Leijse Merel M L, van Dam Levi, Jambroes Tijs, Timmerman Amber, Popma Arne
Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, Netherlands.
JMIR Form Res. 2024 Dec 30;8:e53613. doi: 10.2196/53613.
Delinquent behavior in adolescence is a prevalent issue, often associated with difficulties across multiple life domains, which in turn perpetuates negative life outcomes. While current treatment programs show partial success in improving behavioral changes and reducing recidivism, comprehensive conclusions regarding the overall efficacy of these interventions have yet to be established. In forensic outpatient settings, the discrepancy between adolescents' limited emotional awareness and the predominant emphasis on cognitive reflection, combined with low treatment adherence, may be factors that undermine treatment efficacy. New technologies, such as smartphone apps, may offer a solution by integrating real-life data into treatment to improve emotional and behavioral patterns. The low-threshold use of smartphone data can be useful in addressing these treatment challenges.
This study aimed to explore the feasibility and usability of Feelee (Garage2020), a smartphone app that integrates active emoji and passive behavioral data, as a potential addition to treatment for adolescents in a forensic outpatient setting.
We conducted a prepilot study with adolescents (n=4) who used the Feelee app over a 2-week period. App usage included completing a brief emoji survey 3 times a day (active data) and allowing Feelee to track the call logs, Bluetooth devices in proximity, cell tower IDs, app usage, and phone status (passive data). During treatment sessions, both adolescents and clinicians reviewed and discussed the active and passive data. Semistructured interviews were conducted with adolescents and clinicians (n=7) to gather experiences and feedback on the feasibility and usability of incorporating smartphone data into treatment.
The study showed that adolescents (n=3) succeeded in using Feelee for the full 2 weeks, and data were available for discussion in at least 1 session per participant. Both adolescents and clinicians (n=7) stated that Feelee was valuable for viewing, discussing, and gaining insight into their emotions, which facilitated targeted actions based on the Feelee data. However, neither adolescents nor clinicians reported increased engagement in treatment as a result of using Feelee. Despite technical issues, overall feedback on the Feelee app, in addition to treatment, was positive (n=7). However, further improvements are needed to address the high battery consumption and the inaccuracies in the accelerometer.
This qualitative study provides an in-depth understanding of the potential benefits of integrating active and passive smartphone data for adolescents in a forensic outpatient setting. Feelee appears to contribute to a better understanding of emotions and behaviors, suggesting its potential value in enhancing emotional awareness in treatment. Further research is needed to assess Feelee's clinical effectiveness and explore how it enhances emotional awareness. Recommendations from adolescents and clinicians emphasize the need for prepilot studies to address user issues, guiding technical improvements and future research in forensic outpatient settings.
青少年的不良行为是一个普遍存在的问题，常常与多个生活领域的困难相关联，进而导致负面的生活结果持续存在。虽然目前的治疗方案在改善行为变化和降低再犯率方面取得了部分成功，但关于这些干预措施整体效果的全面结论尚未确立。在法医门诊环境中，青少年有限的情绪意识与主要强调认知反思之间的差异，再加上治疗依从性低，可能是削弱治疗效果的因素。诸如智能手机应用程序等新技术，或许可以通过将现实生活数据整合到治疗中以改善情绪和行为模式来提供解决方案。智能手机数据的低门槛使用在应对这些治疗挑战方面可能会有所帮助。
本研究旨在探索Feelee（Garage2020）这款整合了主动表情符号和被动行为数据的智能手机应用程序作为法医门诊环境中青少年治疗潜在补充手段的可行性和可用性。
我们对4名青少年进行了一项预试验研究，他们在两周时间内使用Feelee应用程序。应用程序的使用包括每天进行3次简短的表情符号调查（主动数据），并允许Feelee跟踪通话记录、附近的蓝牙设备、信号塔ID、应用程序使用情况和手机状态（被动数据）。在治疗过程中，青少年和临床医生都对主动和被动数据进行了回顾和讨论。对青少年和临床医生（共7人）进行了半结构化访谈，以收集关于将智能手机数据纳入治疗的可行性和可用性的经验和反馈。
研究表明，3名青少年成功使用Feelee达两周时间，且每位参与者至少有1次治疗 session 可用于讨论数据。青少年和临床医生（共7人）均表示，Feelee对于查看、讨论和深入了解他们的情绪很有价值，这有助于根据Feelee数据采取有针对性的行动。然而，青少年和临床医生均未报告因使用Feelee而增加了对治疗的参与度。尽管存在技术问题，但除治疗外，对Feelee应用程序的总体反馈是积极的（共7人）。不过，需要进一步改进以解决高电池消耗和加速度计不准确的问题。
这项定性研究深入了解了在法医门诊环境中为青少年整合主动和被动智能手机数据的潜在益处。Feelee似乎有助于更好地理解情绪和行为，表明其在提高治疗中的情绪意识方面具有潜在价值。需要进一步研究以评估Feelee 的临床效果，并探索其如何增强情绪意识。青少年和临床医生的建议强调需要进行预试验研究以解决用户问题，为法医门诊环境中的技术改进和未来研究提供指导。
