Use of technology in treatment of mental disorders

The use of electronic and communication technologies as a therapeutic aid to healthcare practices is commonly referred to as telemedicine[1] or eHealth.[2][3][4] The use of such technologies as a supplement to mainstream therapies for mental disorders is an emerging mental health treatment field which, it is argued, could improve the accessibility, effectiveness and affordability of mental health care.[5][6] Mental health technologies used by professionals as an adjunct to mainstream clinical practices include email, SMS, virtual reality, computer programs, blogs, social networks, the telephone, video conferencing, computer games, instant messaging and podcasts.[7]

Specific technologies

Traditional methods of helping people with a mental health problem have been to use approaches such as medication, counselling, cognitive behavioral therapy (CBT), exercise and a healthy diet. New technology can also be used in conjunction with traditional methods.

PC devices

TED speaker Jane McGanigall's website Games For Change includes a health category, which presents many mental health games improving and education games. Additionally, her own game, Super Better for PC,[8] IOS[9] and Android[10] is also meant for mental health improvement.

Virtual reality

Rizzo et al.[11] have used virtual reality (VR) (simulated real environments through digital media) to successfully treat post-traumatic stress disorder (PTSD). The VR system offers a sense of realism in a safe environment. By gradually exposing the person to their fear with a Virtual Environment the patient becomes accustomed to the trigger of their problem to an extent that it no longer becomes an issue. This form of treatment has also been applied to other mental health problems such as phobias (where anxiety is triggered by a certain situation). For example, fear of flying or arachnophobia (fear of spiders). Computer games have also been used to provide therapy for adolescents.[12] Many adolescents are reluctant to have therapy and a computer game is a fun, anonymous and accessible way to receive therapeutic advice. An example of a computer game that provides such therapy is SPARX, which has notably been shown to be about as effective as face-to-face therapy in a clinical trial.[13]

Mobile devices

Relatively new technology such as mobile phones have also been used to help people with mental health problems by providing timely information.[5][14] David Haniff produced a computer application that would present media to someone suffering from depression in order to lift their mood[15] and produced a computer game to examine the triggers of depression.[16] For example, pictures of the patient's family or their voice. Another way to lift the mood of patients are subliminal relaxing music on an mpg file to get rid of the noise of everyday living.

As technology improves, it may soon be possible for mobile phones or other devices to sense when sufferers are changing state (e.g. entering a manic or a deeply depressed phase), for instance by noticing a change in voice pattern or usage frequency, or facial tension. It may also become possible to measure physical evidence of levels of distress and suffering, such as changes in hormones or adrenalin in blood, and changes in brain activity. Apps may also be able to predict high stress situations, based on location, time, activity (e.g. purchasing of alcohol) and nearby presence of high risk people. The technology could then send calming messages to sufferers, automatically alert carers and even automatically administer meds.[17]

There are different technologies that are used in the mental health field over the past 30 years. "Mobile devices like cell phones, smartphones, and tablets are giving the public, doctors, and researchers new ways to access help, monitor progress, and increase understanding of mental wellbeing. New technology can also be packaged into an extremely sophisticated app for smartphones or tablets. Such apps might use the device’s built-in sensors to collect information on a user’s typical behavior patterns. If the app detects a change in behavior, it may provide a signal that help is needed before a crisis occurs" (Technology and the Future of Mental Health Treatment, n.d.). This connects to Quan-Haase reading about surveillance. The use of a mobile app that knows people behavior has private information about the people who use it. The people are being watched by the app creator or company. Functional view argues that societies, in order to operate effectively, require some element of security and safety. To achieve these goals, personal information in surveillance are only for a degree, not of kind. “This form of surveillance is harmless since third-party companies are primarily interested in aggregate data and will use this information for the purpose of developing and marketing better products, which will benefit consumers in the long run” (Quan-Haase, 2016, p. 222-223). There are many pros of using mental health app such as it is convenience, lower cost, and 24-hour service.

In May 2013, a website was released by MyPsychTES to connect therapists and counselors with patients who use smartphone applications to track emotions and lifestyle. This streamlines therapist-client communication. The system provides real-time data, automated communication tools, and alerts. Technology can also be used to combat dark thoughts or intrusive thought (unwanted thoughts). To move away from dark thoughts you can provide positive approaches to cognition such as text on a mobile phone with positive affirmations or exercise routines on a mobile phones. Technology companies are developing mobile-based artificial intelligence chatbot applications that use evidence-based techniques, such as cognitive behavioral therapy (CBT), to provide early intervention to support mental health and emotional well-being challenges. Artificial intelligence (AI) text-based conversational applications delivered securely and privately over mobile devices have the ability to scale globally and offer contextual and always-available support. A recent real world data evaluation study,[18] published in the open access journal JMIR mHealth & uHealth, that used an AI-based emotionally intelligent mobile chatbot app, Wysa, identified a significantly higher average improvement in symptoms of depression and a higher proportion of positive in-app experience among the more engaged users of the app as compared to the less engaged users.

Technology and cognitive behavioral therapy

The development of mobile phone apps using cognitive behavioral therapy (CBT) has a increasing research area.[19] Using the idea of cognitive behavioral therapy (CBT) apps, self-rated mental health (SRMH) situations can be implemented into these apps and used as information before seeing a professional. Recent research done with self-rated mental health (SRMH) involves survey research which is conducted by with a question that asks respondents to rate their overall mental or emotional health from poor to excellent.[20] The research found with SRMH showed that 62% of people with a mental health problem rated themselves as having positive mental health. The respondents who rated their mental health as good when compared to those with poor mental health, had 30% lower odds of having a mental health problem at a follow-up. This research showcased that without treatment, people with a mental health problem did better if they perceived their mental health in a positive way by declaring a good overall mental or emotional health.[20]

While studies have investigated the clinical efficacy of remote-, internet- and chatbot-based therapy, there are other factors, such as enjoyment and smoothness, that are important for evaluating therapy sessions. Research published in 2019 reported a comparative study of therapy sessions following the interaction of 10 participants with human therapists versus a chatbot (simulated using a Wizard of Oz protocol), finding evidence to suggest that when compared against a human therapist control, participants find chatbot-provided therapy less useful, less enjoyable, and their conversations less smooth (a key dimension of a positively-regarded therapy session).[21]

References

  1. Wechsler, Lawrence R.; Tsao, Jack W.; Levine, Steven R.; Swain-Eng, Rebecca J.; Adams, Robert J.; Demaerschalk, Bart M.; Hess, David C.; Moro, Elena; Schwamm, Lee H.; Steffensen, Steve; Stern, Barney J.; Zuckerman, Steven J.; Bhattacharya, Pratik; Davis, Larry E.; Yurkiewicz, Ilana R.; Alphonso, Aimee L.; American Academy of Neurology Telemedicine Work Group (12 February 2013). "Teleneurology applications: Report of the Telemedicine Work Group of the American Academy of Neurology". Neurology. 80 (7): 670–676. doi:10.1212/WNL.0b013e3182823361. PMC 3590056. PMID 23400317.
  2. Della Mea, Vincenzo (22 June 2001). "What is e-Health (2): The death of telemedicine?". Journal of Medical Internet Research. 3 (2): e22. doi:10.2196/jmir.3.2.e22. PMC 1761900. PMID 11720964.
  3. Kummervold, Per Egil; Johnsen, Jan-Are K.; Skrøvseth, Stein Olav; Wynn, Rolf (28 September 2012). "Using Noninferiority Tests to Evaluate Telemedicine and E-Health Services: Systematic Review". Journal of Medical Internet Research. 14 (5): e132. doi:10.2196/jmir.2169. PMC 3510769. PMID 23022989.
  4. Nicolas, Luc (September 2012). "EHealth, reseaux de sante et dossier medical electronique: vers une culture de partage et de confiance" [EHealth, health networks and electronic health record: Towards a culture of sharing and trust]. Revue medicale de Bruxelles (in French). 33 (4): 416–419. PMID 23091950.
  5. Marcano-Belisario, José S.; Gupta, Ajay K; O'Donoghue, John; Morrison, Cecily; Car, Josip (2016). "Tablet computers for implementing NICE antenatal mental health guidelines: protocol of a feasibility study". BMJ Open. 6 (1): e009930. doi:10.1136/bmjopen-2015-009930. PMC 4735209. PMID 26801468.
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  7. Anthony, Kate; Nagel, DeeAnna Merz; Goss, Stephen, eds. (2010). The Use of Technology in Mental Health: Applications, Ethics and Practice. Springfield, IL: Charles C. Thomas Publishers. ISBN 978-0-398-07953-6 via Google Books.
  8. "Games Archive - Games For Change". Games For Change.
  9. "SuperBetter". App Store.
  10. "SuperBetter - Apps on Google Play". play.google.com.
  11. Rizzo, A; Pair, J; Graap, K; Manson, B; McNerney, P.J; Wiederhold, B; Wiederhold, M; Spira, B (2006). "A Virtual Reality Exposure Therapy Application for Iraq War Military Personnel with Post Traumatic Stress Disorder: From Training to Toy to Treatment" (PDF). In Roy. M. (ed.). NATO Advanced Research Workshop on Novel Approaches to the Diagnosis and Treatment of Posttraumatic Stress Disorder. Washington, DC: IOS Press. pp. 235–250.
  12. Coyle, David; Matthews, Mark; Sharry, John; Nisbet, Andy; Doherty, Gavin (2005). "Personal Investigator: A Therapeutic 3D Game for Adolescent Psychotherapy". Journal of Interactive Technology & Smart Education. 2 (2): 73–88. CiteSeerX 10.1.1.101.9049. doi:10.1108/17415650580000034.
  13. Merry, Sally N.; Stasiak, Karolina; Shepherd, Matthew; Frampton, Chris; Fleming, Theresa; Lucassen, Mathijs F.G. (19 April 2012). "The effectiveness of SPARX, a computerised self help intervention for adolescents seeking help for depression: randomised controlled non-inferiority trial". BMJ. 344: e2598. doi:10.1136/bmj.e2598. PMC 3330131. PMID 22517917.
  14. Goss, Stephen; Ferns, Joe (2010). "Using Cell/Mobile Phone SMS to Enhance Client Crisis and Peer Support". In Anthony, Kate; Nagel, DeeAnna Merz; Goss, Stephen (eds.). The Use of Technology in Mental Health: Applications, Ethics and Practice. Springfield, IL: Charles C. Thomas Pub Ltd. pp. 56–67. ISBN 978-0-398-07953-6 via Google Books.
  15. Haniff, David (2007). Ramduny-Ellis, Devian; Rachovides, Dorothy (eds.). Mental Health Issues and Pervasive Computing (PDF). BCS-HCI '07 Proceedings of the 21st British HCI Group Annual Conference on People and Computers: HCI...but not as we know it. 2. Swindon: British Computer Society. pp. 171–172. ISBN 978-1-902505-95-4.
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  18. Inkster, B; Sarda, S; Subramanian, V (2018). "An Empathy-Driven, Conversational Artificial Intelligence Agent (Wysa) for Digital Mental Well-Being: Real-World Data Evaluation Mixed-Methods Study". JMIR mHealth uHealth. 6 (11): e12106. doi:10.2196/12106. PMC 6286427. PMID 30470676.
  19. Rathbone, Amy Leigh; Clarry, Laura; Prescott, Julie (28 November 2017). "Assessing the Efficacy of Mobile Health Apps Using the Basic Principles of Cognitive Behavioral Therapy: Systematic Review". Journal of Medical Internet Research. 19 (11): e399. doi:10.2196/jmir.8598. PMC 5727354. PMID 29187342.
  20. McAlpine, Donna D.; McCreedy, Ellen; Alang, Sirry (6 February 2018). "The Meaning and Predictive Value of Self-rated Mental Health among Persons with a Mental Health Problem". Journal of Health and Social Behavior. 59 (2): 200–214. doi:10.1177/0022146518755485. PMID 29406825.
  21. Bell, Samuel; Wood, Clara; Sarkar, Advait (2019). "Perceptions of Chatbots in Therapy". Extended Abstracts of the 2019 CHI Conference on Human Factors in Computing Systems. ACM: LBW1712:1–LBW1712:6. doi:10.1145/3290607.3313072. ISBN 9781450359719. Retrieved 22 August 2019.
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