scholarly journals Digital mental health apps and the therapeutic alliance: initial review

BJPsych Open ◽  
2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Philip Henson ◽  
Hannah Wisniewski ◽  
Chris Hollis ◽  
Matcheri Keshavan ◽  
John Torous
Keyword(s):  
Mental Health ◽  
Therapeutic Alliance ◽  
Technology Use ◽  
Mental Healthcare ◽  
Mental Illnesses ◽  
Therapeutic Interventions ◽  
Smartphone Apps ◽  
Health Apps ◽  
Serious Mental Illnesses ◽  
The Impact

BackgroundAs mental healthcare expands to smartphone apps and other technologies that may offer therapeutic interventions without a therapist involved, it is important to assess the impact of non-traditional therapeutic relationships.AimsTo determine if there were any meaningful data regarding the digital therapeutic alliance in smartphone interventions for serious mental illnesses.MethodA literature search was conducted in four databases (PubMed, PsycINFO, Embase and Web of Science).ResultsThere were five studies that discuss the therapeutic alliance when a mobile application intervention is involved in therapy. However, in none of the studies was the digital therapeutic alliance the primary outcome. The studies looked at different mental health conditions, had different duration of technology use and used different methods for assessing the therapeutic alliance.ConclusionsAssessing and optimising the digital therapeutic alliance holds the potential to make tools such as smartphone apps more effective and improve adherence to their use. However, the heterogeneous nature of the five studies we identified make it challenging to draw conclusions at this time. A measure is required to evaluate the digital therapeutic alliance.

scholarly journals Use and impact of smartphone apps in mental health

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Amerio ◽  
A Scardoni ◽  
L Bellini ◽  
S Salvati ◽  
S Buttigieg ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Clinical Decision Making ◽  
Healthcare Providers ◽  
Experimental Studies ◽  
Clinical Decision ◽  
Future Research ◽  
Smartphone Apps ◽  
Health Apps ◽  
The Impact

Abstract As smartphone usage is more and more ubiquitous, the app market is flourishing in all fields, including health. Indeed, the availability and use of smartphone apps (SAs) in health has exponentially grown in recent years. It has been estimated that in 2018 there were over 97,000 health apps available and that, 15% and 8% of US phone users aged 18-29 and 30-49 years respectively had health apps installed on their mobile devices. Health apps might potentially support people health paths in multiple ways: channeling health education, enabling personal health data tracking, self-monitoring and goals setting, facilitating access to health records or compliance to treatment, fostering effective communication with healthcare providers and health services, as well as supporting clinical decision-making. Despite such large potential, still scant evidence is available on the impact of SAs on clinical outcomes in different fields of medicine, including mental health. With an estimated prevalence of around 450 million people currently suffering from mental disorders and 1 in 4 people in the world affected at some point in own life, mental disorders are a leading cause of ill-health and disability worldwide whose prevention and care might be enhanced by mHealth technology. The general aim of the presentation is to provide an overview on the use and impact of SAs in the field of mental health. Specific objectives are: i) to present a conceptual framework on how SAs might support mental disorders prevention, diagnosis and treatment, ii) to report on SAs use in mental health in different settings, iii) to collect and pool available evidence from observational and experimental studies on the impact of SAs use on different mental health outcomes, iv) to explore the quality, effectiveness and attributes of top-rated smartphone mental health apps and lastly, v) to suggest gaps in knowledge to be filled by future research.

scholarly journals The Digital Therapeutic Alliance and Human-Computer Interaction (Preprint)

2020 ◽  
Author(s):  
Simon D'Alfonso ◽  
Reeva Lederman ◽  
Sandra Bucci ◽  
Katherine Berry
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Human Computer Interaction ◽  
Mental Health Care ◽  
Therapeutic Alliance ◽  
Critical Factor ◽  
Therapeutic Interventions ◽  
Face To Face ◽  
Health Apps ◽  
Computer Interaction

UNSTRUCTURED The therapeutic alliance (TA), the relationship that develops between a therapist and a client/patient, is a critical factor in the outcome of psychological therapy. As mental health care is increasingly adopting digital technologies and offering therapeutic interventions that may not involve human therapists, the notion of a TA in digital mental health care requires exploration. To date, there has been some incipient work on developing measures to assess the conceptualization of a digital TA for mental health apps. However, the few measures that have been proposed have more or less been derivatives of measures from psychology used to assess the TA in traditional face-to-face therapy. This conceptual paper explores one such instrument that has been proposed in the literature, the Mobile Agnew Relationship Measure, and examines it through a human-computer interaction (HCI) lens. Through this process, we show how theories from HCI can play a role in shaping or generating a more suitable, purpose-built measure of the digital therapeutic alliance (DTA), and we contribute suggestions on how HCI methods and knowledge can be used to foster the DTA in mental health apps.

The Oxford Handbook of Digital Technologies and Mental Health

2020 ◽  
Keyword(s):  
Mental Health ◽  
Digital Technology ◽  
Technology Use ◽  
Digital Technologies ◽  
Well Being ◽  
Healthcare Services ◽  
Therapeutic Interventions ◽  
Technological Advances ◽  
Wide Range ◽  
The Impact

This book provides an academically oriented and scientifically based description of how technological advances may have contributed to a wide range of mental health outcomes, covering the spectrum from problems and maladies to improved and expanded healthcare services. Digital technologies covered include internet use (including social networking, shopping, gambling, viewing of pornography, etc.), digital gaming, smartphones, mobile applications, virtual reality, and computer-based therapeutic interventions. Both the positive and negative aspects of these various types of digital technologies are discussed. Further, some chapters include a discussion of future developments in the field. The book has been written by international experts in the applications of digital technology across many countries and quality universities. This book consists of eight sections. The first focuses on digital technology in the general population. The second covers problematic conceptual issues in the impact of technology use. The third discusses potential positive impacts of digital technology. The fourth covers potential negative impacts of digital technologies. The fifth evaluates utilizing digital technologies for assessment and legal considerations. The sixth explores using digital technologies to improve overall well-being. The seventh discusses the use of digital technologies to treat specific disorders, and the eighth presents a discussion on treatments of problematic technology use. The book concludes with a brief summary as well as a discussion of future directions for digital technologies.

scholarly journals Staff and patient perspectives on unmet need and therapeutic alliance in community mental health services

2007 ◽  
Vol 191 (6) ◽  
pp. 543-547 ◽  
Author(s):  
Ulrich M. Junghan ◽  
Morven Leese ◽  
Stefan Priebe ◽  
Mike Slade
Keyword(s):  
Mental Health ◽  
Therapeutic Alliance ◽  
Unmet Need ◽  
Secondary Analysis ◽  
Mental Healthcare ◽  
Community Mental Health Services ◽  
Effective Interventions ◽  
Healthcare It ◽  
The Impact ◽  
Unmet Mental Health

BackgroundTherapeutic alliance between clinicians and their patients is important in community mental healthcare. It is unclear whether providing effective interventions influences therapeutic alliance.AimsTo assess the impact of meeting previously unmet mental health needs on the therapeutic alliance between patients and clinicians.MethodSecondary analysis of data from a longitudinal study assessing 101 patients and paired staff.ResultsPatient-rated unmet need was negatively associated with patient-rated and staff-rated therapeutic alliance. Staff-rated unmet need was positively associated with patient-rated therapeutic alliance only. Reducing patient-rated unmet need increased patient-rated but not staff-rated therapeutic alliance, even when controlling for other variables. Reducing staff-rated unmet need increased staff-rated but not patient-rated therapeutic alliance, but the effect became insignificant when controlling for other variables.ConclusionsPatient-rated therapeutic alliance will be maximised by focusing assessment and interventions on patient-rated rather than staff-rated unmet need.

scholarly journals The Therapeutic Alliance in Digital Mental Health Interventions for Serious Mental Illnesses: Narrative Review (Preprint)

2019 ◽  
Author(s):  
Hailey Tremain ◽  
Carla McEnery ◽  
Kathryn Fletcher ◽  
Greg Murray
Keyword(s):  
Mental Health ◽  
Therapeutic Alliance ◽  
Narrative Review ◽  
Mental Illnesses ◽  
Health Interventions ◽  
Face To Face ◽  
Digital Interventions ◽  
Mental Health Interventions ◽  
Serious Mental Illnesses

BACKGROUND Digital mental health interventions offer unique advantages, and research indicates that these interventions are effective for a range of mental health concerns. Although these interventions are less established for individuals with serious mental illnesses, they demonstrate significant promise. A central consideration in traditional face-to-face therapies is the therapeutic alliance, whereas the nature of a digital therapeutic alliance and its relationship with outcomes requires further attention, particularly for individuals with serious mental illnesses. OBJECTIVE This narrative review aims to encourage further consideration and critical evaluation of the therapeutic alliance in digital mental health, specifically for individuals with serious mental illnesses. METHODS A narrative review was conducted by combining 3 main areas of the literature: the first examining the evidence for digital mental health interventions for serious mental illnesses, the second illuminating the nature and role of the therapeutic alliance in digital interventions, and the third surrounding practical considerations to enhance a digital therapeutic alliance. RESULTS Results indicated that a therapeutic alliance can be cultivated in digital interventions for those with serious mental illnesses, but that it may have unique, yet-to-be-confirmed characteristics in digital contexts. In addition, a therapeutic alliance appears to be less directly associated with outcomes in digital interventions than with those in face-to-face therapies. One possibility is that the digital therapeutic alliance is associated with increased engagement and adherence to digital interventions, through which it appears to influence outcomes. A number of design and implementation considerations may enhance the digital therapeutic alliance, including human support and technological features. CONCLUSIONS More research is required to further understand the nature and specific role of a therapeutic alliance in digital interventions for serious mental illnesses, particularly in informing their design. This review revealed several key research priorities to advance the therapeutic alliance in digital interventions.

scholarly journals The Digital Therapeutic Alliance and Human-Computer Interaction

10.2196/21895 ◽  
2020 ◽  
Vol 7 (12) ◽  
pp. e21895
Author(s):  
Simon D'Alfonso ◽  
Reeva Lederman ◽  
Sandra Bucci ◽  
Katherine Berry
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Human Computer Interaction ◽  
Mental Health Care ◽  
Therapeutic Alliance ◽  
Critical Factor ◽  
Therapeutic Interventions ◽  
Face To Face ◽  
Health Apps ◽  
Computer Interaction

The therapeutic alliance (TA), the relationship that develops between a therapist and a client/patient, is a critical factor in the outcome of psychological therapy. As mental health care is increasingly adopting digital technologies and offering therapeutic interventions that may not involve human therapists, the notion of a TA in digital mental health care requires exploration. To date, there has been some incipient work on developing measures to assess the conceptualization of a digital TA for mental health apps. However, the few measures that have been proposed have more or less been derivatives of measures from psychology used to assess the TA in traditional face-to-face therapy. This conceptual paper explores one such instrument that has been proposed in the literature, the Mobile Agnew Relationship Measure, and examines it through a human-computer interaction (HCI) lens. Through this process, we show how theories from HCI can play a role in shaping or generating a more suitable, purpose-built measure of the digital therapeutic alliance (DTA), and we contribute suggestions on how HCI methods and knowledge can be used to foster the DTA in mental health apps.

scholarly journals The Therapeutic Alliance in Digital Mental Health Interventions for Serious Mental Illnesses: Narrative Review

10.2196/17204 ◽  
2020 ◽  
Vol 7 (8) ◽  
pp. e17204 ◽  
Author(s):  
Hailey Tremain ◽  
Carla McEnery ◽  
Kathryn Fletcher ◽  
Greg Murray
Keyword(s):  
Mental Health ◽  
Therapeutic Alliance ◽  
Narrative Review ◽  
Mental Illnesses ◽  
Health Interventions ◽  
Face To Face ◽  
Digital Interventions ◽  
Mental Health Interventions ◽  
Serious Mental Illnesses

Background Digital mental health interventions offer unique advantages, and research indicates that these interventions are effective for a range of mental health concerns. Although these interventions are less established for individuals with serious mental illnesses, they demonstrate significant promise. A central consideration in traditional face-to-face therapies is the therapeutic alliance, whereas the nature of a digital therapeutic alliance and its relationship with outcomes requires further attention, particularly for individuals with serious mental illnesses. Objective This narrative review aims to encourage further consideration and critical evaluation of the therapeutic alliance in digital mental health, specifically for individuals with serious mental illnesses. Methods A narrative review was conducted by combining 3 main areas of the literature: the first examining the evidence for digital mental health interventions for serious mental illnesses, the second illuminating the nature and role of the therapeutic alliance in digital interventions, and the third surrounding practical considerations to enhance a digital therapeutic alliance. Results Results indicated that a therapeutic alliance can be cultivated in digital interventions for those with serious mental illnesses, but that it may have unique, yet-to-be-confirmed characteristics in digital contexts. In addition, a therapeutic alliance appears to be less directly associated with outcomes in digital interventions than with those in face-to-face therapies. One possibility is that the digital therapeutic alliance is associated with increased engagement and adherence to digital interventions, through which it appears to influence outcomes. A number of design and implementation considerations may enhance the digital therapeutic alliance, including human support and technological features. Conclusions More research is required to further understand the nature and specific role of a therapeutic alliance in digital interventions for serious mental illnesses, particularly in informing their design. This review revealed several key research priorities to advance the therapeutic alliance in digital interventions.

Paxton House: Integrating mental health and diabetes care for people with serious mental illnesses in a residential setting.

2011 ◽  
Vol 34 (4) ◽  
pp. 324-327 ◽  
Author(s):  
Alexandra Teachout ◽  
Susan M. Kaiser ◽  
Sandra M. Wilkniss ◽  
Helen Moore
Keyword(s):  
Mental Health ◽  
Diabetes Care ◽  
Mental Illnesses ◽  
Residential Setting ◽  
Serious Mental Illnesses

Mental health recovery and its correlates: Perspectives from 2 countries (Preprint)

2020 ◽  
Author(s):  
Huiting Xie
Keyword(s):  
Mental Health ◽  
United States ◽  
Self Efficacy ◽  
The United States ◽  
Mental Illnesses ◽  
Health Conditions ◽  
Mental Health Recovery ◽  
Mental Health Conditions ◽  
Serious Mental Illnesses ◽  
Promote Mental Health

BACKGROUND Many people are affected by mental health conditions, yet its prevalence in certain populations are not well documented. OBJECTIVE The aim of this study is to describe the attributes of people with mental health conditions in U.S and SG in terms of: perception of mental health recovery and its correlates such as strengths self-efficacy, resourcefulness and stigma experience. With the findings, not only could the knowledge base for mental health recovery in both countries be enhanced but interventions and policies relating to self-efficacy, resourcefulness and de-stigmatization for mental health recovery could be informed. METHODS A A cross-sectional, descriptive study with convenience sample of 200 community dwelling adults were selected, 100 pax from the United States (U.S) and 100 pax from Singapore (SG). Adults with serious mental illnesses without substance abuse impacting on their recovery were recruited. Participants completed self-administered questionaires measuring their mental health recovery, strengths self-efficacy, resourcefulness and stigma experience. RESULTS This study offered the unique opportunity to examine mental health recovery as well as its correlates such as strengths self-efficacy, resourcefulness and stigma experience from both the United States and Singapore. While the perception of mental health recovery and positive attributes like strengths self-efficacy and resourcefulness remained strong in participants with serious mental illnesses across both countries, people with serious mental illnesses in both countries still experienced negative perception like stigma. The findings would not only inform strategies to promote mental health recovery but also enhance the focus on correlates such as strengths self-efficacy and resourcefulness across both countries. CONCLUSIONS The findings would not only inform strategies to promote mental health recovery but also enhance the focus on correlates such as strengths self-efficacy and resourcefulness across both countries.

scholarly journals A study to examine the uses of personal strength in relation to mental health recovery in adults with serious mental illnesses: a research protocol

2015 ◽  
Vol 3 (2) ◽  
Author(s):  
Huiting Xie ◽  
Peng Yuan ◽  
Song Song Cui ◽  
Melissa Sng Siok Yen
Keyword(s):  
Mental Health ◽  
Self Efficacy ◽  
Community Dwelling ◽  
Mental Illnesses ◽  
Mental Health Recovery ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Personal Strengths ◽  
Mental Health Practices ◽  
Serious Mental Illnesses

This study will explore the relationships among strengths self-efficacy, resourcefulness, stigma experience and mental health recovery in community-dwelling adults with serious mental illnesses. Mental health practices have focued on psychopathphysiology. Stigma heavily plagued clients with mental illnesses and is one of the greatest barriers to mental health recovery. Personal strengths like strengths self-efficacy, people’s confidence in using their personal strengths, and resourcefulness, the ability to carry out daily activities, have been linked to positive mental health. However, the linkage between strengths self-efficacy, resourcefulness and mental health recovery remains uncharted. A cross-sectional, descriptive, mixed methods study will be conducted. A funded study by the Sigma Theta Tau, Upsilon Eta Chapter, August 2013, involving a convenience sample of 100 participants is planned. Included are community dwelling adults between 21 to 65 years old having been diagnosed with serious mental illnesses. Clients with current co-occurring substance abuse will be excluded. Participants complete questionnaires and undergo an interview. Correlations among the study variables will be examined. Regression analysis will determine if recovery can be predicted by strengths self-efficacy, resourcefulness and stigma experience. Interview data will be transcribed and analyzed by thematic analysis. This study will look beyond clients’ disability to focus on their recovery and healing capacities such as strengths self-efficacy and resourcefulness. Findings will expand our knowledge about mental health recovery. Knowledge gained from this study may pave the way for future nursing strategies to aid recovery and inform the development of positive, strengths-based interventions.

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