Tomorrow's world: current developments in the therapeutic use of technology for psychosis

O’Hanlon, Puffin; Aref-Adib, Golnar; Fonseca, Andres; Lloyd‐Evans, Brynmor; Osborn, David

doi:10.1192/apt.bp.115.014654

Cited by 32 publications

(30 citation statements)

References 51 publications

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“…growing. Although still in its infancy emerging data suggests that digital interventions may be as effective as more traditional, non-technological self-help interventions 5,6 at improving symptom monitoring, 7 medication management, 8 and access to information and support. 9 Mental health services are often designed to be family and friends orientated and digital interventions could play an important role by providing support digitally where practical issues may impede access to conventional psychosocial interventions.…”

Section: Investment and Interest In Digital Interventions Ismentioning

confidence: 99%

Factors affecting implementation of digital health interventions for people with psychosis or bipolar disorder, and their family and friends: a systematic review

Aref-Adib

McCloud

Ross

et al. 2019

The Lancet Psychiatry

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Digital health interventions present an important opportunity to improve healthcare for people affected by psychosis or bipolar disorder, but despite their potential there have been widespread difficulties in integrating and implementing them into clinical settings. This review aims to identify factors affecting implementation of digital health interventions for people affected by psychosis or bipolar disorder. We searched 7 databases and synthesised data from 26 studies using the Consolidated Framework for Implementation Research. Attitudes and beliefs about interventions were crucial factors for both staff and service users, with negative attitudes and scepticism resulting in a lack of motivation to engage with or complete interventions. The complexity of the interventions was a barrier for people with psychiatric symptoms, lower premorbid IQ, or lower IT skills. The accessibility and adaptability of interventions were key facilitators but lack of resources, finances and staff time were barriers to implementation. Interventions need to be user-friendly and adaptable to the needs and capabilities of people with psychosis or bipolar disorder and the staff who support their implementation. Service users and staff should co-facilitate the process of developing and implementing the interventions. 4

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Section: Investment and Interest In Digital Interventions Ismentioning

confidence: 99%

Factors affecting implementation of digital health interventions for people with psychosis or bipolar disorder, and their family and friends: a systematic review

Aref-Adib

McCloud

Ross

et al. 2019

The Lancet Psychiatry

Self Cite

107

113

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“…SlowMo reflects the rapid growth of digital technology in mental health care, given its potential to improve access, outcomes and costs [24][25][26]. In psychosis, findings indicate promising rates of acceptability, usability and safety for interventions delivered via the web, text messaging, smartphone apps and virtual reality.…”

Section: Introductionmentioning

confidence: 99%

How Inclusive, User-Centered Design Research Can Improve Psychological Therapies for Psychosis: Development of SlowMo

Hardy¹,

Wojdecka²,

West³

et al. 2018

JMIR Ment Health

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Background Real-world implementation of psychological interventions for psychosis is poor.Barriers include therapy being insufficiently usable and useful for a diverse range of people.User-centred, inclusive design approaches could improve the usability of therapy, which may increase uptake, adherence and effectiveness.Objective To optimise the usability of an existing psychological intervention, Thinking Well, which targets reasoning processes in paranoia using a basic digital interface.Methods We conducted inclusive, user-centred design research characterised by purposive sampling of 'extreme' users from the margins of groups, ethnographic investigation of the problem context, and iterative prototyping of solutions. The UK Design Council's Double Diamond method was used. This consisted of 4 phases: discover, including a case series of Thinking Well, stakeholder interviews, desk research, user profiling, system mapping and a mood board; define, consisting of workshops to synthesise findings and generate the design brief; develop, involving concept workshops and prototype testing; and deliver, in which the final minimal viable product was storyboarded and iteratively coded.Results Consistent with our previous work, the Thinking Well case series showed medium/large effects on paranoia and wellbeing, and small effects on reasoning. These were maintained at follow-up despite some participants reporting difficulties with the therapy interface. Insights from the discover phase confirmed that usability was challenged by information complexity and poor accessibility. Participants were generally positive about the potential of technology to be enjoyable, help manage paranoia and provide tailored interpersonal support from therapists and peers, although reported privacy and security concerns. The define phase highlighted that the therapy redesign should support monitoring, simplify information processing, enhance enjoyment and trust, promote personalisation and normalisation, and offer flexible interpersonal support. During the develop phase over 60 concepts were created, with two key concepts of thoughts visualised as bubbles, and therapy as a journey selected for storyboarding. The output of the deliver phase was a minimal viable product of an innovative digital therapy, SlowMo. SlowMo works by helping people to notice their worries and fast thinking habits, and encourages them to slow down for a moment to find ways of feeling safer. A webapp supports the delivery of eight face-to-face sessions, which are synchronised to a native mobile app.Conclusions SlowMo makes use of personalisation, ambient information and visual metaphors to tailor the appeal, engagement and memorability of therapy to a diversity of needs. Feasibility testing has been promising, and the efficacy of SlowMo therapy is now being tested in a multi-centred randomised controlled trial. The study demonstrates that developments in psychological theory and techniques can be enhanced by improving the usability of the therapy interface in order to ...

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“…We wanted to design a service that was "engaging", by grounding the innovation in user needs and by drawing on the power of smartphone technology to extend services beyond the confines of the physical clinic [18] [19] [20]. Smartphone ownership is particularly high in younger people with schizophrenia [21] making the smartphone highly relevant as a tool to respond to service user needs at all times.…”

Section: Introductionmentioning

confidence: 99%

Collaborating with Young Adults Diagnosed with Schizophrenia: A Participatory Design Study to Shape the Healthcare System

Terp¹,

Bjørnes²,

Jørgensen³

et al. 2017

OJN

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Introduction: Disengagement from mental health services in young adults with schizophrenia has been associated with dissatisfaction and unmet needs. Striving to improve engagement, we invited service users recently diagnosed with schizophrenia to be co-designers of a smartphone technology that will be responsive to their needs. Aim: This paper reports the first phase of a threephased participatory design process. The objective was to identify needs of support in young adults recently diagnosed with schizophrenia and to generate ideas of how the needs could be accommodated using smartphone technology. Methods: Participatory design guided the research process and a qualitative approach was used to generate and analyse the data. Data were generated by means of participant observations (n = 45 hours) and interviews (n = 6) with young adults from a first episode psychosis program in Denmark. Findings: Low levels of knowledge and high levels of uncertainties are characteristic of young adults recently diagnosed with schizophrenia, bringing about a vast need of support in order for them to gain power over their new life situation. Our study suggests that the smartphone may be used to foster empowerment by guiding the young adult's actions in situ, providing comprehensive and easily understood information on the go, allowing for recovery tracking, and notification of mental health changes, providing medication overview and giving easy access to healthcare providers. Conclusion: Young adults recently diagnosed with schizophrenia require comprehensive support in order to become empowered to confidently manage their new life situation. The smartphone holds this potential by offering flexible collaboration and timely access to self-management resources.

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Tomorrow's world: current developments in the therapeutic use of technology for psychosis

Cited by 32 publications

References 51 publications

Factors affecting implementation of digital health interventions for people with psychosis or bipolar disorder, and their family and friends: a systematic review

Factors affecting implementation of digital health interventions for people with psychosis or bipolar disorder, and their family and friends: a systematic review

How Inclusive, User-Centered Design Research Can Improve Psychological Therapies for Psychosis: Development of SlowMo

Collaborating with Young Adults Diagnosed with Schizophrenia: A Participatory Design Study to Shape the Healthcare System

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