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Clinical wisdom in the age of computer apps: a systematic review of four functions that may complement clinical treatment

Published online by Cambridge University Press:  19 August 2022

Catalina R. Pacheco Open the ORCID record for Catalina R. Pacheco [Opens in a new window]  and
Michael S. Scheeringa
Catalina R. Pacheco*
Affiliation:
Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, LA, USA
Michael S. Scheeringa
Affiliation:
Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, LA, USA
*
*Corresponding author. Email: cpacheco@tulane.edu
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Abstract

Mental health clinicians perform complex tasks with patients that potentially could be improved by the massive computing power available through mobile apps. This study aimed to analyse commercially available mobile and computer applications (apps) focused on treating psychiatric disorders. Apps were analysed by two independent raters for whether they took advantage of computer power to process data in a fashion that augments four main elements of clinical treatment including (1) assessment/diagnosis, (2) treatment planning, (3) treatment fidelity monitoring, and (4) outcome tracking. The evidence base for each of these apps was also explored via PsychINFO, Research Gate and Google Scholar. Searches of the Google Play Store, the Apple App Store, and the One Mind PsyberGuide found 722 apps labelled for mental health use, of which 163 apps were judged relevant to clinical work with patients with psychiatric disorders. Fifty-nine of these were determined to contain a computer-driven function for at least one of the four main elements of clinical treatment. The most common element was assessment/diagnosis (55/59 apps), followed by outcome tracking (34/59 apps). Six apps updated treatment plans using user input. Only one app tracked treatment fidelity. None of the apps contained computer-driven functions for all four elements. Twelve apps were supported in randomized clinical trials to show greater efficacy compared with either wait-list or other active treatments. Results showed that these four clinical elements can be meaningfully augmented, but the full potential of computer processing appears unreached in mental health-related apps.

Key learning aims

  1. (1) To understand what apps are currently available to treat clinical-level psychiatric problems.

  2. (2) To understand how many of the commercially available mental health-focused apps can be used for the treatment of clinical populations.

  3. (3) To understand how mental health services can be complemented by utilizing computer processing power within apps.

Keywords

appscomputerized mental health caremental healthmobile applicationsmobile appsprogressive web appstelemedicine
Type
Original Research
Information
the Cognitive Behaviour Therapist , Volume 15 , 2022 , e40
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the British Association for Behavioural and Cognitive Psychotherapies

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References

Further reading

Liu, F. F., Cruz, R. A., Rockhill, C. M., & Lyon, A. R. (2019). Mind the gap: considering disparities in implementing measurement-based care. Journal of the American Academy of Child and Adolescent Psychiatry, 58, 459–461. https://doi.org/10.1016/j.jaac.2018.11.015 CrossRefGoogle ScholarPubMed
Imel, Z. E., Caperton, D. D., Tanana, M., & Atkins, D. C. (2017). Technology-enhanced human interaction in psychotherapy. Journal of Counseling Psychology, 64, 385–393. https://doi.org/10.1037/cou0000213 CrossRefGoogle ScholarPubMed

References

Andersson, G. (2009). Using the internet to provide cognitive behaviour therapy. Behaviour Research and Therapy, 47, 175–180. https://doi.org/https://doi.org/10.1016/j.brat.2009.01.010 CrossRefGoogle ScholarPubMed
Andersson, G., Estling, F., Jakobsson, E., Cuijpers, P., & Carlbring, P. (2011). Can the patient decide which modules to endorse? an open trial of tailored internet treatment of anxiety disorders. Cognitive Behaviour Therapy, 40, 57–64. https://doi.org/10.1080/16506073.2010.529457 CrossRefGoogle ScholarPubMed
Bakker, D., Kazantzis, N., Rickwood, D., & Rickard, N. (2018). A randomized controlled trial of three smartphone apps for enhancing public mental health. Behaviour Research and Therapy, 109, 75–83. https://doi.org/https://doi.org/10.1016/j.brat.2018.08.003 CrossRefGoogle ScholarPubMed
Brattland, H., Koksvik, J. M., Burkeland, O., Gråwe, R. W., Klöckner, C., Linaker, O. M., Ryum, T., Wampold, B., Lara-Cabrera, M. L., & Iversen, V. C. (2018). The effects of routine outcome monitoring (ROM) on therapy outcomes in the course of an implementation process: a randomized clinical trial. Journal of Counseling Psychology, 65, 641–652. https://doi.org/10.1037/cou0000286 CrossRefGoogle Scholar
Bry, L. J., Chou, T., Miguel, E., & Comer, J. S. (2018). Consumer smartphone apps marketed for child and adolescent anxiety: a systematic review and content analysis. Behavior Therapy, 49, 249–261. https://doi.org/10.1016/j.beth.2017.07.008 CrossRefGoogle ScholarPubMed
Cartreine, J. A., Ahern, D. K., & Locke, S. E. (2010). A roadmap to computer-based psychotherapy in the United States. Harvard Review of Psychiatry, 18, 80–95. https://doi.org/10.3109/10673221003707702 CrossRefGoogle ScholarPubMed
Ellis, L., Campbell, A., Sethi, S., & O’Dea, B. (2011). Comparative randomized trial of an online cognitive-behavioral therapy program and an online support group for depression and anxiety. Journal of Cyber Therapy and Rehabilitation, 4, 461–467.Google Scholar
Farrer, L., Christensen, H., Griffiths, K. M., & Mackinnon, A. (2011). internet-based cbt for depression with and without telephone tracking in a national helpline: randomised controlled trial. PloS One, 6, e28099. https://doi.org/10.1371/journal.pone.0028099 CrossRefGoogle Scholar
Fitzpatrick, K. K., Darcy, A., & Vierhile, M. (2017). delivering cognitive behavior therapy to young adults with symptoms of depression and anxiety using a fully automated conversational agent (Woebot): a randomized controlled trial. JMIR Mental Health, 4, e19. https://doi.org/10.2196/mental.7785 CrossRefGoogle ScholarPubMed
Fulmer, R., Joerin, A., Gentile, B., Lakerink, L., & Rauws, M. (2018). using psychological artificial intelligence (Tess) to relieve symptoms of depression and anxiety: randomized controlled trial. JMIR Mental Health, 5, e64. https://doi.org/10.2196/mental.9782 CrossRefGoogle ScholarPubMed
Goldberg, L. R. (1968). Simple models or simple processes? Some research on clinical judgments. American Psychologist, 23, 483–496. https://doi.org/10.1037/h0026206 CrossRefGoogle ScholarPubMed
Imel, Z. E., Caperton, D. D., Tanana, M., & Atkins, D. C. (2017). Technology-enhanced human interaction in psychotherapy. Journal of Counseling Psychology, 64, 385–393. https://doi.org/10.1037/cou0000213 CrossRefGoogle ScholarPubMed
Kladnitski, N., Smith, J., Uppal, S., James, M. A., Allen, A. R., Andrews, G., & Newby, J. M. (2020). Transdiagnostic internet-delivered CBT and mindfulness-based treatment for depression and anxiety: a randomised controlled trial. Internet Interventions, 20, 100310. https://doi.org/10.1016/j.invent.2020.100310 CrossRefGoogle ScholarPubMed
Kuhn, E., Kanuri, N., Hoffman, J. E., Garvert, D. W., Ruzek, J. I., & Taylor, C. B. (2017). A randomized controlled trial of a smartphone app for posttraumatic stress disorder symptoms. Journal of Consulting and Clinical Psychology, 85, 267–273. https://doi.org/10.1037/ccp0000163 CrossRefGoogle ScholarPubMed
Lagan, S., D’Mello, R., Vaidyam, A., Bilden, R., & Torous, J. (2021). Assessing mental health apps marketplaces with objective metrics from 29,190 data points from 278 apps. Acta Psychiatrica Scandinavica. https://doi.org/https://doi.org/10.1111/acps.13306 CrossRefGoogle ScholarPubMed
Lau, N., O’Daffer, A., Colt, S., Yi-Frazier, J. P., Palermo, T. M., McCauley, E., & Rosenberg, A. R. (2020). Android and iPhone mobile apps for psychosocial wellness and stress management: systematic search in app stores and literature review. JMIR mHealth and uHealth, 8, e17798. https://doi.org/10.2196/17798 CrossRefGoogle ScholarPubMed
Liu, F. F., Cruz, R. A., Rockhill, C. M., & Lyon, A. R. (2019). mind the gap: considering disparities in implementing measurement-based care. Journal of the American Academy of Child and Adolescent Psychiatry, 58, 459–461. https://doi.org/10.1016/j.jaac.2018.11.015 CrossRefGoogle ScholarPubMed
Mackinnon, A., Griffiths, K. M., & Christensen, H. (2008). Comparative randomised trial of online cognitive-behavioural therapy and an information website for depression: 12-month outcomes. British Journal of Psychiatry, 192, 130–134. https://doi.org/10.1192/bjp.bp.106.032078 CrossRefGoogle Scholar
Mahoney, A. E., Mackenzie, A., Williams, A. D., Smith, J., & Andrews, G. (2014). Internet cognitive behavioural treatment for obsessive compulsive disorder: a randomised controlled trial. Behaviour Research and Therapy, 63, 99–106. https://doi.org/10.1016/j.brat.2014.09.012 CrossRefGoogle ScholarPubMed
Miner, A., Kuhn, E., Hoffman, J. E., Owen, J. E., Ruzek, J. I., & Taylor, C. B. (2016). Feasibility, acceptability, and potential efficacy of the PTSD Coach app: a pilot randomized controlled trial with community trauma survivors. Psychological Trauma: Theory, Research, Practice, and Policy, 8, 384–392. https://doi.org/10.1037/tra0000092 CrossRefGoogle ScholarPubMed
Moberg, C., Niles, A., & Beermann, D. (2019). guided self-help works: randomized waitlist controlled trial of Pacifica, a mobile app integrating cognitive behavioral therapy and mindfulness for stress, anxiety, and depression. Journal of Medical Internet Research, 21, e12556. https://doi.org/10.2196/12556 CrossRefGoogle Scholar
O’Kearney, R., Gibson, M., Christensen, H., & Griffiths, K. M. (2006). Effects of a cognitive-behavioural internet program on depression, vulnerability to depression and stigma in adolescent males: a school-based controlled trial. Cognitive Behaviour Therapy, 35, 43–54. https://doi.org/10.1080/16506070500303456 CrossRefGoogle ScholarPubMed
Olff, M. (2015). Mobile mental health: a challenging research agenda. European Journal Psychotraumatology, 6, 27882. https://doi.org/10.3402/ejpt.v6.27882 CrossRefGoogle ScholarPubMed
Possemato, K., Kuhn, E., Johnson, E., Hoffman, J. E., Owen, J. E., Kanuri, N., De Stefano, L., & Brooks, E. (2016). Using PTSD Coach in primary care with and without clinician support: a pilot randomized controlled trial. General Hospital Psychiatry, 38, 94–98. https://doi.org/10.1016/j.genhosppsych.2015.09.005 CrossRefGoogle ScholarPubMed
Powell, J., Hamborg, T., Stallard, N., Burls, A., McSorley, J., Bennett, K., Griffiths, K. M., & Christensen, H. (2013). Effectiveness of a web-based cognitive-behavioral tool to improve mental well-being in the general population: randomized controlled trial. Journal of Medical Internet Research, 15, e2. https://doi.org/10.2196/jmir.2240 CrossRefGoogle Scholar
Richards, D., Enrique, A., Eilert, N., Franklin, M., Palacios, J., Duffy, D., Earley, C., Chapman, J., Jell, G., Sollesse, S., & Timulak, L. (2020). A pragmatic randomized waitlist-controlled effectiveness and cost-effectiveness trial of digital interventions for depression and anxiety. npj Digital Medicine, 3, 85. https://doi.org/10.1038/s41746-020-0293-8 CrossRefGoogle ScholarPubMed
Richards, D., Timulak, L., O’Brien, E., Hayes, C., Vigano, N., Sharry, J., & Doherty, G. (2015). A randomized controlled trial of an internet-delivered treatment: its potential as a low-intensity community intervention for adults with symptoms of depression. Behaviour Research and Therapy, 75, 20–31. https://doi.org/10.1016/j.brat.2015.10.005 CrossRefGoogle ScholarPubMed
Rose, R. D., Buckey, J. C. Jr, Zbozinek, T. D., Motivala, S. J., Glenn, D. E., Cartreine, J. A., & Craske, M. G. (2013). A randomized controlled trial of a self-guided, multimedia, stress management and resilience training program. Behaviour Research and Therapy, 51, 106–112. https://doi.org/10.1016/j.brat.2012.11.003 CrossRefGoogle ScholarPubMed
Sandoval, L. R., Buckey, J. C., Ainslie, R., Tombari, M., Stone, W., & Hegel, M. T. (2017). Randomized controlled trial of a computerized interactive media-based problem solving treatment for depression. Behavior Therapy, 48, 413–425. https://doi.org/10.1016/j.beth.2016.04.001 CrossRefGoogle ScholarPubMed
Scheeringa, M. S. (2020). A different way to mind the gap: mandated versus voluntary collection of measures. Journal of the American Academy of Child and Adolescent Psychiatry, 59, 576–577. https://doi.org/10.1016/j.jaac.2019.06.021 CrossRefGoogle ScholarPubMed
Schure, M. B., Lindow, J. C., Greist, J. H., Nakonezny, P. A., Bailey, S. J., Bryan, W. L., & Byerly, M. J. (2019). Use of a fully automated internet-based cognitive behavior therapy intervention in a community population of adults with depression symptoms: randomized controlled trial. Journal of Medical Internet Research, 21, e14754. https://doi.org/10.2196/14754 CrossRefGoogle Scholar
Sethi, S., Campbell, A. J., & Ellis, L. A. (2010). The use of computerized self-help packages to treat adolescent depression and anxiety. Journal of Technology in Human Services, 28, 144–160. https://doi.org/10.1080/15228835.2010.508317 CrossRefGoogle Scholar
Shafran, R., Clark, D. M., Fairburn, C. G., Arntz, A., Barlow, D. H., Ehlers, A., Freeston, M., Garety, P. A., Hollon, S. D., Ost, L. G., Salkovskis, P. M., Williams, J. M., & Wilson, G. T. (2009). Mind the gap: improving the dissemination of CBT. Behaviour Research and Therapy, 47, 902–909. https://doi.org/10.1016/j.brat.2009.07.003 CrossRefGoogle ScholarPubMed
Shen, N., Levitan, M. J., Johnson, A., Bender, J. L., Hamilton-Page, M., Jadad, A. R., & Wiljer, D. (2015). Finding a depression app: a review and content analysis of the depression app marketplace. JMIR MHealth and UHealth, 3, e3713. https://doi.org/10.2196/mhealth.3713 CrossRefGoogle ScholarPubMed
Slade, K., Lambert, M. J., Harmon, S. C., Smart, D. W., & Bailey, R. (2008). Improving psychotherapy outcome: the use of immediate electronic feedback and revised clinical support tools. Clinical Psychology & Psychotherapy, 15, 287–303. https://doi.org/10.1002/cpp.594 CrossRefGoogle ScholarPubMed
Stech, E. P., Grierson, A. B., Chen, A. Z., Sharrock, M. J., Mahoney, A. E. J., & Newby, J. M. (2020). Intensive one-week internet-delivered cognitive behavioral therapy for panic disorder and agoraphobia: a pilot study. Internet Interventions, 20, 100315. https://doi.org/https://doi.org/10.1016/j.invent.2020.100315 CrossRefGoogle ScholarPubMed
Twomey, C., O’Reilly, G., Byrne, M., Bury, M., White, A., Kissane, S., McMahon, A., & Clancy, N. (2014). A randomized controlled trial of the computerized CBT programme, MoodGYM, for public mental health service users waiting for interventions. British Journal of Clinical Psychology, 53, 433–450. https://doi.org/10.1111/bjc.12055 CrossRefGoogle ScholarPubMed
Walfish, S., McAlister, B., O’Donnell, P., & Lambert, M. J. (2012). An investigation of self-assessment bias in mental health providers. Psychological Reports, 110, 639–644. https://doi.org/10.2466/02.07.17.PR0.110.2.639-644 CrossRefGoogle ScholarPubMed
Weisz, J. R., Kuppens, S., Eckshtain, D., Ugueto, A. M., Hawley, K. M., & Jensen-Doss, A. (2013). Performance of evidence-based youth psychotherapies compared with usual clinical care: a multilevel meta-analysis. JAMA Psychiatry, 70, 750–761. https://doi.org/10.1001/jamapsychiatry.2013.1176 CrossRefGoogle ScholarPubMed
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