Mobile Technologies in Child and Adolescent Psychiatry: Pushing for Further Awareness and Research
A basic function of cell phone technology—texting—has already infiltrated into Child and Adolescent Psychiatry practice. DeJong and Gorrindo3 reviewed the use of texting in patient care and some of the advantages that it offers, which include speed and directness of interaction, accessibility, and portability. Preliminary evidence shows that adolescents are comfortable with integrating text messaging as part of their care, with the only concerns involving cost and privacy.4 One of the most common uses of texting in the therapeutic relationship is coordination of face-to-face appointments.5 Despite the recent advancements in the capabilities of cell phone technology above and beyond texting (e.g., smartphones with apps), however, few studies have looked into how these new features can be used to improve mental health care for children. A review by Donker and colleagues6 looked at adults’ use of mental health smartphone apps for treating various conditions, including depression, anxiety, and substance abuse, and found that they can effectively improve accessibility to care. Their review identified over 3000 apps available, but only 8 of those involved evidence-based interventions, making it difficult to investigate their efficacy.
One of the most important potential advantages of incorporating smartphone technology into child mental health treatment is the possibility of ecological momentary interventions, which are clinical interventions that are delivered in the context of everyday life and in a person’s natural setting.7 For example, a smartphone app could monitor children’s moods in real time and notify their parents, teachers, or mental health providers if their symptoms worsen. These ecological momentary interventions could be particularly important in implementing cognitive-behavioral therapy (CBT), the gold-standard psychotherapeutic approach for treating children’s depression and anxiety. The success of a CBT intervention is based on the participant’s practice of the skills learned during the session in everyday life, but the necessity of practice in between sessions often presents a major challenge in terms of compliance. Use of smartphone technology to enable skills practice may make the concept of CBT homework more attractive for youngsters and therefore increase participation.
One of the few studies to date that has looked at the use of a CBT-based app for children found some promising results.