Morris Margaret E, Kathawala Qusai, Leen Todd K, Gorenstein Ethan E, Guilak Farzin, Labhard Michael, Deleeuw William
Digital Health Group, Intel Corporation, Beaverton, OR, USA.
J Med Internet Res. 2010 Apr 30;12(2):e10. doi: 10.2196/jmir.1371.
Emotional awareness and self-regulation are important skills for improving mental health and reducing the risk of cardiovascular disease. Cognitive behavioral therapy can teach these skills but is not widely available.
This exploratory study examined the potential of mobile phone technologies to broaden access to cognitive behavioral therapy techniques and to provide in-the-moment support.
We developed a mobile phone application with touch screen scales for mood reporting and therapeutic exercises for cognitive reappraisal (ie, examination of maladaptive interpretations) and physical relaxation. The application was deployed in a one-month field study with eight individuals who had reported significant stress during an employee health assessment. Participants were prompted via their mobile phones to report their moods several times a day on a Mood Map-a translation of the circumplex model of emotion-and a series of single-dimension mood scales. Using the prototype, participants could also activate mobile therapies as needed. During weekly open-ended interviews, participants discussed their use of the device and responded to longitudinal views of their data. Analyses included a thematic review of interview narratives, assessment of mood changes over the course of the study and the diurnal cycle, and interrogation of this mobile data based on stressful incidents reported in interviews.
Five case studies illustrate participants' use of the mobile phone application to increase self-awareness and to cope with stress. One example is a participant who had been coping with longstanding marital conflict. After reflecting on his mood data, particularly a drop in energy each evening, the participant began practicing relaxation therapies on the phone before entering his house, applying cognitive reappraisal techniques to cope with stressful family interactions, and talking more openly with his wife. His mean anger, anxiety and sadness ratings all were lower in the second half of the field study than in the first (P </= .01 for all three scales). Similar changes were observed among other participants as they used the application to negotiate bureaucratic frustrations, work tensions and personal relationships. Participants appeared to understand the mood scales developed for this experience sampling application and responded to them in a way that was generally consistent with self-reflection in weekly interviews. Interview accounts of mood changes, associated with diurnal cycles, personal improvement over the course of the study, and stressful episodes, could be seen in the experience sampling data. Discrepancies between interview and experience-sampling data highlighted the ways that individuals responded to the two forms of inquiry and how they calibrated mood ratings over the course of the study.
Participants quickly grasped the Mood Mapping and therapeutic concepts, and applied them creatively in order to help themselves and empathize with others. 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.
情绪觉察和自我调节是改善心理健康及降低心血管疾病风险的重要技能。认知行为疗法能够传授这些技能，但尚未广泛普及。
本探索性研究考察了手机技术在扩大认知行为疗法技术获取途径及提供即时支持方面的潜力。
我们开发了一款手机应用程序，配备用于情绪报告的触摸屏量表以及用于认知重新评估（即审视适应不良的解读方式）和身体放松的治疗练习。该应用程序在一项为期一个月的实地研究中进行部署，研究对象为八名在员工健康评估中报告有显著压力的个体。通过手机提示参与者每天多次在情绪地图（情绪环形模型的一种转化形式）和一系列单维度情绪量表上报告他们的情绪。借助该原型，参与者还可根据需要激活手机治疗功能。在每周的开放式访谈中，参与者讨论他们对该设备的使用情况，并对其数据的纵向视图做出回应。分析包括对访谈叙述的主题回顾、对研究过程及昼夜周期中情绪变化的评估，以及基于访谈中报告的压力事件对这些手机数据进行探究。
五个案例研究展示了参与者如何使用手机应用程序来提高自我意识并应对压力。一个例子是一名一直在应对长期婚姻冲突的参与者。在反思了他的情绪数据，尤其是每晚精力下降的情况后，该参与者开始在回家前通过手机练习放松疗法，运用认知重新评估技巧来应对紧张的家庭互动，并更坦诚地与妻子交流。在实地研究的后半段，他的愤怒、焦虑和悲伤平均评分均低于前半段（所有三个量表的P值均≤0.01）。在其他参与者使用该应用程序来应对官僚机构带来的挫折、工作压力和人际关系问题时，也观察到了类似的变化。参与者似乎理解了为这种经验抽样应用程序开发的情绪量表，并以一种与每周访谈中的自我反思基本一致的方式对其做出反应。在经验抽样数据中可以看到与昼夜周期、研究过程中的个人改善以及压力事件相关的情绪变化的访谈记录。访谈数据与经验抽样数据之间的差异突出了个体对这两种询问形式的反应方式，以及他们在研究过程中如何校准情绪评分。
参与者迅速掌握了情绪映射和治疗概念，并创造性地应用它们来帮助自己以及理解他人。为手机开发的应用程序有望以一种不会让人感到羞耻的方式，为许多原本无法获得治疗的人提供先进的心理治疗。
