7 Tips for Incorporating Technology Tools into Conventional Therapy Practice

Individuals seeking health care are increasingly interested in using technology to help manage their symptoms and obtain treatment. A poll by The Pew Research Center reported that in 2012, 72 percent of Internet users reported seeking health information online (PRC, 2013) and of the 64 percent of people who own a smartphone (PRC, 2015), 62 percent reported having used it to acquire some type of health-related information (PRC, 2015).  These trends in general health present a great opportunity for improvements to existing care-delivery models in mental health too.

Mobile apps are a burgeoning area of health technology which have substantial opportunity to improve treatment, quality of life, and patient self-management and engagement. Numerous professional and non-professional groups have acknowledged the value of these tools, as they are often well-liked by users and have advantages over traditional in-person therapy. For many individuals, therapy is out of reach due to cost, access/provider availability, transportation, or stigma. Though not necessarily a replacement for traditional therapy, apps and other healthcare technologies can help these individuals overcome these barriers and begin to reduce their symptoms and better manage their mental health.

For others, apps can be a helpful adjunctive to regular treatment, allowing them to be more engaged and get more support between sessions. While in-person therapy offers a human relationship that isn’t always possible within an app, mental health clinicians have an opportunity to work WITH these tech tools to enhance their in-person work and take advantage of the benefits that come with the use of technology in their practices.

When beginning to introduce apps into your practice, there are some things to consider in order to be successful and ensure your clients accept and use the new technology.

1. Think about your goals–what will the app help you or your client to do? Don’t introduce technology just because you can. Have an idea of what you think the app or program can be good for, and explain that. Perhaps it’s mood tracking or building a mindfulness meditation practice. Make sure that whatever tool you are suggesting is clinically appropriate and indicated for that client.

2. Be familiar with the tools you’re suggesting. A surefire way to make your client doubtful of the technology is to lack understanding and knowledge of the app and how it works. The more comfortable you are with the app, the more they will be too. Download and use the app yourself. In addition to having more credibility with your clients, you may discover interesting or valuable ways to use the technology that perhaps aren’t immediately obvious otherwise.

3. Put yourself in your client’s shoes. When introducing the client to the app, don’t grab the client’s phone and do it for them. Instead, talk them through the process, allowing them to click through the different tools and describing what to use and when so that they feel a level of familiarity with the app before they leave your office. This is particularly important for apps that have minimal in-app guidance.

4. Problem solve using the app. When might a client want to use a given tool? Provide some suggestions for scenarios and think about any difficulties they might run into ahead of time.

5. Don’t overwhelm yourself or your clients. You might find it helpful to pick just one app at a time to keep it simple. If you start using a wide variety of products, it may be difficult to keep track of how the apps work, what they do, etc.

6. Be familiar with the app’s security and privacy policy. Your clients may have questions about their app usage data and what happens to it. It’s helpful if you have at least some knowledge of the app’s policies so that you can either explain those policies, or know where to direct your clients so that they can read the policies themselves.

7. Have a discussion about the use of the technology much like you would have at the beginning of therapy. What are the limits of confidentiality? Will your client expect that you will be reviewing their app usage? Should they use the app to communicate with you? It’s important for provider and client to have an open and frank conversation about what is and is not appropriate for app usage, and what the client’s expectations should be. Some clients may not fully understand how apps work, and it’s incumbent upon the provider to make sure their clients are informed before beginning to use an app or other tech tools.

Thinking about taking the leap of bringing your practice into the 21st century by starting to work with a mental health app? Consider Pacifica. Pacifica is a mobile application that empowers people to manage their stress, anxiety, and depression using cognitive behavioral therapy (CBT) and mindfulness techniques. The app currently has over 1.4 million registered users and has been highly-rated and well-received in the App Store and Google Play Store, reflecting its appealing design and engaging tools.

In addition to its iOS and Android consumer apps, Pacifica Labs also offers Pacifica for Clinicians, a dashboard tool designed to help mental health care providers leverage the app with their patients and improve treatment effectiveness. The HIPAA-compliant clinician-facing product allows providers to administer and score assessments, conduct teletherapy, and increase between-session engagement and therapeutic efficiency with assignments and education.

 

Pacifica Mindfulness Updates

We’re delighted to announce the recent renovation of Pacifica’s relaxation and meditation section. Some of the changes we’ve made to this section of the app:

New Design
Perhaps the most obvious change, we’ve shifted from a list to a more visually appealing format, with images that provide some information about the nature of the activity. We’ve also simplified the display of the meditation lengths and updated some meditation names.

 

Daily FREE Meditation
Each day, a different Premium meditation/relaxation activity will be featured and will be available for free. 

New Meditations
These new activities will help you to build new coping skills and think differently.

  • Building PositivityUse mindfulness to identify wins, focus on the upside, and savor moments of joy.
  • Getting Motivated: Use this meditation to build initiative and move towards your goals.
  • Eating Mindfully: Be fully present while eating to savor the experience.
  • Coping with Physical Pain: Use mindfulness to help you manage pain.
  • Defusing Anger: Use mindfulness strategies to cope with frustration.
  • Falling Asleep: Release your stress from the day while relaxing into sleep.

Updates to Existing Meditations
We’ve improved and updated our existing meditations, particularly those designed to help you coping with anxiety-provoking situations, like taking a flight or being in social groups. Be sure to give these a listen!

Meditation Reminders
You can now set up daily reminder notifications for meditations, to help you build a mindfulness habit.

Do you have suggestions or requests for meditations you’d like to see in the future? Send us an email at info@thinkpacifica.com with your ideas!

Our ethical obligation to practice outcome monitoring

Why did you become a therapist?

Many people say that they went into therapy in order to help people, yet despite this initial goal, they report that they actually spend most of their “office time” writing notes and completing paperwork. With complicated EHRs, large caseloads, and increasing administrative responsibilities, some of this is inevitable. Fortunately, however, new tools and technologies are emerging to help clinicians to not only fulfill their job duties, but also more effectively treat their patients and ensure that they are providing quality care and utilizing best practices.

One of the best practices that has been demonstrated repeatedly to improve outcomes is using Measurement-Based Care. Measurement-Based Care is a system that utilizes patient-reported symptom rating scales to inform clinical decisions about patient care. Similar to Measurement-Based Care, outcomes monitoring or progress monitoring, is the routine collection of self-report data from clients to evaluate their progress in treatment and perception of the therapeutic alliance. In both Measurement-Based Care and outcomes monitoring, clinicians use the self-report data provided by their clients to objectively assess their progress and make adjustments to their treatment plan or therapeutic approach in accord. Therapists have been slow to adopt routine progress monitoring or Measurement-Based Care, but the time has come to change that. In addition to standard measures of symptoms (e.g. PHQ-9, GAD-7), there are several published measures which can effectively provide feedback to the clinician (e.g. OQ, ROM, PCOMS). With a wide variety of validated measures available to assess one’s clients, there is little reason not to develop a thoughtful plan for evaluating one’s practice.

Improved Communication

Providers’ desire to offer the highest quality of care possible is not the only reason to practice outcomes monitoring or Measurement-Based Care. Monitoring can help patients to stay more engaged in their treatment and more participatory, both in sessions and with between-session assignments. They are less likely to stop treatment if they feel heard by their clinician. Structured measures provide another opportunity for the therapist to listen to the client and get a better understanding of their emotions, experiences, and feelings about therapy itself. Therapists often report having a strong desire to meet their clients where their clients are ready to be met. Providing an additional channel for communication (i.e. other than informal queries in session) will help them move towards this goal. Some clients may feel more comfortable disclosing a symptom or therapeutic rupture on a form than directly to the clinician; the use of objective, validated measures can allow therapists to be aware of these issues without requiring the client to bring them up on their own.

Clients are also less likely to drop out of treatment if they feel that their therapist is responsive to their needs. This means being aware of both the client’s symptoms and the degree to which they are suffering, and being cognizant of the therapeutic relationship and ensuring that it is productive. Studies have repeatedly demonstrated that there is often a disconnect between how the client feels and how the provider thinks the client feels, and therapists who are able to minimize this gap and flexibly respond will find that their clients stay in therapy longer and get well more quickly.

The Time is Now

Advances in technology have led to the development of a number of different methods for administering, scoring, and integrating clients’ responses to both symptoms and outcomes measures into the EHR, to minimize the burden on providers and administrative staff. Clients are increasingly interested in using technology tools to manage their health care, and the use of such devices and programs to monitor treatment progress is an excellent application of such technology.

Many clinicians have been proactive and excited about implementing empirically-supported treatments, and have been outspoken advocates for the use of proven therapies. Why are we so resistant to outcome monitoring and Measurement-Based Care? While behavior change is never easy, as healthcare providers we are obligated to do it when we know there are effective, proven strategies we can implement to improve our care delivery. This means doing progress monitoring and adjusting treatment plans and interventions based on our clients’ feedback. Mental health providers are also health care consumers, and I challenge them to imagine seeing a physician who does not routinely make objective measurements such as blood tests and weights while crafting and managing a treatment plan. Why should mental health be any different when it comes to tracking progress?

Originally published on PsychCentral Pro: https://pro.psychcentral.com/our-ethical-obligation-to-practice-outcome-monitoring/0019316.html

Managing Work-Related Stress

Many of us experience stress related to our work environment. After all, full-time employees spend about half of their waking hours at work. Often our co-workers become the people we have the most daily contact with. Unfortunately, intense pressure to succeed or complicated interpersonal situations can build tension and lead individuals to feel overwhelmed or burned out and dread going to work in the morning. The good news is that there are some things you can do to manage work stress and improve how you feel about your job.

Take good care of your body. Getting enough sleep, not overdoing it on the office coffee or break-room sweets, and getting regular exercise can help. If you have trouble falling asleep at night, try eliminating afternoon caffeine and turning off screens an hour before you want to fall asleep. Develop a regular pre-bedtime routine like a warm bath, cup of herbal tea, or reading a favorite book. You could also try practicing a meditation or relaxation exercise in the evening to help wind down. Physical exercise can be great for boosting your emotional state–it causes the release of mood-boosting hormones and can help you let go of the stress of the day.

Develop boundaries. Due to the development and ever-increasing presence of communication (phone calls, emails, instant messages, webinars, texts, social media, etc), it can be hard to find time to focus on doing your actual work. Blocking out time in your calendar when you are unavailable can be helpful. Alternatively, you can make specific times available for meetings and last-minute tasks so that they don’t crowd out other things.

It’s also important to have good work/life balance, which might mean turning off your phone in the evening or turning off email or message notifications. It can be hard to put your own needs first, but when you feel rested and like you have your own personal space, you will be much more productive when you ARE in the office.

Delegate, prioritize, and communicate. Remember that you are not the only person at your company. Ask co-workers to contribute with tasks that aren’t in your area, or if you feel you won’t be able to get them accomplished in time. It’s important to keep your job title and role in mind. Prioritizing what needs to be done first and breaking those tasks down into smaller steps can help you feel less overwhelmed and have a clear path forward.  In cases where you need to have difficult conversations with others, try to be specific and clear about your concerns or complaints, and focus on their actions or behaviors rather than their character. Try to avoid gossip and talking about that individual with people other than the individual themselves.

Practice self-care. This could be as simple as taking a ten minute break during your day to practice a guided meditation. Meditation and deep breathing exercises can help you reduce your work stress by redirecting your attention from negative thoughts or emotions.  On your time off, take time to do something fun, like re-engaging with a hobby, or connecting with friends or family. Use your vacation time, stay home when you don’t feel well, and remember that you need to take care of yourself to be your best.

Consider all angles. Difficult or complicated interpersonal situations are not uncommon in work environments. It’s important to keep in mind that our perceptions of these events are just that–our perceptions. Everyone interprets things differently, and it can be helpful to take a step back and try to objectively identify what’s happened. Perhaps you’re making assumptions about someone else’s motives, or allowing your frustration from some other area of your life to bleed into what’s going on at work. Using a thought record (such as the “reframe” tool in the Pacifica app) can help you to break the situation down and get a clearer view. Once you’ve done that and taken a moment to reflect, you can then respond more appropriately.