Abstract

Adjunctive mobile mental health apps to supplement mental health treatment have been growing in recent years given their ability to address treatment engagement barriers. However, few studies have explicitly examined how these mobile apps impact treatment engagement, and even fewer have investigated this topic through adolescents’ perspectives. To this end, we conducted semi-structured interviews with five adolescents who used an adjunctive mobile mental health app in combination with telehealth cognitive behavioral group therapy for social anxiety. Using a multidimensional framework of treatment engagement, we elicited their perspectives on how the app impacted their engagement in telehealth group therapy and gathered their suggestions for improving the app. Using a consensual qualitative research approach, we learned that adolescents felt the app increased their comfort with others in therapy and their expectations about the effectiveness of mental health apps. They also indicated that the app prepared them for in-session participation and facilitated out-of-session skills practice. Adolescents had valuable suggestions such as adding app features to facilitate social connectedness between group members and adding appointment reminders in the app. This preliminary study highlights implications for future adjunctive mobile mental health app developers and researchers to increase adolescents’ treatment engagement in mental health services.

Highlights

  • Adjunctive mobile mental health apps can be especially useful in keeping clients engaged in telehealth therapy, in which therapy is conducted through video conferencing, since previous research suggests that telehealth therapy can hinder therapeutic alliance (Farabee et al 2016)

  • The codebook consisted of 25 codes, which were organized into five categories according to the REACH domains of treatment engagement

  • We interviewed five adolescents who used the SmartCAT app in conjunction with group therapy treatment for social anxiety

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Summary

Introduction

Mobile mental health apps have great potential to supplement traditional adolescent mental health services and facilitate treatment engagement by addressing common barriers to treatment engagement (Silk et al 2020). Some of these barriers include low application of therapeutic skills outside of session or poor knowledge of treatment concepts (Becker et al.2018). Given that higher treatment engagement is associated with better treatment outcomes (Clarke et al.2015; Danko et al 2016), understanding how mobile mental health apps can be leveraged to support treatment engagement may improve adolescent mental health treatment outcomes as well

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