Is that a therapist in your pocket?

Soon it will be possible to access a range of mental health therapies, tests and much more from your smartphone, according to an audio segment on National Public Radio (NPR), a nonprofit membership US-based media organization, on May 24.

"Some of the applications include things like attempts to quit smoking, the treatment of anxiety and for picking-up the early warning signs of relapse in people who have psychotic disorders like schizophrenia," explained Mark Boschen, PhD, MAPS, clinical psychologist, researcher and senior lecturer at the School of Psychology, Griffith University in Queensland, Australia to NPR.

Mobile Therapy
Margaret Morris, PhD, a clinical psychologist and senior researcher in Intel's Digital Health Group, is working on a new mood ring-like application, "Mobile Therapy", where you can "drag a little red dot around that screen" with your finger "to indicate ... current mood," plus it will have the capability to measure and track "energy levels, sleep patterns, activities, food eaten," and much more.

Additionally she published research findings in the Journal of Medical Internet Research on April 30 supporting the use of technology to map moods stating, "applications developed for mobile phones hold promise for delivering state-of-the-art psychotherapies in a nonstigmatizing fashion to many people who otherwise would not have access to therapy."

In the same way meditation and yoga applications offer breathing techniques so will "Mobile Therapy" so that you can find therapeutic advice to manage your moods throughout the day.

"The phone app offers therapeutic exercises. These range from breathing visualizations to progressive muscle relaxation," and "everyone who used it described new insights about their emotional variability," added Morris, however the application is still in beta testing.

Mobile Mood Diary
Mark Matthews, PhD, a computer scientist at Trinity College Dublin in Ireland in collaboration with Trinity College professor Gavin Doherty, PhD and child and family psychotherapist at the Mater Hospital Child and Adolescent Mental Health Service, John Sharry, PhD have created two applications "Mobile Mood Diary" and "My Mobile Story".

Mobile Mood Diary is currently under investigation with therapists and young patients in Ireland and Alan Delahunty, BA, MA Reg EAP, a psychologist, and marital/family therapist in Galway had this to say about it, "From a clinical point of view, I've found it a huge improvement over the pen and paper technique," and "his young patients love the app - rarely missing doing their daily homework."

Plus "you get a complete print-out of their mood, their energy level, their sleep patterns, and any comments they've made over the week or two. And then you can put that down on the table in front of you, and use it to discuss the therapy with the young person. I'm getting more comments. And in some cases, it's really like narrative therapy, where you'd be getting a paragraph of text for each day, which brings out a richness in the therapy situation that you can explore then." Delahunty even found the application a practical tool for managing drug interventions.

CBT MobilWork
Cognitive Behavioural Therapy (CBT) will also get a technological push with this new application developed by Judith A. Callan, PhD, RN, research assistant professor in the Health and Community Systems department of University of Pittsburgh School of Nursing, in collaboration with computer scientists at Carnegie Mellon University.

CBT MobilWork is designed to initially to help adults coping with severe depression with hopes of tackling "anxiety, phobias, eating disorders and other mental health programs" down the line.

The application is sort of like a pocket physical trainer where a depressed individual will receive daily assignments that only progress once a task is accomplished and habitual, Callan explained, "say a patient starts therapy and they're really depressed. And they can hardly get out of bed. One of their homework assignments might be to, each day, just make the bed."

Digital messaging watch
Dimitri Perivoliotis, PhD, a post-doctoral fellow and researcher in the psychiatry department of the University of Pennsylvania, is working to find innovative ways to manage and monitor schizophrenia with both handheld computers and even a digital watch that reads "personalized [therapeutic] messages" with stress reduction exercises instead of the time.

Perivoliotis has found the watch effective, "one of our patients came in with chronic, constant auditory hallucinations (i.e.; hearing voices) that really controlled his life. The voices would threaten him that if he would go outside and do fun things, then terrible, catastrophic things would happen to him. He felt really enslaved by them. He felt no sense of control whatsoever."

He also explains how some easy to follow steps can calm all the voices, a common symptom of schizophrenia. "When a patient starts to hear voices, he applies the technique by looking at an object in the room, pointing to it, and naming it aloud. He repeats this until he runs out of things to name (e.g., "phone, computer, book, pen..."). This is known as the "look, point, and name technique."

The watch is used as a reminder to implement the exercise and "it really did the trick" for his patient, "it kind of broke him out of the stream of voices, and his internal preoccupation with them."

--
Not only do these novel innovations give patient back a sense of control through a simple, mostly enjoyable tool, it also helps the therapists immensely and perhaps will save patient time and money in therapy sessions in the long run.

"It's almost like an electronic therapist, in a way, or a therapist in your pocket," said Perivoliotis.

Since these applications are not yet downloadable via iTunes, it might be good to know that your smartphone can still provide on-the-go therapy. A novel study to be published in the June edition of the journal Behavior Therapy claims clinical depression can be treated"nearly as effectively" by phone as face-to-face.

"Offering a phone or webcam option for psychotherapy does appear warranted from an efficacy point of view. It's more user-friendly - no commutes, more flexibility of place and time - and has no side effects," added Diane Spangler, a psychology professor and a co-author on the study at Brigham Young University in the US state of Utah.

The good news is therapy could become more affordable and user-friendly with flexible schedules and shorter sessions. Perhaps it will also help those that just won't step into a psychotherapist's office and help erode stigmas.

Full study, "Mobile Therapy: Case Study Evaluations of a Cell Phone Application for Emotional Self-Awareness": http://www.jmir.org/2010/2/e10
Full Study, "Evaluating the Effectiveness of Cognitive-Behavioral Teletherapy in Depressed Adults": http://bit.ly/aQGKtW

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