"Technologies evolve rapidly, and new technologies are emerging all the time; clinicians should consider how a given tool will enhance clinical services and select only those technologies that are likely to be most beneficial to their clinical work and that they and their clients can use competently" Using Technology-Based Therapeutic Tools in Behavioral Health Services by SAMHSA
Technology in Care Basics
The Rise of Mobile and Web-based Technology in Health Care
The use of smartphones, tablets, websites, and wearable technologies to monitor and intervene in areas of health and wellness is increasing. The mobile health market is expected to reach $59 billion by the year 2020. In particular, smartphones are among the most rapidly adopted technologies in history and are changing the way information and services are accessed. According to recent studies (Pew Research, 2018), 77% of American adults own a smartphone - in contrast, fewer own a tablet computer (45%). When considering the introduction of technology into care, it may be helpful to be aware of the following recent statistics about smartphone ownership:
85% of those ages 18-29 own a smartphone
79% of those ages 30-49 own a smartphone
54% of those ages 50-64 own a smartphone
27% of those ages 65 or older own a smartphone
Of U.S. adults who own a smartphone, 10% are "smartphone-dependent" — with no other internet access at home
In response to this growth in use, the development of provider and patient smartphone applications (apps) targeting health and wellness has exploded, spanning topics from fitness, meditation, and brain games to interactive treatment plans, medication monitoring, and test results.
This Mini-Clinic focuses on apps and self-management web programs designed by VA and its partners that are relevant to behavioral health and wellness.
Integrating Technology into Care
Integrating Technology into Care
How can using apps support the care I provide to Veterans?
Below are a few of the ways that technology and web programs can be helpful:
Make it easier to monitor symptoms and treatment progress
Provide easily accessed and interactive coping tools for clients
Enable the client to work on concerns outside of the health care setting
There are three types of health apps and web programs:
Companion to Care: Designed to be used by the Veteran/Servicemember client and provider during the course of treatment. These apps provide session by session support for particular treatment protocols.
Self-management: Designed to be used independently by the Veteran/Servicemember client. These apps and programs can provide additional support for the intervention delivered during treatment and can supplement treatment through targeting additional areas.
Clinician Focused: Designed to be used by the provider in support of specific behavioral health conditions.
Download lists of apps and web programs that are currently available. These handouts include apps and programs developed by the VA and the National Center for PTSD (NCPTSD). Apps developed by the Department of Defense, Defense Health Agency Connected Health Branch (aka DHA Connected Health, formerly known as the National Center for Telehealth and Technology, or T2): https://health.mil/mhealthtraining.
Most of the apps are designed for two major operation systems: iOS (iPhone/iPad) and Android. However, there are also many website based programs and they can be accessed by any device (such as computer, tablet, or smartphone) connected to a web browser and the internet. As you explore the various options, keep in mind that it is not only mobile devices that are shaping the future of technology in care. Increasingly, healthcare-focused communications are taking place on social media platforms. Research suggests that, worldwide, 75,000 health professionals use Twitter to discuss treatments and share information. Learning about and incorporating health technology into your practice can be beneficial to both you and your Veteran clients.
Tips for Using Technology in Care
Tips for Using Technology in Care
When deciding whether or not to use available smartphone applications (apps) or web-based tools, the setting and the client’s clinical presentation should be carefully considered. The Substance Abuse and Mental Health Services Administration (SAMHSA) compiled guidelines for the use of technology in behavioral health care (SAMHSA, 2015). While the guide provides extensive information about the use of technology in care, a brief list of tips is provided below:
It can be useful to download the mobile app or run through the web-based program prior to introducing it to your client. While clinician time is often limited, any time that can be spent becoming familiar with the product will help you have greater confidence in its use and increase your understanding of the appropriateness of the product for your client.
Take sufficient time to thoroughly discuss with your client the risks and benefits associated with the use of technology and the product you are considering. Explore your client’s expectations for what the product may do or how useful it may be.
Listen carefully to your client’s preferences – some will appreciate the opportunity to use these additional tools, while others may not feel comfortable with their use.
Take time during your session to demonstrate the tool and its features. Provide the opportunity for your client to practice. This will help to ensure that he/she is able to use the app or program appropriately outside of session.
If any data or information is being collected or entered into the app or web-based product, ensure that your client is aware of this process and understands how this information will be used in the treatment setting. Obtain appropriate permissions and consents.
Check in with your client about their use of the product during subsequent sessions. Troubleshoot any difficulties and reassess the utility of the product for your client’s treatment and recovery goals.
Download the entire SAMHSA guide: Substance Abuse and Mental Health Services Administration. Using Technology-Based Therapeutic Tools in Behavioral Health Services. Treatment Improvement Protocol (TIP) Series 60. HHS Publication No. (SMA) 15-4924. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2015.
The following articles provide additional information on using apps when providing care to Veterans:
Gould, C., Kok B., Ma, V., Zapata, A., Owen J., Kuhn, E. (2018). Veterans Affairs and the Department of Defense mental health apps: A systematic literature review. Psychological Services. doi:10.1037/ser0000289
Owen, J., Kuhn, E., Jaworski, B., McGee-Vincent, P., Juhasz, K., Hoffman, J., & Rosen, C. (2018). VA mobile apps for PTSD and related problems: Public health resources for veterans and those who care for them. mHealth. doi:10.21037/mhealth.2018.05.07
Recently Released Mobile App: Mindfulness Coach
Practicing mindfulness means grounding yourself in the present moment. Mindfulness has been shown to be helpful for reducing stress and coping with unpleasant thoughts and emotions. Mindfulness Coach will help you practice mindfulness meditation. Features include:
Education about the benefits of mindfulness
Mindfulness exercises to practice on your own or with guidance
Strategies to help overcome challenges to mindfulness practice
Log of mindfulness exercises to track your progress