Evaluation of a Mobile App to Enhance Relational Awareness and Change During Cognitive Analytic Therapy: Mixed Methods Case Series (Preprint)

Abstract

BACKGROUND There has been a lack of MMHealth innovation in technology supporting the delivery of integrative psychotherapies. This project evaluated an app that supports patients being treated with cognitive analytic therapy (CAT) to practice relational awareness. OBJECTIVE To assess the manner in which patients and therapists experienced using the technology (i.e. the ‘CAT-App’) and to assess the relationship between CAT-App usage and clinical outcome. METHODS A mixed-methods case series. Patients completed the CORE-OM outcome measure pre and post CAT. Mood data, and the frequency and effectiveness of relational awareness were collected via the CAT-App. Therapists and patients were interviewed about their experiences of using the CAT-App. RESULTS Ten patients (treated by three therapists) were enrolled and seven completed CAT and four had a reliable improvement in their mental health. There was a significant difference in CAT-App usage between completers and dropouts, but CAT-App usage and mood change did not differ according to clinical outcome. Therapists’ qualitative themes were (a) the challenge of incorporating the technology into clinical practice and (b) the perceived barriers/benefits of the technology. Clients’ themes were, (a) data protection, (b) motivation and engagement and (c) restrictions/flexibility. CONCLUSIONS Whilst the CAT-App maps onto the phases of the CAT model and holds promise in terms of enabling relational awareness, it is not a replacement for the therapy itself.