Monday, 5 August 2019

The latest on SilverCloud - online Cognitive Behavioural Therapy

Becka Williams, Project Manager and Catrin Guest, Project Support Office & Online CBT Coordinator
by guest author Becka Williams
Project Manager, Powys Teaching Health Board

Following the implementation of our Online CBT service, SilverCloud, across Powys in May 2018, there has been a lot of work undertaken to develop the service and upscale it across Powys. 

We have received approximately 1100 referrals into the stand-alone service with referrals beings received from a range of different departments, services and healthcare professionals across the Health Board.

Work has commenced on the translation of the main Space from Anxiety and Depression programme and it is hoped that this will be ready for implementation by the end of 2019.

We were fortunate to win the Powys Teaching Health Board's Staff Excellence Award under the category of ‘Digital First’ in July which is a fantastic achievement. 

Becka Williams  Project Manager, Claire Cartwright – Director Ponthafren Association,
Jackie Jones & Sarah Dowler – Blended Online CBT Practitioners, Ponthafren

Blended Online CBT Service

We have implemented our Blended Online CBT service in partnership with Ponthafren Association in North Powys and the Mind Resource Centres in Mid and South Powys. The blended service offers access to the online platform as well as 6 face to face sessions with our Blended Online CBT Practitioners, during which they will review progress of the platform, signpost certain activities, tools and modules within the programmes and offer encouragement and support. The face to face sessions will be offered from the GP practices in Powys.

We are now ‘live’ with this service across nearly all GP practices, and where we have been unable to offer this from the specific practice, an alternative can be offered for the service users in that area should they wish to access this service.

Clinical referrals are required in to the blended service and these can currently be done through GPs of the Local Primary Mental Health Support Services (LPMHSS) within Powys Teaching Health Board.

We have currently received approximately 190 referrals into this service and are continuing to engage with the GPs and clinical teams to further upscale the blended approach.

Becka Williams, Project Manager & Catrin Guest, Project Support Office & Online CBT Coordinator raising awareness of Positive Body Image with PTHB's Occupational Health & Mental Health department during Mental Health Awareness Week

Positive Body Image

As part of Mental Health Awareness week, with ‘body image’ being the topic for 2019, we implemented our Space for Positive Body Image programme, which is now available for our healthcare professionals to refer in to.

This programme looks at the following topics:

  • Improves understanding of body image and the impact on depression and anxiety.
  • Focuses on what factors influence body image and how to improve perceptions of body image. 
  • Introduces the known risk factors of eating disorders.
  • Improves understanding of the effect of the media on understanding of the “ideal body”.
  • Encourages reduction of individuals thin-ideal internalisation through analysis of media messages.
  • Introduces self-esteem and focuses on where it comes from and how to boost it.
  • Introduces the reciprocal relationship between how we feel and how we eat, using the CBT model of Thoughts Feelings Behaviours (TFB) cycle.
  • Recognises emotional eating, mindful eating and how to have a healthy relationship with food.
  • Recognises negative automatic thoughts and how to challenge them.
  • Introduction to Mindfulness.
  • Self-esteem enhancement through activities.
  • Recognises the importance of social support in staying well.


We have designed, developed and recently implemented a self-referral option to this service. This service is available for all Powys residents and Powys patients that would like to self-refer onto an Online CBT Programme for depression, anxiety or stress. This service aims to offer services to those experiencing symptoms of depression, anxiety or stress who want access to an effective Online CBT therapy without having to first have an appointment with their local GP or other health professional.

People will be required to undertake an initial self-assessment and on successful completion of the self-assessment, immediate access to the online programme will be given. However, if the self-assessment results are not within the appropriate threshold for this service, a clinician from the PTHB Online CBT team will contact the person in due course for a follow up phone call assessment to determine whether the service is suitable for that person.

Sign up to the self-referral service here.

Student Programmes

The referral age for this service has now been lowered and therefore we are now accepting referrals for young people aged 16 years and above.

We have also implemented ‘student’ versions of 3 of our programmes: Space from stress, Space from anxiety and Space from depression which all offer support that relates more specifically to students such as educational stresses, friendships, relationships etc.

We have started to engage with the high schools and colleges across Powys to increase awareness of this availability to students.

Fionnuala Clayton, Psychological Assistant & Online CBT Coordinator & Catrin Guest, Project Support Office
& Online CBT Coordinator

All-Wales Roll-out

One of the key aims of this project was to explore the opportunity of implementing Online CBT across Wales, including the other Welsh Health Boards and third sector organisations.

Work has commenced on this and we went ‘live’ with the Welsh Ambulance Service NHS Trust (WAST) in December 2018 with this service being utilised within their Occupational Health and Staff Wellbeing teams.

We have also started working with Aneurin Bevan University Health Boards (ABUHB) with this service now being piloted within their Primary Care Mental Health Support Services (PCMHSS) and referrals being received since June 2019.

Engagement is still being undertaken with the other Welsh Health Boards, with a view to further roll-out this service across the different health board areas.

For further information on any aspects of the project or service, please check out this Powys Teaching Health Board website, or contact Becka Williams, Project Manager, on 01874 712 444 or

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