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

Abstract

BACKGROUND Posttraumatic stress disorder (PTSD) is a common disorder for which more treatment options are needed. Mental health app (mHealth) interventions are promising to patients suffering from PTSD, however, knowledge about mHealth interventions is sparse and primarily based on quantitative studies. OBJECTIVE The aim of this study was to qualitatively explore PTSD patients’ experiences with using a mHealth app as a stand-alone intervention before commencing psychotherapeutic treatment. METHODS Semi-structured interviews were conducted with fourteen partients, who were interviewed six weeks after receiving the app. An inductive analysis style was used and interviews were analyzed using thematic analysis. RESULTS Three overall themes were identified: Use of app, Being a patient and Overall evaluation of the app. Use of the app was described with the subtheme of habits and and the theme of being a patient included the subthemes of negative experiences with the app and being a part of a research project. Use of the app encompassed how psychological factors and technical problems could interfere with the use of the app. Being a patient depicted that the waiting time before starting treatment felt long, and a subgroup of patients experienced feeling worse during this time, which they partly attributed to using the app. Several suggestions of change were 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 patiens to establish a habit of using the app thus reflecting the importance of supporting habit formation when implementing an mHealth app into mental health care services. Some patients shared having negative experiences from using the app reflecting the potential harm from having an mHealth app without the support from a clinician. It is therefore recommended to use a blended-care treatment or an approach where mental health care professionals “prescribe” a mHealth app for relevant patients to avoid increased suicidal risk.