Ethical and Legal Issues Addressing the Use of Mobile Health (mHealth) as an Adjunct to Psychotherapy

Karcher, Nicole R.; Presser, Nan R.

doi:10.1080/10508422.2016.1229187

Cited by 25 publications

(26 citation statements)

References 43 publications

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“…Informed consent includes making a full disclosure to clients about the type of services being offered, the risks, and the potential benefits (Karcher & Presser, 2018). Failure to provide adequate informed consent can result in legal liability.…”

Section: Standards 310: Informed Consent and 402: Limits To Confident...mentioning

confidence: 99%

“…The informed consent process also should address how clients can safeguard their data from unintended disclosures. This often can be accomplished by password protecting either the device or the app itself (Epstein & Bequette, 2013;Karcher & Presser, 2018).…”

Section: Standards 310: Informed Consent and 402: Limits To Confident...mentioning

confidence: 99%

“…Intervention equivalence can be difficult to determine for new technologies, given that the emerging evidence base for mobile health adjuncts to treatment may lag behind adoption rates (Armstrong et al, 2017). In keeping with this principle, psychologists should inform clients about the degree of empirical support for using a particular mobile app as an adjunct to treatment (Epstein & Bequette, 2013; Karcher & Presser, 2018). This is supported in the ethics code (2.04 and 9.01) where “psychologists’ work is based upon established scientific and professional knowledge of the discipline.” Recent reviews differ on whether or not the empirical evidence base for the use of mobile technologies as an adjunct to face-to-face care is sufficient (e.g., Armstrong et al, 2017; Lui, Marcus, & Barry, 2017; Parker et al, 2018).…”

Section: Apa Ethics Principlesmentioning

confidence: 99%

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Mobile applications for client use: Ethical and legal considerations.

Edwards‐Stewart¹,

Alexander²,

Armstrong³

et al. 2019

Psychological Services

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Mobile applications (apps) to support behavioral health are increasing in number and are recommended frequently by medical providers in a variety of settings. As with the use of any adjunct tool in therapy, psychologists adopting new technologies in clinical practice must comply with relevant professional ethics codes and legal standards. However, emerging technologies can outpace regulations regarding their use, presenting novel ethical considerations. Therefore, it is incumbent upon providers to extrapolate current ethical standards and laws to new technologies before they recommend them as adjuncts to face-to-face treatment. This article identifies best practices for incorporating apps into treatment, including competence in the use of smartphones in general and familiarity with the specific apps recommended. Psychologists must conduct informed consent procedures in accordance with existing evidence, as well as privacy and security concerns relating to a particular app, in order to mitigate potential liability regarding the collection of client-generated data. Psychologists also should be prepared to educate clients about how best to safeguard their data, such as through encryption, password protection, or remote deletion of data. By doing so, psychologists can balance potentially competing demands of leveraging emerging technology to improve care while simultaneously ensuring ethical and legal compliance in these new areas.

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Section: Standards 310: Informed Consent and 402: Limits To Confident...mentioning

confidence: 99%

Section: Standards 310: Informed Consent and 402: Limits To Confident...mentioning

confidence: 99%

Section: Apa Ethics Principlesmentioning

confidence: 99%

See 1 more Smart Citation

Mobile applications for client use: Ethical and legal considerations.

Edwards‐Stewart¹,

Alexander²,

Armstrong³

et al. 2019

Psychological Services

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“…Reviews of publicly available apps for depression also highlighted insufficiencies in the treatment and safety information provided, including limited disclaimers [27], limited encouragement for users to seek in-person care [29], and inadequate reporting of affiliations or expert involvement [31,32]. Reviews of the ethics of mobile mental health [33,34] have also raised concerns with acceptance [35], risks and safety of apps [36][37][38][39][40][41][42][43][44][45][46][47], and the poverty of evidence regarding benefits and outcomes [36][37][38][39][40][42][43][44][45][46]48,49]. Therefore, there is uncertainty as to how well apps for depression match existing clinical guidelines and recommendations, their treatment fidelity (ie, adherence to components of a treatment orientation) and evidence base, and their safety for use with or without support.…”

Section: Mobile Apps For Depressionmentioning

confidence: 99%

Evaluation of Treatment Descriptions and Alignment With Clinical Guidance of Apps for Depression on App Stores: Systematic Search and Content Analysis (Preprint)

Bowie-DaBreo¹,

Sünram-Lea²,

Sas³

et al. 2019

Preprint

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BACKGROUND The use of apps for the treatment of depression shows great promise. However, there is uncertainty regarding the alignment of publicly available apps for depression with clinical guidance, their treatment fidelity and evidence base, and their overall safety. OBJECTIVE Built on previous analyses and reviews, this study aims to explore the treatment and safety issues of publicly available apps for depression. METHODS We conducted a content analysis of apps for depression in the 2 main UK app stores (Google Play and Apple App Store). App store listings were analyzed for intervention content, treatment fidelity, and fit with the National Institute for Health and Care Excellence (NICE) guidelines for the treatment of depression in adults. RESULTS A total of 353 apps for depression were included in the review. App descriptions reported the use of 20 treatment approaches and 37 treatment strategies. Many apps used transdiagnostic (155/353, 43.9%) and multitheoretical interventions to treat multiple disorders including depression. Although many interventions appeared to be evidence-informed, there were issues with treatment fidelity, research evidence, and fit with clinical guidelines. None of the apps fully aligned with the NICE guidelines for depression. CONCLUSIONS App developers have adopted many evidence-informed treatments in their interventions; however, more work is needed to improve clinical validity, treatment fidelity, and the safety of apps. We urge developers to consult relevant guidelines and standards, and to engage in reflective questioning on treatment and safety to address these issues and to improve treatment content and intervention design.

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“…However, among the massive number of apps potentially available to users, only a small proportion have been empirically validated, making it tedious for users to identify an app suitable for their concerns [ 5 , 14 ]. Apps also have their share of ethical issues and risks [ 15 - 16 ]. In addition, low mental health literacy and limited to no data on the utility of the information provided within the app adds to the complexity of finding a relevant app [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Suicide Prevention Mobile Apps for Indian Users: An Overview

Sudarshan

Mehrotra

2021

Cureus

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Suicide is an issue of global concern. Mobile applications (apps), if found effective, could supplement suicide prevention efforts by addressing some of the barriers to help-seeking. This study aimed to review the nature of suicide prevention apps available for Indian users using the Android platform. Apps identified were broadly reviewed on general features, inclusion of educative elements, suicide risk assessment, and strategies to manage suicidal thoughts. The search terms "suicide," "suicide prevention," and "feeling suicidal" were used to search the Google Play Store from May to December 2020, and apps exclusively focusing on suicide prevention were identified and reviewed.The initial search resulted in 492 apps, of which 43 met inclusion criteria and were further assessed. Fewer than half the apps included supplementary information to users on scientific, evidence-based content (32.55%), and only a few apps were reported to be empirically validated (11.62%). Approximately one-third of the apps intended for people at suicidal risk had an initial screening aspect (16.12%), and one-third of the apps intended for support providers had a suicide risk assessment tool (25.92%). Most apps (81.39%) included a suicide helpline number specific to the region where they were developed, but only a few (23.25%) included motivational elements to call helplines. Common therapeutic strategies suggested to manage suicidal thoughts included distraction, means restriction, environment safety, perspective-shifting strategies, and calming or soothing strategies. Several apps (39.53%) included therapeutic strategies through safety plans.For apps to be used effectively for suicide prevention, they should include evidence-based content and motivational elements to call helplines, and and clinicians need to examine app features and content before recommending them for use by patients.

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Ethical and Legal Issues Addressing the Use of Mobile Health (mHealth) as an Adjunct to Psychotherapy

Cited by 25 publications

References 43 publications

Mobile applications for client use: Ethical and legal considerations.

Mobile applications for client use: Ethical and legal considerations.

Evaluation of Treatment Descriptions and Alignment With Clinical Guidance of Apps for Depression on App Stores: Systematic Search and Content Analysis (Preprint)

Suicide Prevention Mobile Apps for Indian Users: An Overview

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