In our previous articles, we have discussed the availability of mental health treatment in Sweden, the use cases for digital tools in psychotherapy, and the effectiveness of psychotherapy in general. All in all, our reviews point to an urgent opportunity for leveraging new technologies to improve outcomes within mental health treatment.
To summarise our outlook in a few bullet points - here are a few takeaways:
Cognitive Behavioral Therapy (CBT) has been proven to be an effective form of treatment for mental health disorders.
The treatment components of CBT has been proven to translate well to different digital solutions.
Face-to face (Ft) psychotherapy and I-CBT shows high dropout rates and low adherence rates, which impacts the quality of care.
Even when completing treatment, remission rates are very high.
The demand for effective mental health treatments is large, and per the current patient:clinician ratio, it is virtually impossible to deliver the supply of care in traditional ways.
Digitalisation has been used in CBT in a range of different ways, and continues to disrupt mental health treatment, but solely digital interventions generally don't work as well as blended modularities.
A disruption of the traditional psychotherapeutic practice can clearly be seen in the horizon, and digitalisation is one of its major drivers. But what alternatives do forward-thinking therapists have now, when it comes to leveraging digital technologies to improve the delivery of care?
The Alternatives
Turns out there are alternatives - luckily. These can be divided into different categories.
1. B2C Applications
There is an app for everything nowadays, and CBT is no different. Searching on App Store - one will find a myriad of mindfulness apps, apps for specific disorders or specific modules. Broadly, one might distinguish these apps on wether they are regulatory certified to conduct care - in that case they (in EU) have a CE-mark and are prescribable by a healthcare provider. Otherwise, they are not.
It is not uncommon for therapists to recommend an app or two during treatment. However, these are almost never integrated to the treatment of care in any meaningful way.
This means patients often have to purchase these themselves, and the therapist has no access to the patient data or administration of the application.
2. Client Journal Systems
Healthcare providers track the clinical data in treatment, within healthcare journals. These are systems developed heavily for security and can be quite clunky and unfriendly. They are also entirely clinician-facing. Recently, modern journal systems have adapted to broaden their intended use from simple note-taking to patient contact
Increasingly, systems enable sending out digital formularies or chat messages to patient whilst not in session. Booking and payments can often be handled by these clinician-systems.
The user experience for the patient is often very basic, and rarely does the system keep patients engaged throughout the treatment in any comprehensive way.
The administrative onboarding can prove to be high for the clinician, that has to learn the ins and outs of the system. Furthermore, clinicians have to write their own materials.
3. I-CBT Software Programs
Healthcare providers are also able to purchase in I-CBT software programs. These are largely created as programs, based on treatment manuals, wherein the client gets exercises and reading material on their web application, to go through in desktop format. The clinician is able to chat and see the progress of the patient, but most often the patient is driving the therapy autonomously.
Traditional adaptations are quite-text heavy and require a motivated and engaged patient. As the reading material and the exercises are quite comprehensive, adherence for pure I-CBT is lagging.
Real or video-sessions are rarely integrated into the flow of therapy. This can be quite a stark shift from the FtF-approach that are what most patients expect of CBT, and also what clinicians are trained at.
The user experience has improved in later instantiations of I-CBT solutions but is rarely something which might compete with other tech solutions in other industries, from a user perspective.
Some programs allow clinicians to write their own materials and create their own modules. This can be an arduous process with quite basic tools.
What's The Next Thing?
As you can see, digitalisation has found its way to mental health treatment, but we are presented with quite scattered tools to work with so far, when it comes to helping patients progress in therapy. Each of these have their own pros and cons. To conclude, we propose some bullet points for how an optimally engaging psychotherapeutic tool should behave, by using the strengths and weaknesses of each alternative:
1. Low clinician admin. The send out of whatever material to the patient, should require minimal time to learn the ins and outs of any new system, as clinicians are busy enough as they are.
2. Great patient experience. The patient cohort is not the easiest target group. Tools need to rely on modern UX-principles and be easy to understand, and fill out. They should furthermore be rewarding and engaging.
3. Unified care pathways. To enable to really analyse clinical efficiency, it is important that the interventions are comparable over many patients. As much as chat or idiosyncratic form building is convenient, clinicians should not have to build their own modules at every intervention. This both adds unnecessary treatment time, whilst much complicating the clinical analysis at a group level. The care pathway should be transparent and logical for patient and clinician.
If you would like to know more about how Zeeds aims to provide a better digital solution for psychotherapy -> request a free demo at www.zeedsapp.com/book-a-demo