerised-cbt"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"heatherlevy","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/heatherlevy\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/mental-health-psychology-other-services\/computerised-cbt\/\" rel=\"tag\">computerised CBT<\/a>","rttpg_excerpt":"cCBT and Psycho-educational Programmes The Digital Psychological Intervention Team offer a range of highly effective computer-based treatment programmes for patients in Lothian.&nbsp; The programmes are based on cognitive behavioural therapy, mindfulness and positive psychology. These packages are interactive and very flexible, using internet enabled devices such as mobile phone, tablet or laptop. These CBT based","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3815","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=3815"}],"version-history":[{"count":35,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3815\/revisions"}],"predecessor-version":[{"id":29074,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3815\/revisions\/29074"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4130"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=3815"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=3815"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}