JMIR Publications

ABSTRACT

Background:

Wearable self-tracking technologies are increasingly recognized for their potential to enhance therapeutic engagement and personalize treatment. While many instruments emphasize passive data collection, their role in actively mediating therapeutic processes remains underexplored. This study explores how the One Button Tracker (OBT), a novel single-purpose wearable self-tracking instrument, supports psychotherapeutic treatment by enabling patients to track self-defined, personally relevant phenomena during their daily lives.

Objective:

To explore how the OBT mediates the psychotherapeutic process in patients’ daily lives, focusing on its impact on therapeutic engagement, self-awareness, and the therapeutic relationship.

Methods:

This qualitative study was part of a larger Participatory Action Research project conducted at a specialized clinic for trauma survivors in Denmark. Nine patients, refugees diagnosed with Complex PTSD, used the OBT as part of their therapy. Semi-structured interviews were conducted at three stages: before, during, and after treatment. Thematic analysis was used to analyze the data, guided by postphenomenological framework focusing on technologies mediation of the human-world relations.

Results:

Thematic analysis identified five key themes describing the OBT’s multistable roles: (1) From external instrument to extension of the self (2) mental switch (3) a faithful companion (4) scarlet letter, and (5) emergency lifeline. The OBT supported engagement in therapeutic interventions during moments of distress, enhanced emotional regulation, and strengthened the therapeutic relationship by extending its influence beyond clinical sessions. Its simplicity and vibrotactile feedback facilitated engagement and usability, while its multistability allowed patients to adapt its use to their intentions and contexts. However, the presence and sometimes visibility of the OBT introduced complex social dynamics, amplifying both engagement and stigma depending on individual circumstances and context.

Conclusions:

The findings suggest that the OBT acts as an active mediator in the therapeutic process, fostering agency, emotional regulation, and engagement. By shifting the focus from passive data collection to meaningful interaction with the instrument, the OBT highlights the potential of wearable self-tracking instruments to actively shape therapeutic experiences. These insights underscore the value of designing digital mental health instruments that prioritize simplicity, multistability, and relational engagement to support personalized and context-sensitive care.