Skip to main content
Full access
Articles
Published Online: 7 July 2020

Augmenting Evidence-Based Care With a Texting Mobile Interventionist: A Pilot Randomized Controlled Trial

Abstract

Objective:

This study aimed to evaluate the feasibility and clinical utility of training intensive psychiatric community care team members to serve as “mobile interventionists” who engage patients in recovery-oriented texting exchanges.

Methods:

A 3-month pilot randomized controlled trial was conducted to compare the mobile interventionist approach as an add-on to assertive community treatment (ACT) versus ACT alone. Participants were 49 individuals with serious mental illness (62% with schizophrenia/schizoaffective disorder, 24% with bipolar disorder, and 14% with depression). Clinical outcomes were evaluated at baseline, posttreatment, and 6-month follow-up, and satisfaction was evaluated posttreatment.

Results:

The intervention appeared feasible (95% of participants assigned to the mobile interventionist arm initiated the intervention, texting on 69% of possible days and averaging four messages per day), acceptable (91% reported satisfaction), and safe (no adverse events reported). Exploratory posttreatment clinical effect estimations suggested greater reductions in the severity of paranoid thoughts (Cohen’s d=–0.61) and depression (d=–0.59) and improved illness management (d=0.31) and recovery (d=0.23) in the mobile interventionist group.

Conclusions:

Augmentation of care with a texting mobile interventionist proved to be feasible, acceptable, safe, and clinically promising. The findings are encouraging given the relative ease of training practitioners to serve as mobile interventionists, the low burden placed on patients and practitioners, and the simplicity of the technology. The technical resources are widely accessible to patients and practitioners, boding well for potential intervention scalability. When pandemics such as COVID-19 block the possibility of in-person patient-provider contact, evidence-based texting interventions can serve a crucial role in supporting continuity of care.

Formats available

You can view the full content in the following formats:

Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Pages: 1218 - 1224
PubMed: 32631130

History

Received: 10 April 2020
Revision received: 4 May 2020
Accepted: 21 May 2020
Published online: 7 July 2020
Published in print: December 01, 2020

Keywords

  1. mHealth
  2. schizophrenia
  3. bipolar disorder
  4. depression
  5. assertive community treatment
  6. digital interventions

Authors

Details

Dror Ben-Zeev, Ph.D. [email protected]
Department of Psychiatry and Behavioral Sciences, BRiTE Center, University of Washington, Seattle (Ben-Zeev, Buck, Meller, Hallgren); Department of Psychological and Brain Sciences, Dartmouth College, and Department of Psychiatry, Dartmouth Geisel School of Medicine, Hanover, New Hampshire (Hudenko).
Benjamin Buck, Ph.D.
Department of Psychiatry and Behavioral Sciences, BRiTE Center, University of Washington, Seattle (Ben-Zeev, Buck, Meller, Hallgren); Department of Psychological and Brain Sciences, Dartmouth College, and Department of Psychiatry, Dartmouth Geisel School of Medicine, Hanover, New Hampshire (Hudenko).
Suzanne Meller, M.P.H., M.S.W.
Department of Psychiatry and Behavioral Sciences, BRiTE Center, University of Washington, Seattle (Ben-Zeev, Buck, Meller, Hallgren); Department of Psychological and Brain Sciences, Dartmouth College, and Department of Psychiatry, Dartmouth Geisel School of Medicine, Hanover, New Hampshire (Hudenko).
William J. Hudenko, Ph.D.
Department of Psychiatry and Behavioral Sciences, BRiTE Center, University of Washington, Seattle (Ben-Zeev, Buck, Meller, Hallgren); Department of Psychological and Brain Sciences, Dartmouth College, and Department of Psychiatry, Dartmouth Geisel School of Medicine, Hanover, New Hampshire (Hudenko).
Kevin A. Hallgren, Ph.D.
Department of Psychiatry and Behavioral Sciences, BRiTE Center, University of Washington, Seattle (Ben-Zeev, Buck, Meller, Hallgren); Department of Psychological and Brain Sciences, Dartmouth College, and Department of Psychiatry, Dartmouth Geisel School of Medicine, Hanover, New Hampshire (Hudenko).

Notes

Send correspondence to Dr. Ben-Zeev ([email protected]).

Competing Interests

Dr. Ben-Zeev has an intervention content licensing agreement with Pear Therapeutics and has a financial interest in FOCUS smartphone technology and in Trusst Health. He has consulted for Otsuka and eQuility. Dr. Hudenko has a financial interest in Voi, Trusst Health, and MentorWorks. Dr. Hallgren has consulted for Pear Therapeutics. The other authors report no financial relationships with commercial interests.

Funding Information

This research was supported by a grant from the National Institute of Mental Health (R56MH109554).

Metrics & Citations

Metrics

Citations

Export Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

For more information or tips please see 'Downloading to a citation manager' in the Help menu.

Format
Citation style
Style
Copy to clipboard

View Options

View options

PDF/EPUB

View PDF/EPUB

Full Text

View Full Text

Login options

Already a subscriber? Access your subscription through your login credentials or your institution for full access to this article.

Personal login Institutional Login Open Athens login
Purchase Options

Purchase this article to access the full text.

PPV Articles - Psychiatric Services

PPV Articles - Psychiatric Services

Not a subscriber?

Subscribe Now / Learn More

PsychiatryOnline subscription options offer access to the DSM-5-TR® library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Media

Figures

Other

Tables

Share

Share

Share article link

Share