Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA.
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA.
J Affect Disord. 2021 Feb 15;281:438-446. doi: 10.1016/j.jad.2020.12.012. Epub 2020 Dec 8.
Integrating psychosocial interventions with mobile apps may increase treatment engagement among adolescents. We examined the user experience, uptake, and clinical effects of a mobile-enhanced family-focused therapy (FFT) among adolescents at risk for mood disorders.
We created a mobile app containing 12 lesson plans corresponding to content of weekly FFT sessions, with modules concerning mood management, family communication and problem-solving. We pilot tested the app in an open trial of FFT (12 sessions in 18 weeks) for adolescents who had active depressive or hypomanic symptoms, a parent with mood disorder, and at least one parent who expressed high levels of criticism. Teens and parents made daily and weekly ratings of youths' moods, amount of parent/offspring criticism, and practice of FFT psychoeducational, communication or problem-solving skills. Independent evaluators interviewed adolescents at baseline and every 9 weeks over 27 weeks to measure symptom trajectories.
Participants were adolescents (n=22; mean age 15.4 ± 1.8 years; 45.5% female) and their 34 parents. Completion of requested app assessment and skill practices averaged 46%-65% among adolescents and parents over 18 weeks of treatment. Adolescents showed significant improvement in clinician-rated depression scores over 27 weeks (Cohen's d=1.58, 95% CI, 0.83 to 2.32) and reported reductions in the amount of perceived criticism expressed by parents.
The uncontrolled design limits inferences about whether the mobile app augmented the effects of FFT on moods or family relationships.
Mobile applications may enhance users' responses to family therapy and provide clinicians with information regarding clinical status. Clinicaltrials.gov NCT03913013.
将心理社会干预与移动应用程序相结合可能会提高青少年的治疗参与度。我们研究了一种针对情绪障碍高危青少年的增强型家庭焦点治疗（FFT）移动应用程序的用户体验、采用率和临床效果。
我们创建了一个移动应用程序，其中包含 12 个与每周 FFT 课程内容相对应的课程计划，模块涉及情绪管理、家庭沟通和解决问题。我们在一项针对有活跃抑郁或轻躁狂症状、有情绪障碍父母和至少一位表达高度批评的父母的青少年的 FFT （18 周内 12 个疗程）的开放试验中对该应用程序进行了试点测试。青少年和父母每天和每周对青少年的情绪、父母/子女批评的数量以及 FFT 心理教育、沟通或解决问题技能的实践进行评分。独立评估者在 27 周内每隔 9 周对青少年进行基线和访谈，以衡量症状轨迹。
参与者为青少年（n=22；平均年龄 15.4 ± 1.8 岁；45.5%为女性）及其 34 位父母。在 18 周的治疗过程中，青少年和父母完成了请求的应用程序评估和技能练习，平均比例为 46%-65%。在 27 周的时间里，青少年的临床医生评定抑郁评分显著改善（Cohen's d=1.58，95%CI，0.83 至 2.32），并报告父母表达的感知批评减少。
非对照设计限制了对移动应用程序是否增强了 FFT 对情绪或家庭关系的影响的推断。
移动应用程序可能会增强用户对家庭治疗的反应，并为临床医生提供有关临床状况的信息。Clinicaltrials.gov NCT03913013。
