Evaluation of a Mobile App to Enhance Relational Awareness and Change During Cognitive Analytic Therapy: Mixed Methods Case Series

Digital Health Interventions: New opportunities for health science librarians

This article acquaints health science librarians with digital health interventions (DHIs) and suggests ways they can become involved with initiatives in their own organisations. Examples of DHIs are provided and the risks and benefits of these applications are examined, including increasing accuracy of diagnosis & treatment, and health care efficiencies within legal and ethical frameworks. The WHO Guideline on digital interventions for health system strengthening is a useful resource which highlights ways that countries can use digital health technology to improve people's health and essential services. JM proposes the creation of a road map to assist health science librarians in becoming involved in digital health, providing practical suggestions to inform the development of action plans within your local service provision. J.M.

Blending Cognitive Analytic Therapy With a Digital Support Tool: Mixed Methods Study Involving a User-Centered Design of a Prototype App

BACKGROUND

Patients can struggle to make good use of psychotherapy owing to deficits in awareness, and digital technologies that support awareness are at a premium. Currently, when patients participate in cognitive analytic therapy (CAT), the technology supporting relational awareness work involves completion of paper-based worksheets as between-session tasks.

OBJECTIVE

We aimed to design, with therapists and patients, a prototype digital mobile app. This was to help patients better engage in the "recognition" phase of the CAT treatment model by providing an unobtrusive means for practicing relational awareness with dynamic feedback on progress.

METHODS

A national online survey was conducted with CAT therapists (n=50) to determine readiness for adoption of a mobile app in clinical practice and to identify core content, functionality, and potential barriers to adoption. A prototype mobile app based on data and existing paper-based worksheets was built. Initial face-to-face user testing of the prototype system was completed with three therapists and three CAT expatients.

RESULTS

Among the therapists surveyed, 72% (36/50) reported not currently using any digital tools during CAT. However, the potential value of a mobile app to support patient awareness was widely endorsed. Areas of therapist concern were data security, data governance, and equality of access. These concerns were mirrored during subsequent user testing by CAT therapists. Expatients generated additional user specifications on the design, functionality, and usability of the app. Results from both streams were integrated to produce five key changes for the reiteration of the app.

CONCLUSIONS

The user-centered design process has enabled a prototype CAT-App to be developed to enhance the relational awareness work of CAT. This means that patients can now practice relational awareness in a much more unobtrusive manner and with ongoing dynamic feedback of progress. Testing the acceptability and feasibility of this technological innovation in clinical practice is the next stage in the research process, which has since been conducted and has been submitted. The important challenges of data protection and governance must be navigated in order to ensure implementation and adoption if the CAT-App is found to be acceptable and clinically effective.