Behavioral Intervention Technologies in Current Use

Transcription

1 Behavioral Intervention Technologies in Current Use Michelle Nicole Burns, Ph.D. Assistant Professor Northwestern University Feinberg School of Medicine

2 Behavioral Intervention Technologies (BITs) BITs use technology (websites, mobile phone apps, text messaging, videoconferencing, etc.) and behavioral science to promote healthy behaviors Example: an app designed to help people remember to take their prescribed medications I will talk today about available BITs that aim to help people manage symptoms of anxiety and depression Most websites and mobile phone apps in this area are based on principles of Cognitive Behavioral Therapy Connections between thoughts, behaviors, and emotions

3 Behavioral Intervention Technologies (BITs) Technology can be used: As a communication platform between a mental health provider and the client As a supplement to mental health services Example: A therapist shows the client how to rate their mood using a mood tracking app. The client shows the therapist their mood ratings next week, and they discuss the patterns. As the main source of information, exercises, etc., guided by a mental health professional (sometimes called guided self-help ) As a standalone tool (non-guided) These cannot take the place of assessment and treatment by a qualified mental health professional Buyer beware: There are many BITs (Smartphone apps in particular) that are publically available, but have no research evidence for their effectiveness

4 U.K. National Institute for Health and Clinical Excellence (NICE) Guidelines for Depression Treatment in Adults The Stepped Care Model Step 4: Severe and complex depression; risk to life; severe self-neglect Step 3: Persistent subthreshold depressive symptoms or mild to moderate depression with inadequate response to initial interventions; moderate and severe depression Step 2: Persistent subthreshold depressive symptoms; mild to moderate depression Medication, high-intensity psychological interventions, electroconvulsive therapy, crisis service, combined treatments, multiprofessional and inpatient care Medication, high-intensity psychological interventions, combined treatments, collaborative care and referral for further assessment and interventions Low-intensity psychosocial interventions, psychological interventions, medication and referral for further assessment and interventions Step 1: All known and suspected presentations of depression Assessment, support, psychoeducation, active monitoring and referral for further assessment and interventions

5 Computerized Cognitive Behavioral Therapy for Depression Beating the Blues Online program with eight 50 minute sessions Exercises, homework, information, video vignettes Free if referred by a provider in the U.K. National Health Service There is a U.S. version, and in 2011 healthcare systems in the U.S. started allowing healthcare providers to refer patients to it VA DoD Alexian Brothers Behavioral Health Hospital And more!

6 Generalized Anxiety and Social Anxiety This Way Up They also offer courses for stress, depression, mixed anxiety and depression, panic disorder, and obsessive compulsive disorder, but these have been through fewer clinical trials Online program with six 20 minute sessions, plus 3-4 hours per week of homework Exercises, homework, information, video vignettes $55 and must get a prescription from a clinician Offered by the Clinical Research Unit for Anxiety and Depression, St. Vincent s Hospital, Sydney Australia

7 This Way Up

8 This Way Up: Course Overview for Generalized Anxiety

9 This Way Up: Inside a Lesson

10 MoodGYM Free to the public: Cognitive Behavioral Therapy Quizzes about warpy thoughts, help with perfectionism, low selfesteem, and common upsetting thought patterns. Promoting more balanced thinking about relationships Problem solving Assessments, feedback, information, interactive tools, homework, self-monitoring

11 Didactic Content

12 Interactive Tools

13 Homework

14 Apps for Anxiety and Depression: MoodKit

15 Anxiety Apps: Worry Watch

16 Stress Management: Breathe2Relax

17 Posttraumatic Stress Disorder: PE Coach

18 Consumer Resources Beacon By the Australian National Institute for Mental Health Research at Australian National University Online directory of ehealth programs Can search by diagnosis or problem Can filter by access (free, charge, or research participation), audience, platform, and expert rating

19 Beacon

20 Beacon, Program Details

21 Beacon Expert Ratings

22 Anxiety and Depression Association of America (ADAA) Mobile Apps Reviews ADAA Members (mental health professionals) provide a commentary and rate apps on: Ease of Use How easy was it to use this app at first? (1=very difficult; 5=very easy) Effectiveness How likely will the content provide the tools or methods to accomplish its purpose? (1=highly unlikely; 5=highly likely) Applications: Education, Screening, Self-Monitoring, Treatment Personalize What is its ability to personalize an individual s particular needs? (1=no ability; 5=complete ability) Interactive/Feedback How interactive is the app in giving feedback? (1=not interactive, no feedback; 5=very interactive, helpful feedback) Research Evidence Does scientific research demonstrate its effectiveness? (1=no research evidence; 5=ample research evidence)