Single-Session Mobile-Augmented Intervention in Serious Mental Illness: A Three-Arm Randomized Controlled Trial.

Area of Science:

• Psychiatry and Mental Health
• Digital Health Interventions
• Clinical Psychology

Background:

• Serious mental illnesses (SMI) like schizophrenia and bipolar disorder often face challenges with resource-intensive and inaccessible psychosocial interventions.
• Brief, single-session interventions combined with automated mobile health (mHealth) delivery show promise for expanding treatment accessibility.
• Mobile health interventions can augment traditional therapies, potentially improving outcomes for individuals with SMI.

Purpose of the Study:

• To evaluate the efficacy of a brief intervention augmented by mobile health (CBT2go) compared to a self-monitoring (SM) intervention and treatment-as-usual (TAU) for individuals with SMI.
• To assess the impact of these interventions on global psychopathology, community functioning, and defeatist performance beliefs.
• To determine the feasibility and sustained effects of augmented brief interventions over a 24-week period.

Main Methods:

• A randomized single-blind controlled trial involving 255 participants diagnosed with schizophrenia or bipolar disorder.
• Participants were assigned to CBT2go (individual CBT session + mobile intervention), SM (psychoeducation + self-monitoring), or TAU.
• Outcomes, including global psychopathology (BPRS-24), community functioning (SLOF), and defeatist performance beliefs (DPBs), were assessed at baseline, 6, 12, and 24 weeks.

Main Results:

• Both CBT2go and SM showed significant, modest improvements in global psychopathology (BPRS Total score) compared to TAU over 24 weeks.
• CBT2go demonstrated significant improvements in community functioning (SLOF) over 24 weeks, whereas SM did not.
• Defeatist performance beliefs (DPBs) decreased in the CBT2go group but not in the SM group.

Conclusions:

• Single interventions augmented by mobile health are feasible and demonstrate small, sustained effects on global psychopathology for individuals with SMI.
• The CBT2go intervention, combining brief CBT with mobile support, showed additional benefits in improving community functioning compared to usual care.
• Augmented brief interventions represent a viable strategy to enhance treatment access and outcomes for serious mental illness.