Mobile Technology Boosts the Effectiveness of Psychotherapy and Behavioral Interventions

Lindhiem, Oliver; Bennett, Charles B.; Rosen, Dana; Silk, Jennifer S.

doi:10.1177/0145445515595198

Cited by 190 publications

(133 citation statements)

References 45 publications

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“…These kinds of treatments, which have until now been administered only in a clinician’s office during scheduled visits, or sometimes by desktop computer (Carroll et al 2014) are becoming mobile— adapted for delivery when and where they are needed (Lindhiem et al 2015; Nahum-Shani et al 2016). Our knowledge base has not caught up to this change (Hekler et al 2016; Riley et al 2011).…”

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confidence: 99%

Context and craving during stressful events in the daily lives of drug-dependent patients

et al. 2017

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Rationale Knowing how stress manifests in the lives of people with substance-use disorders could help inform mobile “just in time” treatment. Objectives To examine discrete episodes of stress, as distinct from the fluctuations in background stress assessed in most EMA studies. Methods For up to 16 weeks, outpatients on opioid-agonist treatment carried smartphones on which they initiated an entry whenever they experienced a stressful event (SE) and when randomly prompted (RP) three times daily. Participants reported the severity of stress and craving and the context of the report (location, activities, companions). Decomposition of covariance was used to separate within-person from between-person effects; reffect sizes below are within-person. Results Participants (158 of 182; 87%) made 1,787 stress-event entries. Craving for opioids increased with stress severity (reffect = 0.50). Stress events tended to occur in social company (with acquaintances, 0.63, friends, 0.17, or on the phone, 0.41) rather than with family (spouse, −0.14; child, −0.18), and in places with more overall activity (bars, 0.32; outside, 0.28; walking, 0.28) and more likelihood of unexpected experiences (with strangers, 0.17). Being on the internet was slightly protective (−0.22). Our prior finding that being at the workplace protects against background stress in our participants was partly supported in these stressful-event data. Conclusions The contexts of specific stressful events differ from those we have seen in prior studies of ongoing background stress. However, both are associated with drug craving.

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confidence: 99%

Context and craving during stressful events in the daily lives of drug-dependent patients

et al. 2017

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“…Although user ratings were high on average and apps were described as easy to use and effective, most did not cite evidence other than user testimonials. There is limited evidence for the efficacy of mental health apps, [19][20][21] and few of those studied are available for consumer download. Few applications provided detailed information about the app creator, and of those that did, few were created by an academic or professional organization (e.g., clinical mental health provider), raising questions about credibility of the sources.…”

Section: Discussionmentioning

confidence: 99%

Smartphone Applications for Mental Health

Radovic

Vona

Santostefano

et al. 2016

Cyberpsychology, Behavior, and Social Networking

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Many adolescents and adults do not seek treatment for mental health symptoms. Smartphone applications (apps) may assist individuals with mental health concerns in alleviating symptoms or increasing understanding. This study seeks to characterize apps readily available to smartphone users seeking mental health information and/or support. Ten key terms were searched in the Apple iTunes and Google Play stores: mental health, depression, anxiety, schizophrenia, bipolar, trauma, trauma in schools, post traumatic stress disorder (PTSD), child trauma, and bullying. A content analysis of the first 20 application descriptions retrieved per category was conducted. Out of 300 nonduplicate applications, 208 (70%) were relevant to search topic, mental health or stress. The most common purported purpose for the apps was symptom relief (41%; n = 85) and general mental health education (18%; n = 37). The most frequently mentioned approaches to improving mental health were those that may benefit only milder symptoms such as relaxation (21%; n = 43). Most app descriptions did not include information to substantiate stated effectiveness of the application (59%; n = 123) and had no mention of privacy or security (89%; n = 185). Due to uncertainty of the helpfulness of readily available mental health applications, clinicians working with mental health patients should inquire about and provide guidance on application use, and patients should have access to ways to assess the potential utility of these applications. Strategic policy and research developments are likely needed to equip patients with applications for mental health, which are patient centered and evidence based.

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“…In randomized controlled trials of mental health EMI systems, the addition of EMI was associated with a medium ( g = 0.40) average effect size improvement on change in clinical outcomes (Versluis et al, 2016). A recent meta-analysis of the impact of mobile technology (including, but not limited to, smartphone apps that use EMI) on psychotherapy and behavioral interventions found that mobile technology boosted the impact of treatment (Pooled Effect Size = .27, p < .05) (Lindhiem, Bennett, Rosen, & Silk, 2015). Despite very limited data on the mechanisms through which EMIs result in improved outcomes, improvements in skill acquisition and utilization are thought to be one of the most likely pathways (Lindhiem et al, 2015).…”

Section: Just-in-time Adaptive Interventions Appear Well Suited Tomentioning

confidence: 99%

Just‐in‐time adaptive interventions: A novel approach for enhancing skill utilization and acquisition in cognitive behavioral therapy for eating disorders

Juarascio

Parker

Lagacey

et al. 2018

Intl J Eating Disorders

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The most widely researched treatment for bulimia nervosa (BN) and binge-eating disorder (BED) is cognitive behavioral therapy (CBT), a present-focused, active, skill-oriented treatment. However, despite the success of CBT, many patients fail to achieve sufficient rates of skill utilization (i.e., the frequency with which a patient practices or uses therapeutic skills) or adequate skill acquisition (i.e., the ability to successfully perform a skill learned in treatment) by the end of treatment and outcomes suffer as a result. One method for improving skill acquisition and utilization in patients with BN or BED could be the augmentation of in-person treatment with just-in-time adaptive interventions (JITAIs), which use smartphone technology to deliver real-time interventions during app-identified moments of need. The current article discusses how novel JITAI systems that utilize machine learning or other predictive algorithms could be used to detect momentary risk for eating disordered behavior and provide tailored interventions to enhance outcomes. We will consider technologies that may help reduce patient burden and suggest avenues for future research on developing acceptable and effective JITAIs that can be used as an adjunct to CBT protocols.

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Mobile Technology Boosts the Effectiveness of Psychotherapy and Behavioral Interventions

Cited by 190 publications

References 45 publications

Context and craving during stressful events in the daily lives of drug-dependent patients

Context and craving during stressful events in the daily lives of drug-dependent patients

Smartphone Applications for Mental Health

Just‐in‐time adaptive interventions: A novel approach for enhancing skill utilization and acquisition in cognitive behavioral therapy for eating disorders

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