Patients’ Experiences of Using a Self-help App for Posttraumatic Stress Disorder: Qualitative Study

Abstract

Background Posttraumatic stress disorder (PTSD) is a common disorder that requires more treatment options. Mobile health (mHealth) app interventions are promising for patients with PTSD, as they can provide easily accessible support, strategies, and information. However, knowledge about mHealth interventions is sparse and primarily based on quantitative studies. Objective The aim of this study is to qualitatively explore the experiences of patients with PTSD with regard to using an mHealth app as a stand-alone intervention before commencing psychotherapeutic treatment. Methods We conducted semistructured interviews with 14 participants 6 weeks after they received the app. The participants were all referred to PTSD treatment and were waiting to commence psychotherapeutic treatment. During this waiting time, the participants had no contact with the health staff. Interviews were transcribed and were analyzed using thematic analysis. Results A total of 3 themes were identified—the use of app, being a patient, and the overall evaluation of the app. The use of the app was described with the subtheme of habits, and the theme of being a patient included the subthemes of having negative experiences with the app and being a part of a research project. The use of the app encompassed how psychological factors and technical problems could interfere with the use of the app. The theme of being a patient depicted that the waiting time before starting treatment was long, and a subgroup of patients experienced feeling worse during this time, which they partly attributed to using the app. Several suggestions for change have been described in the overall evaluation of the app. Conclusions The findings in this study revealed that emotional arousal influenced the use of the app and that it was difficult for participants to establish a habit of using the app, thus reflecting the importance of supporting habit formation when implementing an mHealth app in mental health care services. This study makes an important contribution to the field of mHealth research, as it revealed that some participants had negative experiences resulting from using the app, thus reflecting the potential harm of having an mHealth app without the support of a clinician. It is therefore recommended to use a blended care treatment or an approach in which mental health care professionals prescribe an mHealth app for relevant patients to avoid increased suicidal risk.

My Grief App for Prolonged Grief in Bereaved Parents: A Pilot Study

“…Some participants expressed that they did not use the app as much as they intended to, which is in line with other research on self-management smartphone apps for reducing mental illness ( 25 , 47 – 49 ). Some of the parents in the current study expressed that the app would have been most helpful earlier in the grieving process.…”

Mobile applications for individuals affected by a traumatic event: A systematic review of qualitative findings

“…This can prove useful when the availability of mental health professionals and the financial resources are limited. For those who do not use services and those who are waiting for a treatment, self-management apps can constitute a standalone intervention (e.g., McLean, Davis, Miller, Ruzek, & Neri, 2022;Riisager et al, 2021). This way of delivering services can also reduce the stigma associated with mental health (Röhr et al, 2021).…”

“…Several other mobile apps for PTSD were examined. PTSD Help focuses on emotional regulation and psychoeducation (Riisager et al, 2021). An unnamed mobile app aims to promote resilience using principles based on acceptance and commitment therapy (Reyes, 2022;Reyes, Muthukumar, Bhatta, Bombard, & Gangozo, 2020;Reyes, Serafica, & Sojobi, 2020).…”

“…"There was a broad consensus across participants that the key advantages of the app were that it was a reliable source of information on PTSD" (Riisager et al, 2021) Self-assessment (3)…”

“…Most of these concerned "bugs" and challenges with wireless Internet and Bluetooth connections (e.g., Betthauser et al, 2020;Latour et al, 2020). Design issues were reported in five studies where participants thought that certain design choices made the app more challenging to use, such as the localization of certain app components (Riisager et al, 2021), the insufficient color contrast (Kessler et al, 2019), or a font size that was too small (Shakespeare-Finch et al, 2020).…”