From Newsgroup: comp.lang.mumps

<div>Background: A growing number of psychological interventions are delivered via smartphones with the aim of increasing the efficacy and effectiveness of these treatments and providing scalable access to interventions for improving mental health. Most of the scientifically tested apps are based on cognitive behavioral therapy (CBT) principles, which are considered the gold standard for the treatment of most mental health problems.</div><div></div><div></div><div>Methods: We searched the MEDLINE, PsycINFO, EMBASE, and PubMed databases for peer-reviewed studies published between January 1, 2007, and January 15, 2020. We included studies focusing on standalone app-based approaches to improve mental health and their feasibility, efficacy, or effectiveness. Both within- and between-group designs and studies with both healthy and clinical samples were included. Blended interventions, for example, app-based treatments in combination with psychotherapy, were not included. Selected studies were evaluated in terms of their design, that is, choice of the control condition, sample characteristics, EMI content, EMI delivery characteristics, feasibility, efficacy, and effectiveness. The latter was defined in terms of improvement in the primary outcomes used in the studies.</div><div></div><div></div><div></div><div></div><div></div><div>mental ray standalone 3.11.1 crack</div><div></div><div>Download: https://t.co/ed2lV00NQJ </div><div></div><div></div><div>Results: A total of 26 studies were selected. The results show that EMIs based on CBT principles can be successfully delivered, significantly increase well-being among users, and reduce mental health symptoms. Standalone EMIs were rated as helpful (mean 70.8%, SD 15.3; n=4 studies) and satisfying for users (mean 72.6%, SD 17.2; n=7 studies).</div><div></div><div></div><div>Conclusions: Study quality was heterogeneous, and feasibility was often not reported in the reviewed studies, thus limiting the conclusions that can be drawn from the existing data. Together, the studies show that EMIs may help increase mental health and thus support individuals in their daily lives. Such EMIs provide readily available, scalable, and evidence-based mental health support. These characteristics appear crucial in the context of a global crisis such as the COVID-19 pandemic but may also help reduce personal and economic costs of mental health impairment beyond this situation or in the context of potential future pandemics.</div><div></div><div></div><div>As mobile phone usage is ubiquitous, and mobile apps targeted at mental health are flooding the app market, mobile health (mHealth) interventions, which utilize mobile devices and technologies for mental health problems, are gaining popularity.1,2</div><div></div><div></div><div>Mental disorders are highly prevalent worldwide, can often have a detrimental impact on the life of affected individuals, and, to date, remain greatly undertreated.3,4 Although a wide array of evidence-based treatments exist, the majority of individuals with symptoms of mental disorders remain without treatment, even in high-income economies.5,6</div><div></div><div></div><div>Apart from structural treatment barriers such as availability, affordability, and time constraints, attitudinal factors play an even greater role in non-treatment-seeking behavior.7 Contributing factors hindering treatment uptake and treatment continuation include low perceived treatment need, poor mental health literacy, preference for self-reliance, and fear of stigmatization.7,8</div><div></div><div></div><div>Mobile devices could be utilized to overcome some of these issues. mHealth interventions utilizing apps on mobile devices have several benefits: (a) The threshold to use them is generally low and they provide the opportunity to engage individuals in need of treatment timely and anonymously by providing portable and flexible treatment; (b) mHealth might reach individuals who would otherwise not seek treatment;9 (c) most individuals already experience mobile devices to be an integral part of their everyday life and forthcoming generations are growing up as digital natives, where the use of apps for many different areas of life is becoming natural;10 (d) mHealth could be utilized to deliver large-scale interventions in emerging and low-income economies where resources for mental health are greatly limited,4 and (e) individuals can be supported in applying treatment-related skills in real life situations, in which behavior change is at its most vulnerable, and clinicians often struggle to support individuals appropriately.</div><div></div><div></div><div>The app-scape (app landscape) targeting mental health has increasingly been growing. According to a 2017 report, more than 318,000 health-related mobile apps were available for consumers of which 490 unique apps were targeted at mental health and behavioral disorders.11 A 2016 study scanning the app markets found 208 apps related to mental health or stress, most commonly targeting symptom relief (41%, 85/208) or general mental health education (18%, 37/208). The majority of identified apps did not mention any information on its effectiveness (59%, 123/208).12 Another study from 2018 rated the quality of depression apps available in German app stores with only 11% (4/38) showing some face validity, without any evidence on the effectiveness, and safety of any of the apps.13</div><div></div><div></div><div>Apps have been highly praised for their potential towards physical and mental health treatments.14 However, when considering using apps for mental health, there are also potential pitfalls. Disadvantages include technical aspects of delivery, such as screen size, battery life, system updates, technology requirements, as well as usage patterns, such as frequent but brief daily smartphone interactions, attentional competition between apps, short app lifespans, non-private settings, and data-security concerns.15,16,17</div><div></div><div></div><div></div><div></div><div></div><div></div><div>Unexpectedly, only very few studies have systematically examined the overall efficacy of mobile apps for mental health. A systematic review from 2013 by Donker et al., only found five apps, of which only three were evaluated in an RCT; targeting depression, anxiety and substance use, and with-in and between-group intention-to-treat effect sizes ranged from 0.29 to 2.28 at post-assessment and 0.01 to 0.48 at follow-up.18</div><div></div><div></div><div>Menon et al., conducted a systematic review on the feasibility of mobile phone apps and other mobile phone-based technology for psychotherapy in mental health disorders.19 Of 24 eligible articles, only eight involved smartphone apps. The eligible apps were found to be feasible and acceptable; however, no statistical analysis on the pooled efficacy was conducted.</div><div></div><div></div><div>Although apps have been present for approximately ten years and are already being utilized by individuals seeking help for mental health problems, their overall efficacy remains unknown. Therefore, it is crucial to address this issue systematically. The aim of this meta-analysis is to investigate whether standalone psychological interventions for mental health delivered via smartphone apps are efficacious in reducing symptoms of mental disorders and self-injurious thoughts and behaviors (STBs) in adults with heightened symptom severity.</div><div></div><div></div><div>Only 19 eligible trials were identified which evaluated the efficacy of a smartphone app designed to treat mental health symptoms in a randomized controlled trial, although hundreds of apps for mental health are available in the consumer app markets. This evaluation gap is in line with previous findings.13,27 All trials were conducted in high-income countries.</div><div></div><div></div><div>These findings imply that the accumulating evidence for digital mental health interventions delivered through the internet as an effective mean to treat mental health disorders cannot be directly translated to digital interventions delivered via standalone mobile apps for all mental disorders.</div><div></div><div></div><div>Differences between findings in the present study for app-based standalone interventions targeting mental health symptoms and those often found for internet-delivered mental health interventions might be explained by systematic differences in patient, trial, or intervention characteristics. For example, guidance has been associated with higher effect sizes in digital mental health interventions,34 and many of the here included trials evaluated purely self-guided interventions without support from a professional. However, recent trials also indicate significant and moderate to large effects for unguided internet mental health interventions for some disorders such as anxiety or insomnia.35,36 Research has suggested that efficacy of apps is also dependent on long-term adherence to an app, otherwise the impact may be limited, and prompts where shown to increase effectiveness.37 Far fewer than half of the investigated studies employed such strategies; eight studies prompted participant engagement by explicitly requesting input and only five studies sent intervention reminders based on adherence.</div><div></div><div></div><div>Overall, our knowledge of how to design effective mental health apps is very much at the beginning. Unlike established internet interventions, in which manuals for onsite psychotherapy can be directly translated and work very well, clinicians and researchers might need to start thinking outside of the box, and direct greater attention to the technological and persuasive design aspects of app-based interventions. Not being able to detect efficacy in many of the mental health domains might be based on an actual failure to deliver mental health treatment through mobile apps, however, this might also be based on the inefficacious manner in which the treatments were deployed and implemented.</div><div></div><div></div><div>When interpreting the findings, the following limitations should be considered. First, heterogeneity was substantial in most analyses, as was risk of bias. As there were limited studies per disorder, also in the narrative description of study effects, findings should be interpreted with caution. Our findings of limited or non-existent efficacy of standalone treatment delivered by smartphone apps could also be due to the limited amount of studies available. Heterogeneity was not explored in a content-focused manner, nor did we investigate the effects of different features and components on efficacy or engagement. Overall, the limited efficacy does not mean that apps for mental health do not work in general but could also be an indication that the deployment and implementation so far has been unsuccessful. Also, we did not monitor or investigate whether the onboarding process happened in person or virtually which in turn might influence engagement. Engagement should be investigated in future studies.</div><div></div><div> dd2b598166</div>
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