• Posted by admin

Mobile or mHealth

Although the subject has been debated for decades, it is still unclear whether all psychotherapies are equally efficacious.  Meta-analyses of over 50 studies analyzing seven major types of psychological treatment for mild to moderate adult depression (cognitive behavioral therapy [CBT], nondirective supportive treatment, behavioral activation treatment [BAT], psychodynamic treatment, problem-solving therapy, interpersonal psychotherapy, and social skills training) showed no striking differences, with the exception of interpersonal psychotherapy, that was somewhat more efficacious, and nondirective supportive treatment that was somewhat less efficacious than the others.  Mindfulness-based therapy in which attention is sequentially directed throughout the body, has gained increasing appeal as a modality to reduce stress, anxiety, and depression.

Since 2008, applicable mental health therapies have emerged on the internet via smart phone apps making them available to a wider segment of the population.  The literature on mHealth has grown rapidly over recent years with several controlled trials in the field of anxiety disorders, mood disorders and behavioral medicine. For those conditions in which Internet-delivered therapy has been tested, independent replications have shown large effect sizes. In some studies, Internet-delivered treatment achieved similar outcomes as in face-to-face CBT.

Two studies specifically investigated the use of CBT delivered by mobile application. In one study, investigators asked the question whether a previously validated computerized program remained efficacious when delivered via a mobile application. Participants with major depression were randomly allocated to access the program using a mobile app on either a mobile phone or iPad or a computer, and completed 6 lessons, weekly homework assignments, and received email contact from a clinical psychologist or psychiatrist until completion of the study. The primary outcome measure was a patient health questionnaire. The results showed that both the mobile and computer groups derived equally significant benefits. A second study that allocated subjects to eight weeks of a BAT or mindfulness therapy program administered via a smartphone application had main outcome measures of a depression inventory and patient health questionnaire. The results showed that BAT was more effective than the mindfulness treatment among participants with more severe depression, while mindfulness treatment performed better among participants with less severe pretreatment depression. 

Smartphone applications are encoded in a specific programming language as a mobile web application. The BAT applications make it easy for users to remember and register important behaviors in order to increase everyday activation, and with a database of behaviors divided into three different areas, their usefulness is growing in the armamentarium of available psychological approaches to treatable mental health disorders.