If only I'd read about this last week. Would have been a perfect iPhone entry for Grand Rounds over at Shrink Rap (link in sidebar).
A $1.88 million Federal Government grant has been awarded to the Black Dog Institute and the University of New South Wales (UNSW) to undertake a program to enable Australians to manage their mental health problems via mobile phone and the internet.
The idea is that people will be able to track their status on a daily basis in areas such as mood, sleep, activities, medication, physical activity as well as drug and alcohol abuse. Aimed at adolescents and adults with or at risk of developing depression, anxiety or stress, the first stage of the program will be the internet version, to be followed by the mobile phone version.
Dr Judy Proudfoot, Senior Research Fellow at the Black Dog Institute and the School of Psychiatry at the University of New South Wales, explains that information is fed back to the users on how they are going and alerts are sent when things aren’t going well, along with links to appropriate self-help tools. In this way, the program parallels traditional face-to-face therapy, where people are asked to monitor their symptoms and activities.
A timely project. It will interesting to see how it turns out, particularly in terms of management of confidentiality because, quite coincidentally, someone recently mentioned that they do this kind of thing with their therapist between sessions. In contrast to the Black Dog project, they don't receive any feedback or response until the next session. Initially, it raised questions of boundaries and dependency for me, particularly when they said they would demand that any other therapist (they were thinking of changing) also do this. I didn't even stop to consider the unthinkable which happened when the therapist passed his/her phone along to someone else (not a therapist). All journalling entries then went to this third person who didn't pass them on. As you can imagine, the potential for distress in that situation proved significant.
A timely project. It will interesting to see how it turns out, particularly in terms of management of confidentiality because, quite coincidentally, someone recently mentioned that they do this kind of thing with their therapist between sessions. In contrast to the Black Dog project, they don't receive any feedback or response until the next session. Initially, it raised questions of boundaries and dependency for me, particularly when they said they would demand that any other therapist (they were thinking of changing) also do this. I didn't even stop to consider the unthinkable which happened when the therapist passed his/her phone along to someone else (not a therapist). All journalling entries then went to this third person who didn't pass them on. As you can imagine, the potential for distress in that situation proved significant.
6 comments:
We are in the process of putting together a project which will evaluate an SMS-based communications interface for scheduling and following-up apppointments in a youth-oriented mental health service. I think it is great to see these technology inspired projects popping up. The confidentiality issues however are significant and not easily dismissed. Clients need to be fully informed of the risks associated with transmitting information through these channels.
I kinda like the tech ideas. I do worry about confidentiality, liability etc as well.
I know that nothing replaces the human touch, so in person therapy will always be viable option for many, including myself.
Very cool post, HP
I worry more about dependency - at what point do these cues fade?
Hopefully at some point the clients will learn how to do it for themselves?
Having said this, I'm keen to try technology in some form as a 'bridging' programme for people who have completed a chronic pain management programme, for a defined period of time - and with indicators for those 'at risk' of failing to integrate their pain management skills and achieve their goals.
so kind of the twitter of moods - twoodle?
keep us posted. I see so much potential from a research perspective. what variables cause moods to swing low, anxiety to spike, etc.
It's a little to big brother for my taste.
You mentioned sleep patterns. I do shift work so don't have a normal time for sleep. I often sleep during the day. But sometimes have to switch to night sleeping. Sometimes 8 hours of sleep one day, 3 the next. I wounder if that makes depression, and/or anxiety worse?
Also, mobile based treatements are tried among children who are alienated or excluded of the society.
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