Freedom song

Clinical psychologist Dr Lloyd Humphries, one of the directors of Breaking Free Online, has not always been involved in providing treatment via technology.

It was an interest in reaching those for whom accessing psychological care is a challenge that led him to investigate the potential of IT.

“My colleagues and I set up a company back in 2004 to provide psychologists to organisations that find it very difficult to gain access to psychology services via statutory provision,” he explains. “That’s really where Breaking Free Online was born, because we wanted to improve access to psychology.

“Our company trains a number of frontline staff to deliver psychological interventions, but a natural extension was to move beyond training staff and provide a computerised treatment; to make those psychological therapies digital.”

From programme to program

It was an approach that seemed particularly helpful for those with alcohol and drug misuse issues. “We were really aware that a lot of people with these problems don’t seek out treatment,” Dr Humphries explains.

“So we wanted to provide something that was very discrete; something for people who wouldn’t engage with traditional therapy or for those people for whom traditional treatment might just be too disruptive.”

Breaking Free Online was launched in December 2010. The cloud-based programme – which will become available on mobile devices in April 2013 – uses audio, video, text and practical exercises to support those who are concerned about their substance use.

It is a personalised experience. Each user creates an individual diagram showing the factors that are keeping their substance misuse going. They can even customise the look and feel of the software.

Dr Humphries admits that the process of developing the treatment has not been a simple one. With a desire to create a programme that could help a variety of individuals at a variety of points during their recovery, it was necessary to consult a range of experts and use a range of treatment types.

“It took us two and a half years to develop the programme,” he says. “We brought together not only those people who were specialists in substance misuse but also people who were specialists in working with young people, with families, or with those with mental health issues.

“We brought together all the different strands of psychology and distilled everyone’s expertise into this one treatment programme.”

Then came the challenge of actually creating the software. The firm had no in house development team, so it was a case of sourcing partners in the local area and working in collaboration with them to create Breaking Free Online.

Just as creating the treatment programme involved bringing together a range of psychological interventions, so the development of the software program involved bringing together a range of different technology strands.

“We wanted to think about all the different ways people use the internet or mobile devices, look at the very best technology and push that forward,” explains Dr Humphries.

“The whole platform has been built from the ground up – we rarely use any proprietary software in our systems. We have built our own platform and made everything plug into that rather than the other way around.”

Getting social

Increasingly, it is a platform focused on social media. A ‘buddy’ system allows users to connect with others in the online community in real time.

There are both open and closed forums and Facebook-style walls. Dr Humphries says the aim is to use the best and latest technologies available; although sometimes it is a case of waiting for devices and operating systems to catch up.

“We have GPS tracking and mapping technology in the latest version of the software,” he explains. “So if you walk past a place that you’ve identified as risky, it will give you an alert. ‘You are approaching The Red Lion. Phone someone for support now.’

“It’s totally groundbreaking – in previous versions of [iPhone / iPod Touch operating system] iOS, you just couldn’t use GPS tracking and have it running in the background. Windows still can’t do it, but we’re working on ways around that.”

Uptake of the system has been impressive. Around 35 local authorities are now using Breaking Free Online, as are national drug and alcohol treatment services like Addaction.

In Bristol, the system will soon be available in more or less any public health service across the city – GP, A&E and specialist services alike. Dr Humphries feels that an important reason for the program’s success is the array of evidence of its impact.

“We’re in a unique position in that we’re the only psychological treatment that can track how people engage with it and how effective it is.

“We can do that in real time, and segment the data down from a global to a granular level. That allows organisations to talk confidently about it: have interim reports, build business cases, and actually show that they’re doing something incredibly innovative but actually effective too.

“Sometimes new initiatives fall by the wayside through budget cuts. Well this actually allows organisations to feel confident in driving innovation forward.”

New horizons

Dr Humphries and his colleagues are already discussing other areas of public health in which the platform could be useful (“it can be applied to many, many different public health perspectives,” he argues).

But they are also continuing to drive Breaking Free Online for substance misuse, with a clear idea of the people they ultimately wish to reach.

“What we really want is to raise awareness in primary care,” he explains. “We want to get access to the home drinkers, the hidden population.

“We don’t want people just to be asking for the software if they walk into a [drug or alcohol] treatment service; we want people to be going to their GP saying they’ve heard about Breaking Free Online.”

Indeed, Dr Humphries even has export ambitions. “We’re a great importer of treatments, but wouldn’t it be great to send something the other way across the Atlantic?” he asks.

The EHI Awards 2013 are now open for entries. For full details of this year’s categories, judging process and how to submit your entry please visit the dedicated awards website.

This year’s black tie awards dinner will be held at the prestigious Roundhouse in north London on 10 October. For information about sponsorship opportunities contact head of events Neil Hadland. Tickets will also be on sale soon.