JMIR Publications

ABSTRACT

Background:

Therapy-accompanying mental health apps can play an important role in the psychotherapeutic treatment of adolescents. They can increase adolescents’ engagement and autonomy, provide immediate support in critical situations, and have beneficial influence on the therapeutic working alliance. Nevertheless, mental health apps are rarely used by psychotherapists. Additionally, due to the limited or non-existent utilization of apps in psychotherapies, there is little knowledge about actual barriers and drivers for the integration of mental health apps in psychotherapists working routines. To better understand, how mental health apps should be designed to be used by psychotherapists in working routines, it is necessary to know more about psychotherapists perspective on essential app features and characteristics, and the drivers and barriers for the integration of mental health apps into the clinical routines in a more practical way.

Objective:

The aim of the current study was to analyze which app features and app characteristics are essential for psychotherapists to use a mobile application for their psychotherapy with adolescents, and which drivers and barriers determine the integration of a psychotherapeutic app from the psychotherapists’ perspectives.

Methods:

We performed three feasibility studies with a transdiagnostic and therapy-accompanying app named Steps for adolescents in three different psychotherapeutic treatment contexts: inpatient treatment, treatment in psychiatric outpatient clinics, and outpatient treatment with psychotherapists in private practice. All studies had a qualitative quasi-experimental study design. All participants answered questions about their age, occupation, years of work experience, media affinity, attitudes towards psychotherapeutic apps, the perceived app-quality and feasibility, and the implementation process of the therapy-accompanying app. Qualitative data was analyzed using deductive qualitative content analysis.

Results:

Study participation and app usage rates were low across all studies (study one: n=18; study two: n=13; study three: n=9). Overall, the implemented app Steps received good ratings in app quality. Six core features for a transdiagnostic therapy-accompanying app were identified: mood checks, library, reminders, goals & tasks, emergency kit, and questionnaires. Furthermore, the integration of mental health apps in daily routines is associated with many drivers and barriers. The most important barriers for integrating mental health apps were technological issues and conditions in daily practice, like the lack of time and resources. The most important driver was the perceived improvement of treatment quality.

Conclusions:

In sum, psychotherapists were generally willing to use a therapy-accompanying mental health app. However, study participation and app usage were low. As psychotherapists are gatekeepers for mental health app use of patients, their needs should be considered when developing and implementing mental health apps. Clinical Trial: The feasibility study in the psychiatric outpatient clinics was preregistered at the German Clinical Trials register (DRKS00031258).