About the Serenity Programme

CCBT Programme screenshot

The Serenity Programme (previously 'Outreach-online') was designed and developed by Steve Cottrell over a period of several years. Simplicity and ease of use has guided Programme development.

How hard does CCBT need to be?

    ... Make everything as simple as possible, but not simpler' (Albert Einstein).

Since early in 2003 the author has been developing this computerised cognitive behaviour therapy (CCBT) programme with the guiding principles of simplicity and effectiveness in mind. Read more in a Nursing Standard article from July 2013.

The views and feedback of several hundred users have informed the design of the programme at every stage of its development, ensuring it remains accessible and easy to use.

It is this combination of simplicity, user focus and ease of use which makes the Serenity Programme unique and especially effective at reducing the symptoms of anxiety and depression.1

Key benefits

  1. Accessible - service users don't need to travel to receive a service, it's available at home via the Internet or CD.
  2. Equitable - the programme is very flexible, blending face-to-face work, telephone support, group work and a unique Internet programme according to user's needs and wishes.
  3. Effective - the programme is often more effective than 'treatment as usual', while our research shows users are very satisfied and happy with the service.2
  4. Efficient - practitioners can work with twice the number of clients they would usually see, the programme is very simple and inexpensive to implement.

The Serenity Programme is unique because ...

  1. Service users have been closely involved in the entire design process - the author has incorporated their feedback as the programme has developed over the years.
  2. Users of the programme download and keep their entire progress record it's theirs to keep, forever!
  3. The programme is designed around the principles of transdiagnostic CBT, although incorporates a number of other theoretical approaches (most other programmes simply provide 'standard' CBT).
  4. The programme continues to develop in cycles of continuous improvement as new research data and user opinion comes to light.

Why develop the programme?

The missing pieceThe cost to the NHS of some CCBT programmes has become prohibitive, increasing costs to the taxpayer while, in some instances, hampering the wider availability of psychological therapies.

An increasing acknowledgement of a likely 'class effect' - that many programmes can be more or less equally effective - has led many towards a range of 'low' and 'no-cost' CCBT solutions.

Low-cost solutions can deliver significant benefits to users, without restrictive licence conditions, while being significantly more cost-effective than face-to-face CBT.

The author is pleased to work alongside Aberconwy Mind to provide a low-cost, high quality solution to the problem of limited availability of evidence-based therapies in the NHS.

Would you like to discuss how we could help you implement the Serenity Programme in your area? Simply contact us for more information.


The Serenity Programme (known as 'Outreach-online' in its previous incarnation) was supported initially by a financial award from Wales Mental Health in Primary Care (WaMH in PC) in 2003.

The programme has won awards from:

  • Welsh Innovations in Healthcare (WiSH) in 2006
  • British Journal of Nursing in 2006
  • Royal College of Nursing in 2008
  • WAG - Joint 'Best Mental Health Project in Wales' in 2010
  • RCN 'Lightbulb Innovation' in 2012
  • Shortlisted for the 'Chief Nursing Officer's Award' 2014

Outcome studies

A number of outcome studies have been carried out. These studies include a pilot study in collaboration with the 'Want2Work' employment scheme (published paper available here, 270k PDF), an unpublished Masters Degree dissertation by Gill Hunt and John Moore's University and an ongoing quasi-experimental NHS study.

Results from twenty participants in the NHS trial are presented below in chart one (anxiety scores) and chart two (depression scores). The Hospital Anxiety and Depression Scale (HADS) was used to measure symptom levels prior to treatment and after three months use of the programme (data collected in February 2011). Baseline scores are in red, scores after three months in green.

Chart 1 - Changes in HADS anxiety scores over 3 months

Anxiety outcome scores, 31% reduction over 3 months

Chart 2 - Changes in HADS depression scores over 3 months

Depression outcome scores - 52% reduction over 3 months

The study shows anxiety symptoms were reduced by almost a third, while depression symptoms were more than halved for an unselected sample of people who presented in primary care with moderate to severe anxiety.

These figures compare favourably to the results we would expect with either antidepressant or conventional individual CBT treatment. The above study continues to recruit participants to gather further usage and outcome data.

User feedback

The following is an excerpt of feedback from users in late 2010:

     Gives great insight and understanding to anxiety and the reasons why it is happening ...' CR, Rhyl.

     The programme instantly appealed, as it immediately seemed to address my problems ...' JT, Rhyl.

     I really liked the points of interest, helpful hints, and breakdown of what was wrong and how I could deal with it ...' RW, Colwyn Bay.

     Not loads of medical jargon, so I could understand what was being said ...' SW, Chester.

Please feel free to download further information about the programme in Microsoft PowerPoint format (Note: large file - 5.1Mb). If you'd like more information, please use our contact form or view our brochure (750k PDF).

Thanks for reading to the end,

Steve Cottrell

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Page last updated:  Friday, November 17, 2017