JMIR Publications

ABSTRACT

Background:

Adolescents who engage in delinquent behavior often show problems with the emotion regulation. Treatments in the forensic outpatient setting therefore generally focus on enhancing emotion awareness to improve emotion regulation skills. Notably, most adolescents experience difficulties with recognizing and understanding emotions that diminish their understanding of emotionally driven behaviors. Particularly this aspect of emotion regulation has proven difficult to improve with current treatment strategies. Potentially, new technologies such as smartphone apps can counter these challenges by adding real-life data into treatment to increase understanding of their emotions and behavioral patterns. These low-threshold usage of smartphone data can be useful to enhance the adolescents’ emotional awareness in treatment.

Objective:

This study aimed to explore the feasibility and usability of a new smartphone app (Feelee), that adds active emoji and passive behavioral data into treatment, to contribute to the adolescent’s emotional awareness in a forensic outpatient setting.

Methods:

First, adolescents (N = 4) used the Feelee app during a two-week testing period. Using Feelee involved completing a short emoji survey three times a day (active data) while giving Feelee permission to track the call logs, Bluetooth devices in proximity, cell tower IDs, application usage and phone status (passive data). During the treatment session, adolescents and clinicians checked the overview of the active and passive data and discussed the interpretation and meaning of the data. Second, semi structured interviews were conducted with both adolescents and clinicians (N= 7) to collect experiences regarding the feasibility and usability of adding smartphone data into treatments in the forensic outpatient setting.

Results:

The two-week test period showed that, expect for one, all adolescents succeeded to use Feelee for two weeks straight. Among all adolescents, data was available to discuss at least once during a treatment session. The interviews showed that Feelee was valuable in viewing, discussing and gaining insight in their emotions and subsequently taking specific actions based on the Feelee data. In addition, both adolescents and clinicians did not experience a strengthening of the adolescents’ engagement for treatment through working with Feelee. Despite some technical flaws, adolescents and clinicians generally positive regarding the use of Feelee as an addition in treatment.

Conclusions:

This qualitative feasibility and usability study provides a more in-depth understanding about the potential use of active and passive smartphone data for adolescents a forensic outpatient setting. Results indicated that Feelee contributed to the adolescents’ emotional and behavioral understanding and could, therefore, be valuable in treatment to improve the adolescents’ emotional awareness. Further research is needed to investigate the clinical effectiveness and working mechanism of Feelee in enhancing emotional awareness. Suggestions for improvements from adolescents and clinicians should be incorporated for further development and research with Feelee in the forensic outpatient setting.