Adding an App-Based Intervention to the Cognitive Behavioral Analysis System of Psychotherapy in Routine Outpatient Psychotherapy Treatment: Proof-of-Concept Study.
Cognitive Behavioral Analysis System of Psychotherapy
blended therapy
eHealth
internet and mobile-based Interventions
mobile phone
persistent depressive disorder
routine clinical care
Journal
JMIR formative research
ISSN: 2561-326X
Titre abrégé: JMIR Form Res
Pays: Canada
ID NLM: 101726394
Informations de publication
Date de publication:
09 Aug 2022
09 Aug 2022
Historique:
received:
08
12
2021
accepted:
03
02
2022
revised:
03
02
2022
entrez:
9
8
2022
pubmed:
10
8
2022
medline:
10
8
2022
Statut:
epublish
Résumé
The Cognitive Behavioral Analysis System of Psychotherapy (CBASP) is an empirically supported psychotherapeutic treatment developed specifically for persistent depressive disorder. However, given the high rates of nonresponse and relapse, there is a need for optimization. Studies suggest that outcomes can be improved by increasing the treatment dose via, for example, the continuous web-based application of therapy strategies between sessions. The strong emphasis in CBASP on the therapeutic relationship, combined with limited therapeutic availabilities, encourages the addition of web-based interventions to face-to-face therapy in terms of blended therapy. The aim of this study was to test an app-based intervention called CBASPath, which was designed to be used as a blended therapy tool. CBASPath offers 8 sequential modules with app-based exercises to facilitate additional engagement with the therapy content and a separate exercise to conduct situational analyses within the app at any time. CBASPath was tested in an open pilot study as part of routine outpatient CBASP treatment. Participating patients were asked to report their use patterns and blended use (integrated use of the app as part of therapy sessions) at 3 assessment points over the 6-month test period and rate the usability and quality of and their satisfaction with CBASPath. The results of the pilot trial showed that 93% (12/13) of participants used CBASPath as a blended tool during their therapy and maintained this throughout the study period. Overall, they reported good usability and quality ratings along with high user satisfaction. All participants showed favorable engagement with CBASPath; however, the frequency of use differed widely among the participants and assessment points. Situational analysis was used by all participants, and the number of completed modules ranged from 1 to 7. All participants reported blended use, although the frequency of integration in the face-to-face sessions varied widely. Our findings suggest that the digital augmentation of complex and highly interactive CBASP therapy in the form of blended therapy with CBASPath is feasible in routine outpatient care. Therapeutic guidance might contribute to high adherence and increase patient self-management. A few adjustments, such as saving entries directly in the app, could facilitate higher user engagement. A randomized controlled trial is now needed to investigate the efficacy and added value of this blended approach. In the long term, CBASPath could help optimize persistent depressive disorder treatment and reduce relapse by intensifying therapy and providing long-term patient support through the app.
Sections du résumé
BACKGROUND
BACKGROUND
The Cognitive Behavioral Analysis System of Psychotherapy (CBASP) is an empirically supported psychotherapeutic treatment developed specifically for persistent depressive disorder. However, given the high rates of nonresponse and relapse, there is a need for optimization. Studies suggest that outcomes can be improved by increasing the treatment dose via, for example, the continuous web-based application of therapy strategies between sessions. The strong emphasis in CBASP on the therapeutic relationship, combined with limited therapeutic availabilities, encourages the addition of web-based interventions to face-to-face therapy in terms of blended therapy.
OBJECTIVE
OBJECTIVE
The aim of this study was to test an app-based intervention called CBASPath, which was designed to be used as a blended therapy tool. CBASPath offers 8 sequential modules with app-based exercises to facilitate additional engagement with the therapy content and a separate exercise to conduct situational analyses within the app at any time.
METHODS
METHODS
CBASPath was tested in an open pilot study as part of routine outpatient CBASP treatment. Participating patients were asked to report their use patterns and blended use (integrated use of the app as part of therapy sessions) at 3 assessment points over the 6-month test period and rate the usability and quality of and their satisfaction with CBASPath.
RESULTS
RESULTS
The results of the pilot trial showed that 93% (12/13) of participants used CBASPath as a blended tool during their therapy and maintained this throughout the study period. Overall, they reported good usability and quality ratings along with high user satisfaction. All participants showed favorable engagement with CBASPath; however, the frequency of use differed widely among the participants and assessment points. Situational analysis was used by all participants, and the number of completed modules ranged from 1 to 7. All participants reported blended use, although the frequency of integration in the face-to-face sessions varied widely.
CONCLUSIONS
CONCLUSIONS
Our findings suggest that the digital augmentation of complex and highly interactive CBASP therapy in the form of blended therapy with CBASPath is feasible in routine outpatient care. Therapeutic guidance might contribute to high adherence and increase patient self-management. A few adjustments, such as saving entries directly in the app, could facilitate higher user engagement. A randomized controlled trial is now needed to investigate the efficacy and added value of this blended approach. In the long term, CBASPath could help optimize persistent depressive disorder treatment and reduce relapse by intensifying therapy and providing long-term patient support through the app.
Identifiants
pubmed: 35943764
pii: v6i8e35482
doi: 10.2196/35482
pmc: PMC9399836
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e35482Informations de copyright
©Anna-Lena Netter, Ina Beintner, Eva-Lotta Brakemeier. Originally published in JMIR Formative Research (https://formative.jmir.org), 09.08.2022.
Références
Can J Psychiatry. 2009 Jun;54(6):389-98
pubmed: 19527559
J Affect Disord. 2018 Feb;227:455-462
pubmed: 29154168
World Psychiatry. 2017 Oct;16(3):287-298
pubmed: 28941113
BMJ. 2015 May 07;350:h2336
pubmed: 25953643
Depress Anxiety. 2019 Jan;36(1):18-30
pubmed: 30300454
Psychother Psychosom. 2011;80(3):191-4
pubmed: 21389759
J Affect Disord. 2017 Dec 1;223:28-40
pubmed: 28715726
World Psychiatry. 2019 Feb;18(1):20-28
pubmed: 30600624
Psychother Psychosom. 2017;86(6):341-350
pubmed: 29131090
JAMA Psychiatry. 2021 Apr 1;78(4):361-371
pubmed: 33471111
PLoS One. 2020 Jan 30;15(1):e0228100
pubmed: 31999743
JMIR Mhealth Uhealth. 2016 Jun 10;4(2):e72
pubmed: 27287964
JMIR Mhealth Uhealth. 2015 Mar 11;3(1):e27
pubmed: 25760773
J Affect Disord. 2016 May;195:144-7
pubmed: 26895092
Brain Behav. 2016 May 03;6(8):e00486
pubmed: 27247856
Eur Arch Psychiatry Clin Neurosci. 2018 Dec;268(8):783-796
pubmed: 28956140
Clin Psychol Psychother. 2017 Sep;24(5):1155-1162
pubmed: 28326653
J Clin Psychol. 2002 May;58(5):489-98
pubmed: 11967875
NPJ Digit Med. 2019 Dec 2;2:118
pubmed: 31815193
Psychother Psychosom. 2015;84(1):51-6
pubmed: 25547778
J Affect Disord. 2018 Jan 1;225:733-755
pubmed: 28922737
J Affect Disord. 2015 Nov 15;187:136-41
pubmed: 26331687
J Clin Psychol. 2003 Aug;59(8):833-46
pubmed: 12858425
Psychol Med. 2003 May;33(4):693-702
pubmed: 12785471
Clin Psychol Rev. 2012 Jun;32(4):329-42
pubmed: 22466510
J Med Internet Res. 2017 Jan 05;19(1):e10
pubmed: 28057609
J Med Internet Res. 2016 Aug 31;18(8):e234
pubmed: 27582341
JAMA Psychiatry. 2017 Mar 01;74(3):233-242
pubmed: 28146251
Clin Psychol Rev. 2010 Feb;30(1):51-62
pubmed: 19781837
Am J Psychiatry. 2018 Mar 1;175(3):242-250
pubmed: 28969439
Psychother Psychosom. 2014;83(5):263-9
pubmed: 25116461
Psychiatry Res. 2020 Nov;293:113398
pubmed: 32920524
J Med Internet Res. 2016 Dec 23;18(12):e337
pubmed: 28011445
Proc Natl Acad Sci U S A. 2003 Nov 25;100(24):14293-6
pubmed: 14615578
Psychotherapy (Chic). 2008 Dec;45(4):491-506
pubmed: 22122536
JAMA Psychiatry. 2019 Jul 1;76(7):700-707
pubmed: 30994877
Psychother Psychosom. 2019;88(3):154-164
pubmed: 31121581
JMIR Ment Health. 2019 Jul 25;6(7):e12707
pubmed: 31344670
BMJ Open. 2018 Mar 12;8(3):e018412
pubmed: 29530905
Eur Arch Psychiatry Clin Neurosci. 2021 Apr;271(3):495-505
pubmed: 31300878
J Affect Disord. 2009 May;115(1-2):112-21
pubmed: 18973954
BMC Psychiatry. 2014 Dec 14;14:355
pubmed: 25496393
J Affect Disord. 2012 Jul;139(2):172-80
pubmed: 22381955
J Med Internet Res. 2017 Sep 15;19(9):e306
pubmed: 28916506
PLoS One. 2020 Aug 12;15(8):e0236995
pubmed: 32785245
J Affect Disord. 2020 Sep 1;274:643-651
pubmed: 32663998
Psychother Psychosom. 2018;87(1):46-48
pubmed: 29306939
Psychiatr Serv. 2012 Nov;63(11):1063-71
pubmed: 22983558
Psychother Psychosom. 2018;87(3):140-153
pubmed: 29847831