Designing Mobile Applications to Support Mental Health Interventions

Abstract

The advent of mobile technology has brought computing to a wide range of new contexts, some of which are highly sensitive and place new constraints on the designer. In this chapter we discuss issues related to the design and evaluation of mobile software for sensitive situations where access to the end-user is extremely restricted. We focus on the specific example of technological interventions that support adolescents in mental health care settings. We examine the practical and ethical constraints placed on access to end-users and contexts of use, and how this may affect approaches to design and evaluation. General design recommendations for this area are described. We consider approaches to iterative design with mental health care professionals, and how research on technological and therapeutic aspects may proceed in tandem. We identify methods that can be used when conducting evaluation in these limited situations and describe a methodology for maximising the value of such evaluation. By way of illustration, we present the design and evaluation of a mobile phone-based "mood diary" application designed for use in clinical situations by adolescents undergoing mental health interventions.

Cognitive Behavior Therapy for Anxious and Depressed Youth: Improving Homework Adherence Through Mobile Technology

“…The process is user-centered from the outset involving end users (youth, therapists) participating in multiple iterative rounds of design, testing, redesign, and retesting until the interface is deemed easy to use, acceptable, and ready for implementation [64]. In the area of mental health, ethical guidelines emphasizing the protection of patients against harm [65,66] suggest that, to ensure a safe design, the process should begin outside the context of treatment with end users who are similar to the target patient end users but are free of diagnosed mental health problems. Once the design is deemed safe, further rounds of testing and refinement are conducted with target end users who are diagnosed and in treatment.…”

“…The think aloud method [65] involves verbalizing thoughts while performing a task. It is effective for usability testing because it helps identify which interface features users find intuitive and easy to use and which require improvement and further evaluation [65].…”

“…We will also adhere to a design approach recommended for sensitive areas like mental health [65,66], in which design begins in a nonclinical context to ensure a safe design before evaluating usability in the context of treatment (see below). In addition, the design will include a data collection system that enables analytics for ongoing improvement and customization of the app for different cognitive profiles.…”

Design and evaluation guidelines for mental health technologies

“…Peer trials have been used at a later stage of development to help evaluate the suitability, viability and appeal of systems in realistic contexts (Matthews et al, 2008a). One benefit of this type of evaluation is that it can provide evidence that the system is engaging and is suitable for clinical use.…”

A systematic review of the psychometric properties, usability and clinical impacts of mobile mood-monitoring applications in young people

“…A scoping review by Seko et al (2014) suggested that mood-monitoring apps are positively perceived by youth (Matthews et al 2008a), may improve treatment adherence (Matthews et al 2008b) and possibly improve mental wellbeing . While intriguing, findings were preliminary due to the low quality of available evidence (NCCMH, 2014), the small number of studies on mood-monitoring apps specifically and the limited number of apps studied (n = 2) (NCCMH, 2014;Seko et al 2014).…”