PSYC 403 Lecture Notes - Lecture 22: Psychoeducation, Physical Therapy, Psychopathology
13 May 2018
School
Department
Course
Professor
Integrating Technology into Treatment
• Uses of technology in treatment
o Psychoeducational or self-help formats
▪ Collection of tools designed to be educational
▪ Presented as lessons, rather than sessions
• Steven Hayes 7 part ACT mini-series
o Digital treatments
▪ Retain structure and components of original treatment
▪ Session times set aside by user for intervention
▪ May have some degree of personalization (based on demographic group
or presenting psychopathology)
• Developments in machine learning will make greater
personalization possible
▪ User may select components of intervention that are most relevant
o Digital assessment
▪ Questionnaires can be automatically scored and interpreted, with
information transmitted to clinician
▪ Can self-monitor thoughts, mood, activities using smart phone
▪ Can track non self-report phenomena, such as sleep, physical activity,
speech, device usage, etc.
o Digital training and dissemination
▪ Clinician training websites with videos and demonstrations
• Can reach people in rural areas
▪ Reach more users and lower costs
▪ Standardizes training provided
• A video can train everyone in the same way
o What dos this research suggest?
▪ Digital interventions are popular and reach a lot of people
• 3/4 million people are popular and reach a lot of people
• but completion rates are low without accompanying support
▪ Online clinics can produce clinically relevant change on a large scale
• In first year of operation, Australian online clinic MindSpot
reached 2000 people, with 70% completing treatment
▪ Supported intervention have a greater impact than unsupported ones
• Differences not always large
▪ With support, outcomes for digital interventions are similar to face-to-
face interventions
• Need larger scale studies to systematically test this
o Future research questions
▪ Does the functionality of the intervention impact its efficacy?
• Every app looks different
▪ How can interventions be tailored to the nature of the psychopathology?
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• Depression and concentration problems
• Need the apps to be engaging so people use them
▪ How do we evaluate the efficacy of digital interventions?
• Field is arguably moving too fast for traditional RCTs
▪ How much support is necessary for improved outcomes?
• Less support= more scalable
o Examples:
▪ MindSpot-> funded by the Australian government
• Online therapy
o Spence et al. 2011
▪ Barriers to treatment: failure to recognize a problem, lack of knowledge
of availability, long waiting lists, lack of trained therapists, high costs,
perceived stigma, time constraints
▪ Computer-based therapies may appeal to adolescents because of the
sense of privacy and confidentiality and their preference for online
communication
▪ Important that parents see online therapy as a viable option given
parents are often the ones initiating treatment
▪ 115 adolescents with a primary anxiety disorder diagnosis and at least on
participating parent
▪ Randomized to clinic-based treatment, internet-based treatment, or
waitlist control
▪ Outcomes:
• Diagnostic status and severity (clinical interview)
• Child global assessment scale (blind assessor)
• Anxiety symptom questionnaire (child and parent report)
• Treatment satisfaction
▪ Online treatment condition: BRAVE for teenagers online
• CBT techniques like recognising physiological anxiety, cognitive
strategies for coping and restricting, graded exposure, problems
solving
• Parent sessions cover techniques and strategies to empower
parents to help adolescents
• Homework is set and reviewed at beginning of next question
• Eye-catching graphics, sounds, games, and quizzes used to
maintain interest
• Adolescent characters used to demonstrate implementation of
skills
▪ CLIN and NET> WLC on clinically significant improvement on anxiety
disorder
▪ CLIN and NET showed change over time in clinician ratings of severity and
global functioning; WLC did not
▪ At 6 and 12 month follow ups
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