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The use of wearable and mobile technologies in clinical psychology research and clinical practice
Mobile and wearable technologies including smartphones are among the most acceptable and promising technologies that are used by clinical researchers to study different psychopathological disorders such as schizophrenia. These technologies can not only help in the assessment of the problem but also help the patient and his or her family members in the self-management and treatment of the disorder. These technologies are also suitable for patients and researchers as they often come with impressive computational capabilities and they can be connected to the internet. Increased utilization of mobile technologies in the field of clinical psychology and mental health has resulted in the phenomenal development of new applications to help the researches and patients (Ben-Zeev et al., 2013).
Schizophrenia
One of the most severe and costly psychopathological disorders is schizophrenia. This psychiatric disorder requires long-term management. Medications alone are unable to deal with occupational, social, and cognitive impairments developed in the disorder. It has also been found that most of the patients of schizophrenia don’t take their medications as prescribed to them (Ben-Zeev et al., 2013). If the disorder is not properly managed, it can result in significant level of personal distress as well as impairment resulting in increased chances of anxiety, depression, homelessness, substance use, hospitalization, victimization, and suicide (Ben-Zeev et al., 2014). In these circumstances, mobile technologies can provide significant help in self-management and treatment of the problem of schizophrenia.
Summary of Articles
In a study published in the journal JMIR mhealth and uhealth, Firth & Torous (2015) reported the use of smartphone apps for improving the condition of patients of schizophrenia. They reviewed the published literature and found 5 studies on smartphone apps used for the patients of schizophrenia and other related disorders. Researchers found that smartphones and their applications can provide significant help to the patients of schizophrenia. Schizophrenic patients also showed increased level of willingness to use smartphone apps. They could also use them to check their symptoms; to work on self-directed therapeutic strategies, and to enhance their physical activities. Researchers also reported that the adherence level of patients to the smartphones was greater as compared to the patients of other disorders such as cardiovascular diseases and diabetes. Moreover, no adverse outcomes were reported while using the smartphone apps (Firth & Torous, 2015).
In another study published in the Journal of Dual Diagnosis, researchers worked on the self-stigma that may result in significantly negative impacts on the overall well-being of patients with severe mental-illnesses such as schizophrenia. They found that the individual level of self-stigma may vary with time and factors including external factors such as society and location, and internal factors such as mood and psychiatric symptoms. Researchers used mobile technologies to monitor the levels of self-stigma, activity, psychotic symptoms, positive and negative effects, and immediate physical and social environment of patients of schizophrenia. They found that the current activity of participants of the study varies as a result of self-stigma. However, self-stigma has no effect on immediate location as well as social company. Research also showed that the severity of psychotic symptoms and negative affects increase with increase in the intensity of self-stigmatizing beliefs in schizophrenic patients. Researchers also concluded that mobile technologies can effectively be used in the research on self-stigma and in the delivery of clinical interventions (Ben-Zeev, Frounfelker, Morris, & Corrigan, 2012).
Ben-Zeev et al., (2014) worked on the efficacy, acceptability, and feasibility of a smartphone intervention, FOCUS. This system has been specially designed for the patients with cognitive impairment and psychotic symptoms. It also helps patients in symptom management, medication adherence, mood regulation, and social functioning. Researchers worked on 33 participants having the problem of schizophrenia. Those participants were asked to use FOCUS for one month on their own as they were trained to use the system without any assistance. Most of the participants of the study used FOCUS on their own, while automated prompts also helped the participants in using the system. Nearly 90% of the participants reported the increased level of acceptability and usability. Researchers also performed statistical tests, and found significant decrease in depression, psychotic symptoms, and general psychopathology, after using FOCUS for one month (Ben-Zeev et al., 2014).
In another study, Ben-Zeev and colleagues (2013) worked on the usability of FOCUS for self-management of schizophrenia. They worked with the consumers and practitioners at a rehabilitation agency. The study was conducted in 3 different stages. In the stage 1, more than 900 people with schizophrenia and/or other related disorders were asked to complete a survey reporting their current use of mobile technologies and interest in such technologies. Eight practitioners also completed a survey and reported the needs as well as potential obstacles in such technologies. In stage 2, a multidisciplinary team worked on the input of consumers and practitioners and developed resources for mobile technology for use by such people. In the stage 3, 12 consumers participated in the usability sessions of the newly developed resources. They performed the required tasks according to the new system and provide ratings. Over 60% of the participants reported that they have a mobile device and would like to take part in mobile-technology health services. Practitioners also showed positive response in the use of such services by patients. Researchers reported that through all these feedbacks and reports, they developed a smartphone system (FOCUS) that can help in medication adherence, social functioning, mood regulation, and dealing with symptoms of the disorder. Most importantly, FOCUS can help the patients to self-manage their conditions (Ben-Zeev et al., 2013).
Xu et al., (2016) worked on the use of mobile phone messaging system for improving the care of villagers having schizophrenia in China. Researchers worked with 258 villagers having schizophrenia, and divided them into two groups, i.e. control group and treatment group. Primary outcome of the study was medication adherence, and the secondary outcomes included symptoms of the disorder and level of function. Researchers noted that non-adherence is one of the most important problems in poorer functions of patients. However, this non-adherence can be reduced by using the help of lay health supporters including family members; mobile technologies that could help in sending mobile texts and voice messages; award system to strengthen the support of family members and to motivate patients, and involving the village doctors in increasing the adherence of patients (Xu et al., 2016).
Conclusions and Future Directions
Schizophrenia is one of the most severe psychological problems requiring novel strategies of management because the problem can be worsened without proper management. It becomes often difficult to properly manage the problem as the patient may show decreased adherence to the medication and therapeutic interventions. In this situation, novel strategies such as mobile technologies can be used as they are among the most acceptable technologies by the patients of schizophrenia. They are not only acceptable and feasible in the assessment, management, and treatment of schizophrenia, but they are also efficacious. Psychologists and researchers can use messaging systems and apps such as FOCUS to deal with the problem of schizophrenia. Moreover, the use of mobile technologies can be combined with the help of family members and friends to improve the adherence of patients to medications and to improve their conditions.
Future studies can work on long-term improvements as a result of the use of mobile technologies. Moreover, further studies can be done to improve the acceptability of such technologies. It has also been found that most of the studies on mobile technologies deal with the management of symptoms, so future studies can focus on the treatment interventions using mobile technologies.
Description of mobile technology
The use of mobile technology including the use of smartphones, personal digital assistants (PDAs), and tablets has increased a lot in recent times. This is due to the fact that mobile technologies are among the most acceptable technologies. Moreover, they are available in different price ranges, and people from every class can afford these technologies in one form or the other. They are easily available in almost every part of the world.
Developers are also working on the different forms of applications for these mobile technologies; thereby, making the lives of people easier. With the help of new research-based applications and systems in these mobile technologies, consumers and researchers can work on different conditions. They can also improve their knowledge as, for example, practitioners can increase their knowledge about the condition of their patients through the use of online questionnaires and other applications.
Research shows that the use of smartphone apps by the people having schizophrenic disorder has no adverse effects on their lives (Firth & Torous, 2015). Therefore, this mobile technology and its related apps can safely be used for patients of mental disorders. They can be recommended to the patients, but it is better to use the apps that are specially designed for patients by some healthcare organizations. Moreover, improvements can be made in the use of these technologies as, for example, developers and researchers can work together to develop treatment-oriented apps for patients.
References
Ben-Zeev, D., Brenner, C. J., Begale, M., Duffecy, J., Mohr, D. C., & Mueser, K. T. (2014). Feasibility, acceptability, and preliminary efficacy of a smartphone intervention for schizophrenia. Schizophrenia bulletin, sbu033.
Ben-Zeev, D., Frounfelker, R., Morris, S. B., & Corrigan, P. W. (2012). Predictors of self-stigma in schizophrenia: New insights using mobile technologies. Journal of dual diagnosis, 8(4), 305-314.
Ben-Zeev, D., Kaiser, S. M., Brenner, C. J., Begale, M., Duffecy, J., & Mohr, D. C. (2013). Development and usability testing of FOCUS: A smartphone system for self-management of schizophrenia. Psychiatric rehabilitation journal, 36(4), 289.
Firth, J., & Torous, J. (2015). Smartphone apps for schizophrenia: a systematic review. JMIR mHealth and uHealth, 3(4).
Xu, D. R., Gong, W., Caine, E. D., Xiao, S., Hughes, J. P., Ng, M., . . . Brown, H. S. (2016). Lay health supporters aided by a mobile phone messaging system to improve care of villagers with schizophrenia in Liuyang, China: protocol for a randomised control trial. BMJ Open, 6(1), e010120.
