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An outcomes study of eTherapy for dual diagnosis using Breaking Free Online

Sarah Elison (Head of Research, based at Breaking Free Online, Manchester, UK)
Jonathan Ward (Breaking Free Online, Manchester, UK)
Glyn Davies (Breaking Free Online, Manchester, UK)
Nicky Lidbetter (Self-Help Services, Manchester, UK)
Daniel Hulme (Service Lead, based at Self-Help Services, Manchester, UK)
Mike Dagley (eTherapy Co-Ordinator, based at Self-Help Services, Manchester, UK)

Advances in Dual Diagnosis

ISSN: 1757-0972

Article publication date: 13 May 2014




In recent years there has been a proliferation of computer-based psychotherapeutic interventions for common mental health difficulties. Building on this, a small number of such interventions have now been developed to address substance dependence, one of which is Breaking Free Online (BFO). A new “eTherapy” self-help service, which was set up by the UK mental health charity Self-Help Services, has provided access to BFO to service users presenting with comorbid mental health and substance misuse difficulties. The purpose of this paper is to evaluate a range of clinical outcomes in the first cohort of service users accessing this dual diagnosis service.


A number of standardised psychometric assessments were conducted with service users at baseline and post-treatment at discharge from the service. Outcome data were available for 47 service users out of an original cohort of 74.


Statistically significant improvements were found in terms of measures of social functioning, depression, anxiety, alcohol and drug use and social anxiety. Clinically relevant gains were also identified, with fewer service users reaching threshold scores for depression and anxiety at post-treatment compared to baseline. Effect sizes also indicated that the identified improvements across the psychometric measures were robust and significant.

Research limitations/implications

These findings provide further support for the clinical effectiveness of BFO, and also provide evidence that an eTherapy self-help service may be appropriate for some individuals presenting with dual diagnosis. Further research is underway with larger and alternative clinical populations to examine the effectiveness of BFO and also this novel eTherapy self-help approach.


This paper has provided initial data to support effectiveness of a novel eTherapy service for dual diagnosis.



The authors would like to thank the service users at Self-Help Services for their participation in the service.


Elison, S., Ward, J., Davies, G., Lidbetter, N., Hulme, D. and Dagley, M. (2014), "An outcomes study of eTherapy for dual diagnosis using Breaking Free Online", Advances in Dual Diagnosis, Vol. 7 No. 2, pp. 52-62.



Emerald Group Publishing Limited

Copyright © 2014, Emerald Group Publishing Limited

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