JMIR Publications

ABSTRACT

Background:

Substance use disorder is one of the severe public health problems around the world. Inequitable resources, discrimination, and physical distances limit the possibility of patients seeking medical help. Automated conversational agents have the potential to provide in-home and remote therapy. However, automatic dialogue agents mostly used text and other methods to interact, which affected the interaction experience, treatment immersion, and clinical efficacy.

Objective:

To describe the design and development of Echo-APP, a tablet-based app with the function of a virtual digital psychotherapist, and to conduct the pilot study to explore the feasibility, acceptability, and preliminary efficacy results of Echo-APP for patients with methamphetamine use disorder.

Methods:

Echo-APP is an assessment and rehabilitation program developed for substance use disorder (SUD) by a team of clinicians, psychotherapists, and computer experts. The program is available for Android tablets. In terms of assessment, it mainly focuses on the core characteristics of SUD, such as emotion, impulsivity, treatment motivation, and craving level. In terms of treatment, Echo-APP provides ten treatment units, involving awareness of addiction, motivation enhancement, emotion regulation, meditation, etc. Forty-seven methamphetamine-dependent patients were eventually enrolled in the pilot study to receive a single session of the Echo-APP-based Motivational Enhancement Treatment. Patients were assessed for treatment motivation and craving levels before and after treatment. After treatment, patients underwent semi-structured interviews and questionnaires to investigate their experience after using the Echo-APP.

Results:

In the pilot study, scores on the SOCRATES scales and the questionnaire on motivation for abstaining from drugs significantly increased after the Echo-APP-based treatment, while the craving was reduced. Patients emotional state and impulsivity trait at baseline were predictive of changes in the patient’s treatment motivation and craving during treatment. Most participants were satisfied with the functions of the Echo-APP.

Conclusions:

Echo-app is a practical, accepted and promising virtual digital psychotherapist program for patients with methamphetamine-dependent patients. The current preliminary findings lay a good foundation for further optimization of the program and the promotion of large-scale randomized controlled clinical studies for SUD.