Technologies such as smartphones and digital cameras are an increasingly ubiquitous part of modem life, and the increasing convenience of these electronic tools provides psychotherapists with opportunities to incorporate these technologies into psychotherapy. In the face of so much opportunity, psychotherapists must Ieam how to incorporate these tools effectively and responsibly. The authors present three case studies that demonstrate the use of digital technology to individualize and enhance the efficiency of existing evidence-based treatments. In the first, digital pictures were used to track the treatment progress of a client who compulsively hoards. In the second, a smartphone was used to record a personalized progressive muscle relaxation file for a client with agoraphobia, hypochondriasis, and generalized anxiety disorder. In the third, a smartphone was used to photograph and send pictures of in-session work to a client with trichotillomania and generalized anxiety disorder. The implications and ethical considerations of using technology in psychotherapeutic settings are explored, and practical strategies are provided for incorporating common digital technology into psychotherapeutic practice.New technology has frequently been implemented as an adjunct to cognitive-behavioral psychotherapy, from early computerassisted systematic desensitization (Lang, Melamed, & Hart, 1970) to the recent virtual/augmented reality-assisted exposure treatment (Botella, Bretón-López, Quero, Baños, & García-Palacios, 2010). While technology has influenced and expanded the practice of psychology in some cases, such as with telehealth and virtual reality applications, technology has not revolutionized the field in the way it has with some other domains in health care, such as radiology, surgery, or dentistry. This may be in part because new technology is, at least initially, often too expensive for private psychotherapists or community-based clinics, where most psychotherapy services are provided (Boschen & Casey, 2008).There are at least two ways in which technology can significantly influence current practice in a field. First, cutting-edge technology provides such a leap forward in knowledge, methods, and capability that it revolutionizes practice in the way that scanning technologies have changed neurology, to use an example from another field. Revolution can also occur when a technology becomes ubiquitous and integrates itself into the cultural and social Editor's Note. This is one of 19 accepted articles received in response to an open call for submissions on Telehealth and Technology Innovations in Professional Psychology.-MCR ALISON M. EONTA received her MS in Clinical Psychology from Virginia Commonwealth University and is currently pursuing her PhD in the program. Her areas of research and practice include anxiety disorders (specifically posttraumatic stress disorder), behavioral medicine, and psychophysiology. LILLIAN M. CHRISTON received her MA in psychology from the University of Richmond and is currently pursuing he...

Writing about a personal stressful event has been found to have psychological and physical health benefits, especially when physiological response increases during writing. Response training was developed to amplify appropriate physiological reactivity in imagery exposure. The present study examined whether response training enhances the benefits of written emotional disclosure. Participants were assigned to either a written emotional disclosure condition (n = 113) or a neutral writing condition (n = 133). Participants in each condition wrote for 20 minutes on three occasions and received response training (n = 79), stimulus training (n = 84) or no training (n = 83). Heart rate and skin conductance were recorded throughout a 10-minute baseline, 20-minute writing, and a 10-minute recovery period. Self-reported emotion was assessed in each session. One month after completing the sessions, participants completed follow-up assessments of psychological and physical health outcomes. Emotional disclosure elicited greater physiological reactivity and self-reported emotion than neutral writing. Response training amplified physiological reactivity to emotional disclosure. Greater heart rate during emotional disclosure was associated with the greatest reductions in event-related distress, depression, and physical illness symptoms at follow-up, especially among response trained participants. Results support an exposure explanation of emotional disclosure effects and are the first to demonstrate that response training facilitates emotional processing and may be a beneficial adjunct to written emotional disclosure.

The present study illustrates the benefits of examining changes in RSA over time. Future work with clinical samples should include additional measures and tasks to better define these mechanisms and rule out alternative hypotheses.

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