Introduction to the Special Series: Applying New Technologies to Extend the Scope and Accessibility of Mental Health Care

doi:10.1016/j.cbpra.2015.04.002

Cognitive and Behavioral Practice

Volume 22, Issue 3, August 2015, Pages 253-257

https://doi.org/10.1016/j.cbpra.2015.04.002 Get rights and content

Highlights

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Reviews the current barriers to mental health care.
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Addresses the appropriate, safe, and secure application of technology to mental health care.
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Presents recent efforts illustrating the potential of and challenges associated with incorporating technologies into mental health care.

Abstract

Rapidly developing and affordable information and communication technologies, broadening Internet availability, and increasingly sophisticated capacities for live home-based and mobile broadcasting have transformed how we communicate, work, and learn. The growing potential for technological innovations to transform the scope of psychological interventions and extend the accessibility of evidence-based mental health care for traditionally underserved individuals holds enormous promise. New technologies also offer exciting opportunities to broaden the reach of treatment dissemination efforts to previously unimaginable capacities. As the incorporation of new technologies into clinical practice and training efforts becomes increasingly routine, a new set of ethical, legal, and risk management issues must be carefully considered and as a field we must be cautious against technological innovations and opportunities advancing at a pace more rapid than the development of appropriate consensus guidelines and relevant regulatory standards. This special series (a) addresses key matters of consideration regarding the appropriate, safe, and secure application of technology into mental health care from leading experts in the emerging field of behavioral telehealth, and (b) presents recent efforts that illustrate the promise, potential, and challenges associated with the incorporation of new technologies into mental health care.

Section snippets

Technological Innovations May Help Overcome Traditional Barriers to Care

Contributing Articles in This Series

There are three sections in this special series on technology and mental health care. The first section provides guiding overviews and thorough considerations of key areas in the emerging field of behavioral telehealth. First, Kramer, Kinn, and Mishkind (2015-this issue) address the legal, regulatory, and risk management issues that are central to the use of technology to remotely deliver mental health care. Second, Nelson and Duncan (2015-this issue) address the use of real-time

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Citation Excerpt :
Traditional EBPIs are greatly limited due to implementation cost (Eiraldi, Wolk, Locke, & Beidas, 2015), time burden, and lack of administrative support (Langley, Nadeem, Kataoka, Stein, & Jaycox, 2010). Digital mental health innovations have the potential to transform EBPIs in ways that increase accessibility, engagement, and scalability, especially for traditionally underserved individuals (Comer, 2015). Previous digital adolescent depression treatments have included a range of options including multi-modal (e.g., videos, online workbooks and modules, animations) self- and therapist-guided computer-based cognitive behavioral therapy (CBT), video game based EBPI learning, and self-guided smartphone applications or text-based therapy (see Grist, Croker, Denne, & Stallard, 2019 and Hollis et al., 2017 for reviews).
Adolescent depression is common; however, over 60% of depressed adolescents do not receive mental health care. Digitally-delivered evidence-based psychosocial interventions (EBPIs) may provide an opportunity to improve access and engagement in mental health care. We present a case study that reviews lessons learned from using the Discover - Design - Build - Test (DDBT) model to create, develop, and evaluate a high-fidelity prototype of an app to deliver an EBPI for depression, behavioral activation (BA), on an Asynchronous Remote Communities (ARC) platform (referred to as ActivaTeen). We review work at each stage of the DDBT framework, including initial formative work, iterative design and development work, and an initial feasibility study. We engaged teens with depression, mental health clinicians, and expert evaluators through the process. We found that the DDBT model supported the research team in understanding the requirements for our prototype system, ActivaTeen, and conceiving of and developing specific ideas for implementation. Our work contributes a case study of how the DDBT framework can be applied to adapting an EBPI to a new, scalable and digital format. We provide lessons learned from engaging teens and clinicians with an asynchronous approach to EBPIs and human centered design considerations for teen mental health.
The adoption, diffusion & categorical ambiguity trifecta of social robots in e-health – Insights from healthcare professionals
2021, Futures
Citation Excerpt :
Past research showed that social robots improve psychological and physiological well-being and enhanced quality of life (Costescu, Vanderborght, & David, 2014). Other streams on robotics research focused on the technical implementation and technology development (e.g., Comer, 2015; Dahl & Boulos, 2014). There has been little discussion of product and categorical issues that might be equally important for robots' success.
Social robots are artificial agents communicating in a human-like way. These assistive technologies are surging particularly to address personal healthcare shortages while allowing aging people to stay in their homes. Social robots belong to a rapidly changing AI industry. Such innovation may adopt different diffusion and adoption processes due to the categorical ambiguity of these products; their features vary from those typical of an object (i.e., delivering food) to those typical of a human being (i.e., speaking with and answering to patients). Social robots combine product, service, and software elements, making them hybrid products categorized into alternative categories, fluctuating users’ attitudes towards these products. The paper draws on prior research on social robots, categorization, and innovation adoption and diffusion. The aim is to explore healthcare professionals’ perception of social robots’ adoption and diffusion, allowing us to understand how they view and handle their categorical ambiguity feature. Using the Delphi technique targeting experts with extensive knowledge of social robots and e-health practice, the results emphasize that even if the ambiguous nature of social robots may represent a barrier to their adoption, their categorical ambiguity is an opportunity to create interactive experiences that ultimately increase their acceptance and diffusion.
When children and adolescents do not go to school: Terminology, technology, and trends
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This chapter addresses the many challenging issues faced by children who struggle to attend school. First, we review history and terminology and discuss the longstanding difficulty of accurately classifying and understanding these children and families. We then summarize Christopher Kearney and his colleagues’ important school refusal framework that uses functional analysis as the key organizing rubric to understand what causes and maintains school refusal behavior. Finally, we use this framework to integrate and explore recent trends in digital technology that both provide resources and challenges as children have more opportunity to connect to educational activities but also be distracted from them. Throughout the chapter, we examine the complexities so often experienced when assessing and intervening with children and families who refuse school by using a challenging case example to illustrate key concepts.
Working From Home: An Initial Pilot Examination of Videoconferencing-Based Cognitive Behavioral Therapy for Anxious Youth Delivered to the Home Setting
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Citation Excerpt :
Large numbers of families have no way to get to a mental health facility or report that mental health care is simply too far away, and high rates of stigma-related beliefs about attending a mental health clinic can also interfere with treatment seeking (Owens et al., 2002). Technology-assisted treatment methods hold promise for enhancing treatment and extending access to services (Chou et al., 2016; Comer, 2016; Comer & Barlow, 2014; Doss et al., 2017; Jones, 2014; Kazdin & Blase, 2011; Kendall et al., 2011; Myers & Comer, 2016). In addition to behavioral intervention technologies (BITs) that do not involve real-time interaction with a therapist (e.g., Khanna & Kendall, 2010; Morgan et al., 2017), telemental health (TMH) approaches using videoconferencing to hold real-time, remote treatment with a live therapist have shown increasing support for a range of child problems (Comer et al., 2017a, 2017b; Doss et al., 2017; Sibley, Comer, & Gonzalez, 2017; Vigerland et al., 2017).
Progress in evidence-based treatments for child anxiety has been hampered by limited accessibility of quality care. This study utilized a multiple baseline design to evaluate the pilot feasibility, acceptability, and preliminary efficacy of real-time, Internet-delivered, family-based cognitive-behavioral therapy for child anxiety delivered to the home setting via videoconferencing. Participants included 13 anxious youth (mean age = 9.85) with a primary/co-primary anxiety disorder diagnosis. Eleven participants (84.6%) completed treatment and all study procedures. Consistent with hypotheses, the intervention was feasible and acceptable to families (i.e., high treatment retention, high client satisfaction, strong therapeutic alliance, and low barriers to participation). Moreover, the novel videoconferencing treatment format showed preliminary efficacy: 76.9% of the intention-to-treat (ITT) sample and 90.9% of treatment completers were treatment responders (i.e., Clinical Global Impressions-Improvement Scale = 1 or 2 at posttreatment), and 69.2% of the ITT sample and 81.8% of treatment completers were diagnostic responders (as per the Anxiety Disorders Interview for Children). Gains were largely maintained at 3-month follow-up evaluation. Outcome patterns within and across subjects are discussed, as well as limitations and the need for further controlled evaluations. With continued support, videoconferencing treatment formats may serve to meaningfully broaden the reach of quality care for youth anxiety disorders.

View all citing articles on Scopus

^☆: Funding for this work was provided by NIH (K23 MH090247) and by the Charles H. Hood Foundation.

View full text

SPECIAL SERIES Technology and Mental HealthIntroduction to the Special Series: Applying New Technologies to Extend the Scope and Accessibility of Mental Health Care☆

Highlights

Abstract

Section snippets

Technological Innovations May Help Overcome Traditional Barriers to Care

Contributing Articles in This Series

Journal of the American Academy of Child and Adolescent Psychiatry

Journal of Psychiatric Research

Biological Psychiatry

Cognitive and Behavioral Practice

Cognitive and Behavioral Practice

Journal of the American Academy of Child and Adolescent Psychiatry

Cognitive and Behavioral Practice

Cognitive and Behavioral Practice

Cognitive and Behavioral Practice

Cognitive and Behavioral Practice

Cognitive and Behavioral Practice

Cognitive and Behavioral Practice

Cognitive and Behavioral Practice

The occasional case against broad dissemination and implementation: Retaining a role for specialty care in the delivery of psychological treatments

American Psychologist

Health-related quality of life across the anxiety disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)

Journal of Clinical Psychiatry

New methods of service delivery for children’s mental health care

Internet-delivered, family-based treatment for early-onset OCD: A preliminary case series

Journal of Clinical Child and Adolescent Psychology

SPECIAL SERIES Technology and Mental Health
Introduction to the Special Series: Applying New Technologies to Extend the Scope and Accessibility of Mental Health Care☆