We believe currently available interventions can be easily divided into; Type 1. Interventions delivered by human therapists through eMedia (e.g.,AVATAR Therapy), Type 2. Interventions that are underpinned by a manualized, evidence based, and theoretically sound real world intervention (e.g., Mood gym) or apps that help with such interventions, like thought diaries or breathing apps, and Type 3. Interventions that are not based in real world examples, and are purely developed to be delivered in mHealth format. It follows that the type 1, and 2 interventions need less rigorous testing and reporting than the type 3 apps. It also means the type 1 apps are only to be used by trained therapists, while type 2 can be used by the public (like over the counter drugs). These are initial thoughts and opinions and disagreements are welcome.
In the case of Internet-based therapies I have most often read the following differentiations in the literature: unguided self-help treatment (mostly ICBT, self-help apps), therapist/Counselor-guided self-help treatment (ICBT, IPT, bibliotherpy-approaches) and videoconference psychotherapy.
Dear Jennifer
Thank you. Yes, this is right. We have recently tried to clarify these definitions in a chochrane review http://www.cochrane.org/CD011698/SCHIZ_self-help-and-guided-self-help-interventions-for-schizophrenia-and-related-disorders
But the issue is more complex as we try to classify the apps that deliver psycho-social interventions. Hence the suggested classification. However, I am looking for a wider consultation as this field is still at its infancy stages.
Regards
There is going to be a type 4 which is new mhealth interventions that work in new ways. These will need more research and validation - but likely me more successful than trying to fit old treatments into the new form of a phone (eg CBT on a smartphone) or forcing clinical workflow that already exists onto mobile. Instead something new may emerge that takes full advantage of the phone for mental health. Look to other fields and the IoT for inspiration, like dimming lights on schedule of iCBT and behavioral nudges delivered via the environment. New Tools -> New Treatments.
Also, be careful with type 2. What works well face to face does not always work well in mobile, eg https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4410684/. Engagement is also trickier here than many want to admit.
Regards
Thank you for sharing your insights, John. I totally agree, especially with your comments regarding the engagement. I think people are still in the excitement of new gadget phase now. The best example of failure to look at the engagement is Simon Gilbody's paper in which they found no effect between usual care and mHealth interventions for depression. I call it Gilbody's fallacy, as they did not look into digital literacy of the group and gave no information on age and did not take into consideration the results according to the digital literacy factors.
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