Derek Richards

Derek Richards
SilverCloud Health · SilverCloud Research

PhD

About

111
Publications
45,782
Reads
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3,636
Citations
Introduction
I am very interested in the development, implementation and research of technology delivered interventions for mental health problems. In particular I have an interest in researching such interventions for high prevalence disorders such as depression and anxiety.
Additional affiliations
September 2013 - present
SilverCloud
SilverCloud
Position
  • Principal Investigator
January 2012 - September 2017
Trinity College Dublin
Position
  • Fellow
June 2001 - present
Trinity College Dublin
Position
  • Research Associate
Education
October 2007 - October 2010
Trinity College Dublin
Field of study
  • Online treatments for depression: A randomised controlled trial with an adult student population
October 2004 - October 2006
Trinity College Dublin
Field of study
  • e-mental health interventions

Publications

Publications (111)
Article
A major obstacle to mental health treatment for many Americans is accessibility: the United States faces a shortage of mental health providers, resulting in federally designated shortage areas. Although digital mental health treatments (DMHTs) are effective interventions for common mental disorders, they have not been widely adopted by the U.S. hea...
Article
Full-text available
Utilization of internet-delivered cognitive behavioural therapy (iCBT) for treating depression and anxiety disorders in stepped-care models, such as the UK’s Improving Access to Psychological Therapies (IAPT), is a potential solution for addressing the treatment gap in mental health. We investigated the effectiveness and cost-effectiveness of iCBT...
Article
Full-text available
Background: Research has shown that internet-based cognitive behavioral therapy (iCBT) can be a very promising solution to increase access to and the dissemination of evidence-based treatments to all of the population in need. However, iCBT is still underutilized in clinical contexts, such as primary care. In order to achieve the effective implemen...
Preprint
BACKGROUND Research suggests there is heterogeneity on treatment response for internet-delivered CBT (iCBT) users, but few studies have investigated the trajectory of individual symptom change across iCBT treatment. Large patient datasets using routine outcome measures provides an opportunity to investigate treatments effect over time, as well as t...
Preprint
BACKGROUND Research suggests there is heterogeneity on treatment response for internet-delivered CBT (iCBT) users, but few studies have investigated the trajectory of individual symptom change across iCBT treatment. Large patient datasets using routine outcome measures provides an opportunity to investigate treatments effect over time, as well as t...
Article
Full-text available
Background: Clients independently applying Cognitive Behavior Therapy (CBT) skills is an important outcome of CBT-based treatments. The relationship between posttherapeutic CBT skills usage and clinical outcomes remains under-researched-especially after internet-delivered CBT (iCBT). Objective: Explore contemporaneous and lagged effects of postt...
Article
Full-text available
Background Major depressive disorder (MDD) is a leading cause of disease morbidity. Combined treatment with antidepressant medication (ADM) plus psychotherapy yields a much higher MDD remission rate than ADM only. But 77% of US MDD patients are nonetheless treated with ADM only despite strong patient preferences for psychotherapy. This mismatch is...
Article
Full-text available
Background Major depressive disorder (MDD) and generalized anxiety disorder (GAD) are highly prevalent among university students and predict impaired college performance and later life role functioning. Yet most students do not receive treatment, especially in low-middle-income countries (LMICs). We aim to evaluate the effects of expanding treatmen...
Article
Full-text available
Background: Previous research has shown a strong relationship between financial difficulties and mental health problems. Psychological factors such as hope and worry about finances appear to be an important factor in this relationship. Objective: To develop an online based psychological intervention (Space from Money Worries) to tackle the psychol...
Article
Full-text available
Objective Over half of the world's forcibly displaced persons are under the age of 25, with many suffering from symptoms of psychological disorders. Many refugees from Afghanistan or Iran speak either Dari or Farsi, which are mutually intelligible dialects of the Persian language. Previous research on adult refugees and immigrants have shown that i...
Article
Full-text available
Objective: To investigate post-treatment relapse and remission rates 3-, 6-, and 9- months after completion of an acute phase of a clinician-supported internet-delivered cognitive-behavioral therapy (iCBT) for anxiety and depressive symptoms, within a routine care setting. Method: Secondary analysis from a 12-month pragmatic randomized-controlle...
Preprint
Full-text available
Background: Evidence-based treatments for depression exist but not all patients benefit from them. Efforts to develop predictive models that can assist clinicians in allocating treatments are ongoing, but there are major issues with acquiring the volume and breadth of data needed to train these models. We developed a protocol for internet-based dat...
Article
Full-text available
Objectives This study aimed to explore quality-adjusted life-year (QALY) and subsequent cost-effectiveness estimates based on the more physical health–focused EQ-5D 5-level version (EQ-5D-5L) value set for England or cross-walked EQ-5D 3-level version UK value set scores or more mental health recovery-focused Recovering Quality of Life Utility Inde...
Article
Full-text available
Background: Mental health difficulties in children and adolescents are highly prevalent; however, only a minority receive adequate mental health care. Internet-delivered interventions offer a promising opportunity to increase access to mental health treatment. Research has demonstrated their effectiveness as a treatment for depression and anxiety...
Preprint
BACKGROUND Mental health difficulties in children and adolescents are highly prevalent; however, only a minority receive adequate mental health care. Internet-delivered interventions offer a promising opportunity to increase access to mental health treatment. Research has demonstrated their effectiveness as a treatment for depression and anxiety in...
Article
Full-text available
Purpose Generic health measures have been questioned for quantifying mental-health-related outcomes. In patients with anxiety and/or depression, our aim is to assess the psychometric properties of the preference-based EQ-5D-5L (generic health) and ReQoL-UI (recovery-focussed quality of life) for economic evaluation against the PHQ-9 (depression) an...
Article
Full-text available
Insomnia is a highly prevalent, often comorbid disorder associated with difficulties sleeping, remaining awake, and impaired quality of life. Internet-delivered Cognitive Behavioral Therapy for insomnia (ICBT-I1) has the potential to help large numbers of people with sleep disorders. This study investigated the preliminary effects of an 8-week guid...
Article
Full-text available
Background Internet-delivered cognitive behavior therapy (iCBT) is effective in treating anxiety and depression. Research on how these interventions operate is scarce. This study explored whether emotion regulation skills and positive beliefs about rumination were affected by iCBT and if these constructs mediated changes in depression and anxiety....
Article
Full-text available
Background While the acquisition and application of Cognitive Behavior Therapy (CBT) skills is a core component and likely mechanism of effect maintenance in all CBT-based treatments, the extent of post-therapeutic CBT skills usage among internet-delivered CBT (iCBT) clients remains under-researched. Method Nested within a pragmatic randomized con...
Article
Background Internet cognitive behavioural therapy (iCBT) is a viable delivery format of CBT for depression. However, iCBT programmes include training in a wide array of cognitive and behavioural skills via different delivery methods, and it remains unclear which of these components are more efficacious and for whom. Methods We did a systematic revi...
Conference Paper
Full-text available
Background/Aims Depression is common among axial spondyloarthritis (axSpA) patients and is associated with greater axSpA disease severity. Cognitive behavioural therapy (CBT) is recommended by NICE, but access is often limited. Internet-delivered CBT (iCBT) is efficacious for treating depression in other healthcare settings. The aims of this study...
Preprint
Full-text available
Background: Major Depressive Disorder (MDD) is a leading cause of disease morbidity. Combined treatment with antidepressant medication (ADM) plus psychotherapy yields a much higher MDD remission rate than ADM-only. But 77% of US MDD patients are nonetheless treated with ADM-only despite strong patient preferences for psychotherapy. This mismatch is...
Article
Full-text available
Background Generalized anxiety disorder (GAD) is a highly prevalent, chronic disorder associated with impaired quality of life, societal burden, and poor treatment rates. Internet‐delivered interventions may improve the accessibility of treatments and are increasingly being used. This study aimed to update a previous meta‐analysis to determine the...
Article
Full-text available
Introduction: The immediate impact of COVID-19 on morbidity and mortality has raised the need for accurate and real time data monitoring and communication. The aim of this study is to document initial observations from multiple digital services providers during the COVID-19 crisis, especially those related to mental health and wellbeing. Materials...
Article
Full-text available
Background Mood tracking is commonly employed within a range of mental health interventions. Physical activity and sleep are also important for contextualizing mood data but can be difficult to track manually and rely on retrospective recall. Smartwatches could enhance self-monitoring by addressing difficulties in recall of sleep and physical activ...
Article
Full-text available
Background Depression and anxiety are common problems among breast cancer survivors. Carer support is one of the most important determinants of women’s psychological wellbeing. Survivors’ distress can be alleviated by giving carers access to survivors’ evidence-based treatment, which will help carers understand what survivors have been going throug...
Article
Full-text available
Importance Personalized treatment choices would increase the effectiveness of internet-based cognitive behavioral therapy (iCBT) for depression to the extent that patients differ in interventions that better suit them. Objective To provide personalized estimates of short-term and long-term relative efficacy of guided and unguided iCBT for depressi...
Preprint
BACKGROUND Treatment dropout continues to be reported from iCBT interventions and lower completion rates are generally associated with lower treatment effect sizes. However, evidence is emerging to suggest that completion of a pre-defined number of modules is not always necessary for clinical benefit nor considerate of the needs of each individual...
Article
Full-text available
Background Treatment dropout continues to be reported from internet-delivered cognitive behavioral therapy (iCBT) interventions, and lower completion rates are generally associated with lower treatment effect sizes. However, evidence is emerging to suggest that completion of a predefined number of modules is not always necessary for clinical benefi...
Article
Full-text available
Background College students are at elevated risk for developing mental health problems and face specific barriers around accessing evidence-based treatment. Web-based interventions that focus on mental health promotion and strengthening resilience represent one possible solution. Providing support to users has shown to reduce dropout in these inter...
Article
Full-text available
Importance The mechanisms by which engagement with internet-delivered psychological interventions are associated with depression and anxiety symptoms are unclear. Objective To identify behavior types based on how people engage with an internet-based cognitive behavioral therapy (iCBT) intervention for symptoms of depression and anxiety. Design, S...
Preprint
BACKGROUND College students are at elevated risk for developing mental health problems and face specific barriers around accessing evidence-based treatment. Web-based interventions that focus on mental health promotion and strengthening resilience represent one possible solution and providing support to users has shown to reduce drop-out in these i...
Article
Full-text available
Bipolar Disorder (BD) is a chronic condition that requires continued care. Psychological interventions are recommended by clinical guidelines but there are treatment barriers that prevent patients to access these services. Internet‐delivered self‐management interventions are promising alternatives to improve treatment accessibility in patients with...
Article
Full-text available
Background: Internet-delivered treatments for depressive symptoms have proved to be successful in high-income Western countries. There may be potential for implementing such treatments in low- and middle-income countries such as Colombia, where access to mental health services is limited. Objective: The objective of this study was to assess the ef...
Article
Full-text available
Background: The UK's Improving Access to Psychological Therapies (IAPT) program is a stepped-care model treating individuals with depression and anxiety disorders. Internet-delivered cognitive behavioral therapy (iCBT) is routinely offered to individuals with mild to moderate symptoms, but its applicability to individuals with severe clinical sympt...
Article
Full-text available
Background: Internet interventions can easily generate objective data about program usage. Increasingly, more studies explore the relationship between usage and outcomes, but they often report different metrics of use, and the findings are mixed. Thus, current evaluations fail to demonstrate which metrics should be considered and how these metrics...
Article
Full-text available
Background: Exposure to new stressors places college students at increased risk for developing mental health problems. Preventive interventions aimed at enhancing resilience have the potential to improve mental health and well-being in college students and internet-delivery may improve access to these interventions. However, few studies have evalu...
Article
Full-text available
Objective: To evaluate the efficacy of computer-assisted forms of cognitive-behavior therapy for major depressive disorder (MDD) and examine the role of clinician support and other factors that might affect outcomes. Data sources: Ovid MEDLINE, PsycINFO, PubMed, and Scopus from their beginnings to July 18, 2016. Keywords were “randomized, controlle...
Chapter
Full-text available
Introduction In recent years, computer-based and internet-delivered CBT (iCBT) has become an attractive and evidence-based alternative to face-to-face CBT, and in some cases, a significantly better option for some individuals. This chapter will discuss the origins of iCBT and the research that supports its efficacy and effectiveness, as well as the...
Preprint
Full-text available
BACKGROUND Internet-delivered treatments for depression have proved successful in high-income Western countries. There may be potential for implementing such treatments in low and middle-income countries such as Colombia, where access to mental health services is limited. OBJECTIVE To assess the efficacy of the culturally adapted internet-delivere...
Article
Full-text available
Background: Culturally adapted psychotherapy (CAP) studies are limited and until now there are few published examples that illustrate the process of cultural adaptation with internet-delivered treatments. Aim: This paper aims to illustrate an integrative approach to the cultural adaptation of an evidence-based internet-delivered cognitive-behaviou...
Article
Full-text available
Background: Many university campuses have limited mental health services that cannot cope with the high demand. One alternative is to use internet-delivered cognitive behavioral therapy (iCBT) as a way of tackling barriers such as lack of availability and scheduling issues. Objective: This study aimed to assess feasibility, acceptability, effective...
Preprint
Full-text available
BACKGROUND Internet interventions are able to easily generate objective data about program usage. Increasingly, more studies are exploring the relationship between usage and outcomes but they often report different metrics of use and the findings are mixed. Thus, current evaluations fail to demonstrate which metrics should be considered and if it i...
Article
Background: Anxiety disorders are a highly prevalent cause of impairment globally with generalized anxiety disorder (GAD) sharing many features with other anxiety disorders. Aims: The present study investigated the helpful and hindering events and impacts for individuals with generalized anxiety who engaged with a supported 6-week online interve...
Article
Quality of Life (QoL) outcomes in interventions for depression are an area in the literature that has received little focus, particularly in trials relating to internet-delivered psychological interventions. Evaluating QoL outcomes are necessary to more completely understand if an intervention is successful in the treatment of depression, given tha...
Preprint
Full-text available
BACKGROUND Many university campuses have limited mental health services that cannot cope with the high demand. One alternative is to use internet-delivered cognitive behavioral therapy (iCBT) as a way of tackling barriers such as lack of availability and scheduling issues. OBJECTIVE This study aimed to assess feasibility, acceptability, effectiven...
Article
Quality of Life (QoL) outcomes in interventions for depression are an area in the literature that has received little focus, particularly in trials relating to internet-delivered psychological interventions. Evaluating QoL outcomes are necessary to more completely understand if an intervention is successful in the treatment of depression, given tha...
Article
Full-text available
Background Depression and anxiety are common mental health disorders worldwide. The UK’s Improving Access to Psychological Therapies (IAPT) programme is part of the National Health Service (NHS) designed to provide a stepped care approach to treating people with anxiety and depressive disorders. Cognitive Behavioural Therapy (CBT) is widely used, w...
Article
Full-text available
Objective: To examine evidence for the effectiveness of computer-assisted cognitive-behavior therapy (CCBT) for depression in primary care and assess the impact of therapist-supported CCBT versus self-guided CCBT. Methods: A search for randomized studies of CCBT compared to control groups for treating depression in primary care settings was cond...
Article
Full-text available
Background: Depression is the principal cause of disability in the world. High prevalence rates of depression in general populations and college students have been found worldwide and in various cultural groups. Low-intensity cognitive behavioural internet-delivered treatment has demonstrated efficacy in high-income-countries (HICs). However littl...
Article
Full-text available
Background: Depression is a highly prevalent mental health issue that exacts significant economic, societal, personal, and interpersonal costs. Innovative internet-delivered interventions have been designed to increase accessibility to and cost-effectiveness of treatments. These treatments have mainly targeted mild to moderate levels of depression...