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Enhancing Problem-Solving Therapy With Smartphone Technology: A Pilot Randomized Controlled Trial
Kathleen M Grubbs1, Traci H Abraham1, Jeffrey M Pyne1
1Center for Mental Health Outcomes Research, Health Services Research and Development, and South Central Mental Illness Research Education and Clinical Center (MIRECC), Central Arkansas Veterans Healthcare System, North Little Rock (Grubbs, Abraham, Pyne); Department of Psychiatry, College of Medicine, University of Arkansas for Medical Sciences, Little Rock (Grubbs, Abraham, Pyne, Greene); Translational Research Institute, University of Arkansas for Medical Sciences, Little Rock (Greene); Department of Psychology, Michael E. DeBakey VA Medical Center, Houston (Teng); Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (Teng); Health Services Research and Development, Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle (Fortney); Department of Psychiatry, School of Medicine, University of Washington, Seattle (Fortney).
Objective:
Development of smartphone apps for mental health care has outpaced research on their effectiveness. This pilot study tested Moving Forward, an app designed to support problem-solving therapy (PST).
Methods:
Thirty-three veterans seeking mental health care in U.S. Department of Veterans Affairs primary care clinics were randomly assigned to receive six sessions of PST accompanied by either the Moving Forward app (N=17) or a workbook (N=16). Participants completed measures of anxiety, depression, stress, problem-solving style, satisfaction, and between-session practice at baseline and 6- and 12-week follow-ups. Qualitative interviews were used to elicit feedback.
Results:
Participants in both groups reported high satisfaction and reductions in depression, anxiety, and stress. Veterans who used the app reported skills practice, and qualitative data indicated that patients perceived the app as valuable, with the potential to reduce barriers to care.
Conclusions:
This study provides preliminary evidence to support the ability of the Moving Forward app to augment brief psychotherapy in primary care clinics.
