This continues the discussion of the first meta analysis of smartphone interventions for the treatment of psychological problems, the discoveries that have been made, and the questions that still remain. One area ripe for further scrutiny is the capacity of these smartphone applications to engender real-world consequences in real time. As the authors put it,
[…] future studies must identify and report safety concerns regarding the use of smartphone interventions. The ability of smartphones to immediately register entered mood data, compute if responses exceed a certain threshold, and if so activate emergency response systems, offer real time safety monitoring absent from traditional depression treatment.
A person who is not in real danger could be surprised by the arrival of an ambulance and devastated by the consequent gigantic bill, which could trigger a cascade of events ending in actual harm. There could even be a potential for abuse, where someone desperate to escape an uncomfortable situation (a final exam?) could create confusion equivalent to setting off a fire alarm.
Among the smartphone apps, mindfulness, cognitive behavioral therapy, and mood monitoring are all good. But this is the big news:
Interventions that used entirely “self-contained” apps — meaning the app did not rely on other aspects such as clinician and computer feedback — were found to be significantly more effective than “non-self-contained” apps.
Overall, smartphone-only therapy looks as good as (but not better than) standard psychological approaches, and the combination with anti-depressant medication still seems indicated. There is undoubtedly a need for what the professionals call non-stigmatizing and self-managed avenues of care. In other words, autonomy and privacy are important selling points.
One of the attractions of smartphone-administered therapy, with or without human intervention, is privacy. A person who struggles with psychological malaise does not necessarily want their superiors and co-workers all up in their business. A 9-to-5 employee cannot take time off to drive to an appointment, and may not want to share the fact that they are seeing a therapist. But it might be possible to sit in the car or go up on the roof at lunch break, and check in with the program.
Here is more information from the meta study we have been discussing:
Smartphone interventions which involved “in‐person” (i.e., human) feedback had small, non‐significant effects on depressive symptoms…, whereas those which did not use in‐person feedback had moderate positive effects. The difference between these subgroups was statistically significant…
Additionally, the effects of smartphone interventions which were delivered entirely via the smartphone device […] appeared larger than those which were not self‐contained smartphone‐only interventions.
Your responses and feedback are welcome!
Source: “Smartphone apps can reduce depression,” ScienceDaily.com, 09/22/17
Source: “The efficacy of smartphone-based mental health interventions for depressive symptoms: a meta-analysis of randomized controlled trials,” NIH.gov, October 2017
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