Intervention innovations concern the development of low cost online psychological interventions. Individuals who have suffered brain injuries frequently need support for problems they experience with their thinking skills (eg memory, planning),emotions (e.g., sadness, loss, frustration) and participation in society. A tenet of this proposal is that rehabilitation is similar to education – just as University (eg Open University) students can learn a great deal online – patients, with the right resources, could also be helped to overcome some difficult problems. We are developing and evaluating such resources creating a “Virtual Learning Environment” (VLE) for use by clinicians as an adjunct to face-to-face therapy.
The scarcity of specialists who can provide support for people with brain injuries means that sometimes there are inevitable delays in accessing support.
We are proposing a VLE solution that will be accessible to patients while waiting for therapy, as an adjunct to ongoing therapy, and to support post-therapy follow-up. In some cases the self-management achieved by use of such online resources means that the face-to-face contact is not needed – this is of relevance in our resource limited NHS.
Initially we are starting with the application to post brain injury fatigue because clients may be too fatigued to even attend for outpatient rehabilitation, or manage their return-to-work. Providing strategies to help with this in their own home setting is something we have discussed with our patient advisory group and is directly associated with quality of life.
A feasibility study is planned that will address 2 key issues:
- Patient experience: Focus group work will ensure that the platform is well tuned to the needs of patients
- Service Objective: We wish to uncover barriers to implementation within a clinical service. Can the service support patients to manage their own fatigue to enable better use of clinical visits? Does this approach enable better patient outcomes and more efficient use of service provider resources?
Conceptually, we are also planning to complete (with Wendel) more detailed narrative explorations about the meaning of fatigue among brain injury survivors.
Medium term plans
Further supporting clients with cognitive challenges such as memory, emotional challenges such as depression, self-esteem; and behaviours that can affect personal relationships. Building on our experiences in the fatigue management App we will be extending the platform’s capabilities to tackle these domains.
We will be looking to implement our work in different international settings. Translation and feasibility work with colleagues in Brazil and Japan simultaneously provide potential for scaling up, as well as data collection for research purposes on a much larger scale than is possible in the UK.
Long term plans
long term plans concern expanding the adoption and sustainable maintenance with our partners, SilverCloud Health, who already deliver online interventions for people with anxiety and depression on a large scale (but not adapted to the needs of people with brain injury). Their offer of a widely used platform that enables onward sale of our content includes a fair revenue split. Income is shared 70%-30% in favour of the authors of material in this case any funds generated will go to the research group in CCS NHS Trust to support further research and development.