Martínez-García Laura, Belaunzaran Mendizabal Jon, Santos Goñi María Asunción, Miralles Ignacio, Osma Jorge
Department of Psychology and Sociology, University of Zaragoza, Teruel, Spain.
Aragón Health Research Institute, Zaragoza, Spain.
Digit Health. 2025 Apr 29;11:20552076251334442. doi: 10.1177/20552076251334442. eCollection 2025 Jan-Dec.
The Spanish national health system (SNHS) faces significant barriers to psychological care, such as long waiting lists and a lack of human resources. In addition, with emotional disorders being the most prevalent disorders worldwide, and less than half of those affected receiving proper treatment, there is an urgent need for new treatment alternatives for this group of disorders. The Unified Protocol (UP) is presented as a possible solution that has amply demonstrated its efficacy in different formats and contexts. Another promising alternative involves the use of blended formats, combining face-to-face UP sessions with a UP-based application. This manuscript focuses on the description of RegulEm, a UP-based application developed following a participatory design approach. In addition, a case example of receiving UP in a blended format in a specialized mental health unit of the SNHS is presented.
The following components of RegulEm are described: content and exercises of the modules; aesthetics and multimedia-based content; intervention delivery; testimonials section; emotional and motivation assessment; exposure hierarchy for guided in vivo and imaginal exposure; emergency button and Gamification. A case example of a 26-year-old male patient with anxiety and depressive symptoms receiving UP in a blended format in a specialized mental health unit of the SNHS is presented.
The user showed improvements in emotional regulation skills, anxiety, and depressive symptoms over time, though stressors remained. RegulEm allowed independent progress between face-to-face UP sessions, but low internalization of some content emphasized the importance of therapist guidance in face-to-face sessions. User feedback highlighted satisfaction with the intervention but improvement proposals for RegulEm were identified, such as simplifying emotional exposure exercises.
This manuscript describes in detail the first UP-based smartphone application's components and illustrates important implications, such as enabling users to progress at their own pace between sessions and advancing more quickly in the intervention.
西班牙国家卫生系统(SNHS)在心理护理方面面临重大障碍,如等待名单过长和人力资源短缺。此外,情绪障碍是全球最普遍的疾病,而接受适当治疗的患者不到一半,因此迫切需要针对这类疾病的新治疗方案。统一方案(UP)被认为是一种可能的解决方案,它已在不同形式和背景下充分证明了其有效性。另一种有前景的替代方案是采用混合形式,将面对面的UP课程与基于UP的应用程序相结合。本文重点描述了RegulEm,这是一款采用参与式设计方法开发的基于UP的应用程序。此外,还介绍了在SNHS的一个专门心理健康单元中以混合形式接受UP治疗的一个案例。
描述了RegulEm的以下组成部分:模块的内容和练习;美学和基于多媒体的内容;干预交付;推荐部分;情绪和动机评估;用于引导现场和想象暴露的暴露等级;紧急按钮和游戏化。介绍了一名26岁男性患者的案例,该患者有焦虑和抑郁症状,在SNHS的一个专门心理健康单元中以混合形式接受UP治疗。
随着时间的推移,用户在情绪调节技能、焦虑和抑郁症状方面有所改善,尽管压力源仍然存在。RegulEm允许在面对面的UP课程之间独立取得进展,但一些内容的内化程度较低,强调了治疗师在面对面课程中指导的重要性。用户反馈突出了对干预的满意度,但也提出了对RegulEm的改进建议,如简化情绪暴露练习。
本文详细描述了首个基于UP的智能手机应用程序的组成部分,并说明了其重要意义,如使用户能够在课程之间按照自己的节奏取得进展,并在干预中更快地推进。