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电子心理健康应用中认知行为疗法的实施:文献综述。

Implementation of Cognitive Behavioral Therapy in e-Mental Health Apps: Literature Review.

机构信息

Institute for Medical Informatics, Bern University of Applied Sciences, Biel, Switzerland.

Suchtfachklinik Zurich, Zurich, Switzerland.

出版信息

J Med Internet Res. 2022 Mar 10;24(3):e27791. doi: 10.2196/27791.


DOI:10.2196/27791
PMID:35266875
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8949700/
Abstract

BACKGROUND: To address the matter of limited resources for treating individuals with mental disorders, e-mental health has gained interest in recent years. More specifically, mobile health (mHealth) apps have been suggested as electronic mental health interventions accompanied by cognitive behavioral therapy (CBT). OBJECTIVE: This study aims to identify the therapeutic aspects of CBT that have been implemented in existing mHealth apps and the technologies used. From these, we aim to derive research gaps that should be addressed in the future. METHODS: Three databases were screened for studies on mHealth apps in the context of mental disorders that implement techniques of CBT: PubMed, IEEE Xplore, and ACM Digital Library. The studies were independently selected by 2 reviewers, who then extracted data from the included studies. Data on CBT techniques and their technical implementation in mHealth apps were synthesized narratively. RESULTS: Of the 530 retrieved citations, 34 (6.4%) studies were included in this review. mHealth apps for CBT exploit two groups of technologies: technologies that implement CBT techniques for cognitive restructuring, behavioral activation, and problem solving (exposure is not yet realized in mHealth apps) and technologies that aim to increase user experience, adherence, and engagement. The synergy of these technologies enables patients to self-manage and self-monitor their mental state and access relevant information on their mental illness, which helps them cope with mental health problems and allows self-treatment. CONCLUSIONS: There are CBT techniques that can be implemented in mHealth apps. Additional research is needed on the efficacy of the mHealth interventions and their side effects, including inequalities because of the digital divide, addictive internet behavior, lack of trust in mHealth, anonymity issues, risks and biases for user groups and social contexts, and ethical implications. Further research is also required to integrate and test psychological theories to improve the impact of mHealth and adherence to the e-mental health interventions.

摘要

背景:为了解决治疗精神障碍患者资源有限的问题,近年来电子心理健康(e-mental health)引起了关注。更具体地说,移动健康(mHealth)应用程序被提议作为伴随认知行为疗法(CBT)的电子心理健康干预措施。

目的:本研究旨在确定现有 mHealth 应用程序中实施的 CBT 的治疗方面以及使用的技术。从中,我们旨在得出未来应解决的研究空白。

方法:从 3 个数据库中筛选了有关实施 CBT 技术的精神障碍 mHealth 应用程序的研究:PubMed、IEEE Xplore 和 ACM Digital Library。这两项研究由 2 位评审员独立选择,然后从纳入的研究中提取数据。对 mHealth 应用程序中的 CBT 技术及其在技术上的实施情况进行了叙述性综合。

结果:从 530 条检索引用中,有 34 项(6.4%)研究纳入本综述。CBT 的 mHealth 应用程序利用了两组技术:用于认知重构、行为激活和解决问题的 CBT 技术(暴露在 mHealth 应用程序中尚未实现)以及旨在提高用户体验、依从性和参与度的技术。这些技术的协同作用使患者能够自我管理和自我监测自己的精神状态,并访问有关其精神疾病的相关信息,这有助于他们应对心理健康问题并进行自我治疗。

结论:有一些 CBT 技术可以在 mHealth 应用程序中实施。需要进一步研究 mHealth 干预措施的疗效及其副作用,包括因数字鸿沟、上网成瘾行为、对 mHealth 的不信任、匿名问题、用户群体和社会环境的风险和偏见以及道德影响而产生的不平等。还需要进一步研究以整合和测试心理理论,以提高 mHealth 的影响和对电子心理健康干预措施的依从性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e169/8949700/ef8f8638c192/jmir_v24i3e27791_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e169/8949700/ef8f8638c192/jmir_v24i3e27791_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e169/8949700/ef8f8638c192/jmir_v24i3e27791_fig1.jpg

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本文引用的文献

[1]
Effectiveness of a stand-alone, smartphone-based virtual reality exposure app to reduce fear of heights in real-life: a randomized trial.

NPJ Digit Med. 2021-2-8

[2]
The effects of mobile apps on stress, anxiety, and depression: overview of systematic reviews.

Int J Technol Assess Health Care. 2020-12-14

[3]
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Psychiatry Res. 2020-6-18

[4]
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Curr Opin Psychol. 2020-12

[5]
How to Evaluate Health Applications with Conversational User Interface?

Stud Health Technol Inform. 2020-6-16

[6]
Technical Metrics Used to Evaluate Health Care Chatbots: Scoping Review.

J Med Internet Res. 2020-6-5

[7]
An mHealth intervention for the treatment of patients with an eating disorder: A multicenter randomized controlled trial.

Int J Eat Disord. 2020-7

[8]
Engagement and Usability of a Cognitive Behavioral Therapy Mobile App Compared With Web-Based Cognitive Behavioral Therapy Among College Students: Randomized Heuristic Trial.

JMIR Hum Factors. 2020-2-3

[9]
Randomized Controlled Trial of a Smartphone Application as an Adjunct to Acceptance and Commitment Therapy for Smoking Cessation.

Behav Ther. 2019-6-12

[10]
Smartphones in mental health: a critical review of background issues, current status and future concerns.

Int J Bipolar Disord. 2020-1-10

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