Easton Katherine, Kellett Stephen, Cooper Martin, Millings Abigail, Varela Jo, Parry Glenys
School of Education, University of Sheffield, Sheffield, United Kingdom.
Sheffield Health & Social Care NHS Foundation Trust, University of Sheffield, Sheffield, United Kingdom.
JMIR Ment Health. 2021 Feb 1;8(2):e20213. doi: 10.2196/20213.
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.
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.
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.
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.
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.
由于意识缺陷，患者在充分利用心理治疗方面可能会遇到困难，而支持意识提升的数字技术备受青睐。目前，当患者参与认知分析疗法（CAT）时，支持关系意识工作的技术包括完成纸质工作表作为疗程间的任务。
我们旨在与治疗师和患者共同设计一款数字移动应用程序原型。通过提供一种不引人注意的方式来练习关系意识，并对进展情况提供动态反馈，以帮助患者更好地参与CAT治疗模式的“识别”阶段。
对CAT治疗师（n = 50）进行了一项全国性在线调查，以确定在临床实践中采用移动应用程序的准备情况，并确定核心内容、功能以及采用的潜在障碍。基于数据和现有的纸质工作表构建了一个移动应用程序原型。对该原型系统进行了初步的面对面用户测试，测试对象为三名治疗师和三名CAT康复患者。
在接受调查的治疗师中，72%（36/50）报告目前在CAT治疗期间未使用任何数字工具。然而，移动应用程序对支持患者意识的潜在价值得到了广泛认可。治疗师关注的领域包括数据安全、数据治理和获取平等性。这些担忧在随后CAT治疗师的用户测试中也有所体现。康复患者对应用程序的设计、功能和可用性提出了更多用户规格要求。将两方面的结果整合起来，为应用程序的迭代产生了五个关键变化。
以用户为中心的设计过程使得能够开发出一款原型CAT应用程序，以增强CAT的关系意识工作。这意味着患者现在可以以一种更加不引人注意的方式练习关系意识，并获得关于进展的持续动态反馈。在临床实践中测试这项技术创新的可接受性和可行性是研究过程的下一阶段，该阶段已经完成并已提交相关成果。如果发现CAT应用程序是可接受的且具有临床效果，那么必须应对数据保护和治理方面的重要挑战，以确保其实施和采用。
