How Are Information and Communication Technologies Supporting Routine Outcome Monitoring and Measurement-Based Care in Psychotherapy? A Systematic Review

Abstract

Psychotherapy has proven to be effective for a wide range of mental health problems. However, not all patients respond to the treatment as expected (not-on-track patients). Routine outcome monitoring (ROM) and measurement-based care (MBC), which consist of monitoring patients between appointments and using this data to guide the intervention, have been shown to be particularly useful for these not-on-track patients. Traditionally, though, ROM and MBC have been challenging, due to the difficulties associated with repeated monitoring of patients and providing real-time feedback to therapists. The use of information and communication technologies (ICTs) might help reduce these challenges. Therefore, we systematically reviewed evidence regarding the use of ICTs for ROM and MBC in face-to-face psychological interventions for mental health problems. The search included published and unpublished studies indexed in the electronic databases PubMed, PsycINFO, and SCOPUS. Main search terms were variations of the terms “psychological treatment”, “progress monitoring or measurement-based care”, and “technology”. Eighteen studies met eligibility criteria. In these, ICTs were frequently handheld technologies, such as smartphone apps, tablets, or laptops, which were involved in the whole process (assessment and feedback). Overall, the use of technology for ROM and MBC during psychological interventions was feasible and acceptable. In addition, the use of ICTs was found to be effective, particularly for not-on-track patients, which is consistent with similar non-ICT research. Given the heterogeneity of reviewed studies, more research and replication is needed to obtain robust findings with different technological solutions and to facilitate the generalization of findings to different mental health populations.

Telemonitoring in Chronic Pain Management Using Smartphone Apps: A Randomized Controlled Trial Comparing Usual Assessment against App-Based Monitoring with and without Clinical Alarms

“…While developing alternatives to face-to-face multidimensional treatments for chronic pain is indeed important, most patients still advocate individual, face-to-face treatments [ 67 ] and the first-line intervention for patients with chronic pain, namely medical treatment, will probably continue to require some patient-professional face-to-face interaction. Thus, the development of tools that improve face-to-face interventions and allow for a rapid adaptation of treatments as a function of patient evolution during treatment, as in measurement-based care [ 68 ], should be a major focus of research in chronic pain settings. This study may provide some novel insights about the potential utility, as well as the implementation challenges of this new approach to monitoring.…”

Effectiveness of a Multicomponent Treatment based on Pain Neuroscience Education, Therapeutic Exercise, Cognitive Behavioural Therapy, and Mindfulness in Patients with Fibromyalgia (FIBROWALK study): A Randomized Controlled Trial.

“…Recently, methodologists have recommended "factorial designs" to test the active components of complex therapies. 64 These factorial designs permit to explore main effects of components and interactions among components. In short, using our multicomponent treatment as example, patients would be As stated above, this is the first study to demonstrate the effectiveness of a multicomponent treatment that specifically integrates PNE in patients with FM.…”

“…In short, using our multicomponent treatment as example, patients would be As stated above, this is the first study to demonstrate the effectiveness of a multicomponent treatment that specifically integrates PNE in patients with FM. There are many studies that support the individual effectiveness of each of the treatment components that constitute this multicomponent therapy 11,[13][14][15][18][19][20][21][22][23][24][25][26][27][63][64][65][66][67][68][69][70][71][72] . In spite of the complexity of integrating different ingredients, the present RCT was designed on the basis of a clear and replicable methodology.…”

Using Information and Communication Technologies (ICT) for Mental Health Prevention and Treatment

“…The results showed that certain personality characteristics (e.g., high neuroticism) may be a risk factor to pregnant women’s wellbeing deterioration and therefore should be assessed early during pregnancy mental health screening, which might be facilitated through the use of ICT tools. In a related topic, Gual-Montolio et al [ 13 ] presented a systematic review about the use of ICTs for routine outcome monitoring (ROM) and measurement-based care (MBC) in face-to-face psychological interventions for mental health problems. The eighteen articles revised showed that handheld technologies such as smartphone apps, tablets, or laptops were used for assessment and feedback during psychological interventions (including ROM and MBC), providing evidence about their feasibility and acceptability.…”