Therapy by Computer — Or Psycho-education on Steroids?
Technology is here and evolving more rapidly than we might imagine. It is time that we shed the idea that all good work needs to be “therapy.” Behavior change simply isn’t a black or white issue. We’ve already seen the rapid evolution of various forms of online psycho-education, cognitive rehabilitation (mental gyms), relaxation training, cognitive thought monitoring, journal review and sharing with social networks, and much more. The psycho-education potential of mental health practitioners has barely begun. Existing informational marketing approaches developed exclusively for the Internet will bring billions of people into the fold. It’s just up to us to get involved and be the ones who bring them to such resources.
A quick search online will show thousands of weight loss, stress management, ADHD, smoking cessation, dating, divorce, parenting and other programs that are developed by some guy in his garage. They are void of an empirical base of knowledge, and lack their own efficacy studies. This is where we have an unprecedented opportunity as a community of scientifically trained professionals who are experts at changing human behavior. At the TeleMental Health Institute, we will systematically show you how to get involved with the largest human growth movement the world has ever seen — and much of it will be served to the consumer through their smartphone or tablet.
Apps as Tools for Clinicians
Clinicians may also develop new and more efficient ways of processing information transmitted to them from the patients who use such apps. For instance, clinicians may be able to respond to their self-help programs “users” both in a group and individual way — combining generic, “core” information and tailoring it to each individual. For example, an eating disordered woman who is single may be given eating disorder information and asked to speak with her family or friends about it, but a married woman getting the same information may be asked to speak with her spouse as well as their family and friends. With time, such interfaces (smartphone apps) will evolve to give very specific and accurate “next lessons” to consumers based on their previous submissions. Combined with anonymous and secure social networking systems, these systems effectively change behavior. They will only improve between now and 2020.
For instance, see Jim Procahska’s Prochange.com website for an example of computer-based psychotherapeutic interventions not only of the future, but of today. Smartphones then, will revolutionize how we conceptualize treatment as well as how we work. We will be able to reach people who never knew of psychotherapy, and possibly never will, but who may benefit from learning diaphragmatic breathing, behavioral rehearsal, brainstorming skills, or simple tracking of their own behavior sequences. Our apps can be translated into other languages, adapted by colleagues we never met to serve purposes we never imagined.
Self-help Available to Everyone?
Not only will we be able to provide direct care through 1-1 psychotherapy via mobile phones, but we will have hundreds of thousands of “apps” to help us serve the patient who sits in front of us, either in-person, through a video screen, or who will never conceive of seeing a therapist at all. We can and will reach worldwide populations. Self-help psycho-education, unlike direct care, is not subject to licensing limitations, so an international audience is certainly possible. All in all, consumers will have a dizzying array of self-help options, so the role of the therapist may be to suggest, direct and oversee the use of various technology-based self-help tools, specific social networks, and other tools which we haven’t yet imagined. It’s a brave new world, and hopefully, some of you will join us in it.
In summary, by 2020, mobile telephone connections will all be HIPAA secured, consumers will understand that 2-way video aided by text as it already is in Skype is optimal for serious, emotionally-laden conversations. To make it more reasonable for professionals to engage in their work, and to lower health care dollars, we will receive insurance reimbursement for telehealth. Furthermore, we will have dizzying access to tools developed from worldwide clinicians through “apps.” We will have begun the exciting work of collaborating with unknown colleagues from around the planet to develop tools to change human behavior.
These are some of my thoughts. What are yours?