Previously submitted to: JMIR Mental Health (no longer under consideration since Nov 18, 2024)
Date Submitted: Nov 17, 2024
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Perspectives of patients with early psychosis on the use of an app in Acceptance and Commitment Therapy: a qualitative study.
ABSTRACT
Background:
Ecological Momentary Assessments (EMA) and Interventions (EMI), commonly delivered via smartphones, hold the potential to bridge the gap between therapy sessions and the daily life of individuals experiencing early psychotic symptoms. Acceptance and Commitment Therapy in Daily Life (ACT-DL) combines 8 face-to-face ACT sessions with the use of an app in everyday life. The app randomly prompts individuals multiple times a day in between sessions, with questionnaires (EMA) and metaphors or exercises (EMI). Previous quantitative findings showed promising results in terms of ACT-DL on transferring therapy skills to daily life and treating momentary psychotic distress and negative symptoms. However, participants reported a perceived burden related to length and frequency of notifications.
Objective:
This study qualitatively explores the perspectives of individuals with Clinical High Risk for Psychosis (CHR-P) or with First Episode Psychosis (FEP) on the use of the ACT-DL app, and perceived areas for improvement.
Methods:
User experiences with the ACT-DL app were explored in 17 semi-structured interviews within six months after the intervention and analyzed using template thematic analysis.
Results:
Three themes were formed: 1. App functionalities and usability; consisting mainly of perceived practical obstacles. 2. Additional value of the app; on how the EMAs positively raised levels of awareness for feelings, thoughts, and behavior, and on how receiving EMIs increased transferability of sessions to daily life. 3. Improving applicability and effect of the ACT-DL app; with practical feedback from participants.
Conclusions:
Although participants struggled with the applicability of the ACT-DL app during work and social activities, many were positive about using the ACT-DL app. Positive effects were often attributed to increased awareness related to EMAs and to the ACT exercises on the ACT-DL app. Clinical Trial: This study is part of the INTERACT trial - A real-time and real-world intervention focusing on stress and reward. This trial was prospectively registered in the Dutch Trial Register (ID: NTR4252).
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