JMIR Publications

ABSTRACT

Background:

Smartwatches can be of added value in mental healthcare, by giving insights into activity and sleep of patients, which are fundamental aspects of daily functioning that are strongly linked to mental health. However, their implementation in mental healthcare practice remains limited. Professionals can feel resistance towards digital mental health interventions if they feel their use is not aligned with therapeutic values, and report a need for guidance on how to use technologies in ways that do align with such values. Compassion, a core value in mental healthcare, may provide a meaningful frame for implementation. Therefore, we previously co-designed compassion-focused implementation materials: a card set offering practical suggestions of how smartwatch data can support group treatments in ways that counter the self-optimization logic of commercial devices and instead align with compassion.

Objective:

The current study evaluated the compassion-focused card set in practice, to explore whether the introduction of the card set influenced the use of smartwatches, experienced compassion when using the smartwatches, the therapeutic alliance and the acceptance of smartwatches in social psychiatric nurses.

Methods:

The card-set was evaluated in a mixed-methods replicated single-case design with five social psychiatric nurses from an acute mental healthcare team. Data collection included pre- and post-questionnaires, repeated measures, a focus group, and interviews.

Results:

Quantitative results showed no consistent significant improvements in compassion, therapeutic alliance, or the acceptance of smartwatches. However, smartwatch use started or increased temporarily after the introduction of the card set. Qualitative findings indicated that the card set was experienced as flexible and easy to use, supporting session structure and enabling more in-depth, compassionate conversations. At the same time, barriers to sustained smartwatch integration included low patient uptake, challenges in mixed groups in which only some patients wore the smartwatch, and varying digital affinity among professionals.

Conclusions:

These findings suggest that compassion-focused materials may trigger initial adoption and help reframe smartwatch use in line with therapeutic values. Broader implementation strategies, including further training and tailoring to patient readiness, are required for sustainable integration.