The use of real-time “live therapy” is helping several trusts improve the experience of patients requiring mental or psychological health treatments.

“Live therapy” is being used by trusts as a means of meeting IAPT activity targets while increasing choice of, and accessibility to, psychological therapies.

Provided in partnership with the Tavistock and Portman Foundation Trust, Big White Wall is delivering an online pathway for Steps 1, 2 and 3 of the NICE Stepped Model of Care for anxiety and depression.

Live Therapy offers a range of real-time therapies by instant text, audio or audio-visual channels from a panel of TPFT approved therapists who are accredited and have at least five years’ experience.

Big White Wall members select a therapist of their choice from profiles of approved therapists and then propose a date/time that suits them for one or more sessions. 

All therapies are NICE approved treatments for anxiety and depression - CBT, IPT, DIT, person-centred counselling, and integrative counselling.  

Members are assisted by a decision tree to help them to identify the most appropriate therapy for their needs. Or they can be aided in their decision by one of the Wall Guides who moderate and facilitate BWW’s Support Network 24/7.

Members complete standard clinical tests on BWW prior to their sessions. This helps to identify and manage risk as well as to provide outcome data for, example, the IAPT Minimum Data Set. At the end of the session, the therapist produces a clinical record of the session, which the patient may contribute to. Patients can choose to electronically share aspects of these records with third parties such as their GPs.

Members are given the opportunity to rate the therapist on the Johnson, Miller and Duncan scale. The ratings are made public and appear openly on therapists’ BWW profiles. This will help others assess which therapists they would find most helpful.

The service has been adopted by South London and Maudsley Foundation Trust, Tees, Esk and Wear Valleys Foundation Trust and Norfolk and Suffolk Foundation Trust.

Big White Wall chief executive Jen Hyatt said, “We identified a need to develop live online therapies as a result of demand from our existing online community. It was also a response to existing commissioners who were looking for innovative ways to reduce waiting times and extend access to, approved therapies such as the Improving Access to Psychological Therapies Programme.”

Big White Wall Support Network combines social networking principles with a choice of clinically informed interventions to improve mental wellbeing. 

The network is the baseline service of that provides peer and community support; 24/7 guided self-help and individual support by staff trained and supervised by TPFT; self-testing on standardised clinical instruments and a wide range of explanatory and self help materials. This is complemented at Step 2 by art and writing therapies; and psycho-educational groups. 

Highlights of the online pathway:

  • Clear pathway: Allows people to move from Steps 1, 2 and 3 of NICE recommended therapies through self or supported choice
  • Out of hours support: Enabling access to a course of therapy from home or work at any time 24/7 including same day sessions
  • Choice: Provides a range of evidence-based clinical interventions through both referral and self-referral
  • No waiting lists: Immediate access via the internet
  • Cuts costs: Demonstrable cost savings through 80 per cent self management
  • Safe: Conducted within TPFT’s clinical governance and risk management framework