Smart phone as patient tool: A mental health application

A project funded by the National Institute on Drug Abuse can turn a smart phone into a tool for aiding people with borderline personality disorder during vulnerable moments when therapists are not available.

The Dialectical Behavior Therapy (DBT) Field Coach is spearheaded by Behavioral Tech Research, a Seattle-based company that applies information technology and e-learning to mental health applications. The company received a grant from the institute to fund a prototype of the mobile application.

DBT helps patients learn skills for regulating their emotions through individual and group therapy. The DBT Field Coach aims to keep the principles readily at hand when a therapist isn’t available.

“When you are in a crisis, the time to actually use DBT skills is in the moment in the field, in the context of real life,” said Linda Dimeff, vice president and chief scientific officer at Behavioral Tech Research. “It’s not always possible to contact the therapist after-hours.”

Dimeff and Shireen Rizvi, assistant professor of psychology at the Graduate School of Applied and Professional Psychology at Rutgers University, are principal investigators on the project. They work in collaboration with the University of Washington and with David Carroll, an assistant professor of media design at Parsons the New School for Design.

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People with borderline personality disorder have a high risk of suicide and substance abuse, which makes the immediacy of the cell phone-based coach especially important. But timeliness isn’t the application’s only virtue, Rizvi said.

She cited the app’s ability to engage clients and said DBT Field Coach emerged from an iterative development process in which users were asked about the specific language used in the application and their experience navigating it.

“We really developed something in line with what people wanted and could use,” she said.

Patients follow a flow chart of sorts that seeks to help them deal with difficult emotions. For example, the application prompts patients to scroll through a menu of emotions to identify the one that is causing them the most distress. Depending on the emotion, the application then leads users down a step-by-step path for defusing the situation using DBT skills.

In addition to skills coaching, the application includes a set of definitions that users can refer to if a word or phrase is unclear to them.

Dimeff said the next phase of the application might use a smart phone’s Global Positioning System capabilities to provide contextual intelligence. She said she envisions adding information on places known to be high-risk areas for drug purchasing and use. As the user enters a hot spot, a message would pop up on the phone asking whether the person needs coaching.

The next phase of the application will be Web browser-based and available for a range of smart phones, Dimeff said. The prototype runs on Nokia phones.