Target Therapies Project

About the Target Therapies project

Our aim is to know how well different digital and talking therapies work in England’s healthcare system. Also, to see if they offer value for money and how well they work for different groups of people. 

The Target Therapies project is evaluating the following digital and talking therapies:

• Group versus individual-based low-intensity cognitive behavioural therapy (CBT) for depression and anxiety.

• Low-intensity digitally-enabled interventions (with support) versus therapist-guided self-help for depression and anxiety.

• CBT versus counselling for depression.

• Eye Movement Desensitisation and Reprocessing (EMDR) versus trauma-focussed CBT for post-traumatic stress disorder (PTSD).

Background

NHS Talking Therapies for anxiety and depression services offer different types of mental health treatments. For example, cognitive behavioural therapy and counselling. Randomised controlled trials provide the best evidence about how well different treatments work. These trials randomly assign people to treatments. Thus, the groups receiving different treatments are otherwise similar. This means we can separate the effect of treatment from effects due to differences between people. But trials are expensive and time consuming. Also, many people who receive therapy do not take part in trials. This limits what we can learn from trials.

Real-world data (RWD) studies can be used to compare treatments without assigning people to treatments at random. Real-world data studies often use data already collected within healthcare services.  This means they can include people who do not usually take part in trials, but do use the treatments in healthcare services. We can then see how well therapies work for people currently receiving healthcare. This can add to trial evidence in a less expensive and quicker way. But, not allocating treatments at random can cause problems. For example, it can be harder to know if treatment benefits are due to patient differences. Our proposed study design and methods can aid avoid these problems.

Patient and Public Involvement

We are working with the McPin Foundation, a mental health research charity. Together we are forming a diverse lived experience advisory panel. Our advisory panel will help develop the study design and research questions. They will also develop ways to explain our study design and results. Advisory panel members will receive training and support. 

Real-World Data (RWD) Study

We will see how well different therapies work using already collected healthcare data. For example, comparing cognitive behavioural therapy to counselling for people with depression. We will do this by conducting 'target trials' which resemble the good aspects of trials. We will also examine if individual circumstances change the treatment outcome, for example, based on ethnicity or social deprivation. This could help healthcare staff better know which therapy to recommend for each patient.

Our study will use data normally collected within England’s healthcare system. We will use data from NHS Talking Therapies for anxiety and depression services. Other data will come from hospitals, pharmacies, and other mental health services. 

Work-Packages

To achieve our project aim, our project has five work-packages:

1. Project Oversight

2. Patient and Public Involvement

3. Real-World Data (RWD) Study Preparation 

4. Real-World Data (RWD) Study

5. Dissemination

Funding

The Target Therapies project is funded by the NIHR Research for Patient Benefit (RfPB) Programme. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.