Technology in Care
“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
Overview
The use of smartphones, tablets, websites, and wearable technologies to monitor and intervene in areas of health and wellness is increasing. According to recent studies (Pew Research, 2021), 97% of American adults own a cellphone of some kind and 85% own a smartphone . When considering the introduction of technology into care, it may be helpful to be aware of the following recent statistics about smartphone ownership:
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96% of those ages 18-29 own a smartphone
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95% of those ages 30-49 own a smartphone
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83% of those ages 50-64 own a smartphone
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61% of those ages 65 or older own a smartphone
Of U.S. adults who own a smartphone, 15% are “smartphone-only internet users”— they own a smartphone but do not have other traditional home internet service. Those in rural areas were found to be less likely to own a smartphone than those in suburban areas. One reason cited for differences in technology ownership was relative lack of reliable high-speed internet access in some areas. More information can be found in the 2021 report by the Pew Research Center.
In response to this growth in use, the development of apps targeting health and wellness has exploded, spanning topics from fitness, meditation, and brain games to interactive treatment plans, medication monitoring, and test results.
The Department of Veterans Affairs and VA’s National Center for PTSD (NCPTSD) has developed smartphone mobile applications for Veterans and others focused on mental health and wellness. Please visit the section for more Information.
Video
VA App Store mobile.va.gov/appstore
Access dozens of apps specifically created for Veterans, their caregivers, and VA Staff that expand clinical care beyond the traditional office visit. Check out the apps and learn more at https://mobile.va.gov/appstore.
To view demos for the VA mobile mental health apps, please visit: Mobile Mental Health Apps Playlist.
Video source: Department of Veterans Affairs - Veterans Health Administration
Integrating NCPTSD Mobile Apps into Veteran Mental Health Care
A quick overview on how mental health apps developed by National Center for PTSD can be integrated into mental health care.
Related resource: Learn more about mobile apps developed by National Center for PTSD

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:
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Make it easier to monitor symptoms and treatment progress
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Provide easily accessed and interactive coping tools for clients
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Enable the client to work on concerns outside of the health care setting
There are three types of health apps and web programs:
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Treatment Companion: Designed to be used by the Veteran/Service member client and provider during the course of treatment. These apps provide session by session support for specific treatment protocols.
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Self-management: Designed to be used independently by the Veteran/Service member client. These apps and programs can provide additional support for the intervention delivered during treatment and can supplement treatment through targeting additional areas.
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Clinician-focused: Designed to be used by the provider in support of specific behavioral health conditions.
View available apps and programs.
These websites provide information about apps and programs developed by the VA and the National Center for PTSD (NCPTSD):
There are also 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).
Most of the apps are designed for two major operation systems: iOS (iPhone/iPad) and Android. However, there are also many online programs which 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
When deciding whether or not to use available 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). Additionally, the American Psychiatric Association provides an App Evaluation Model that highlights important considerations in choosing which app may be helpful for a particular client or context. While these guides provide extensive information about the use of technology in care, a brief list of tips is provided below:
Preparation:
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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. In addition to the app or web-based program content, it is important to familiarize yourself with the product’s privacy policy, cost, and evidence base. See the Evaluation Screener in the APA App Evaluation Model for more information.
Orientation:
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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.
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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.
In-Session Practice:
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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 they are able to use the app or program appropriately outside of session.
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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.
Follow-up:
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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.

Additional Resources
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Order free promotional items for apps developed by the VA and NCPTSD from the Government Publishing Office, including brochures, screen cleaners, behavioral health prescription pads, and more.
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Take the free online course, “Integrating National Center for PTSD Mobile Apps into Veteran Mental Health Care”
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Attend the Practice-Based Implementation (PBI) Network CE Lecture Series
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Download handouts for patients and providers on NCPTSD’s Tech into Care webpage.
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Complete VA Mobile Mental Health Apps Courses available on the VA TRAIN website:
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Read the APA App Evaluation Model to learn important considerations in choosing apps to use in care.
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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.
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Download information on using technology in PTSD care, PTSD Research Quarterly
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View the Mobile Mental Health Apps Playlist on YouTube, which features brief video tutorials for each NCPTSD app.
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The following articles provide additional information on using apps when providing care to Veterans:
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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
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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
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