Digital Psychotherapy

The Ascent of Digital Therapies


Since 2000, technology had been evolving, making our lives simpler and faster. Aside from that, technology is now revolutionizing even our health care services. We are introduced to telepsychology and online consultations from the traditional and most common face-to-face appointments and sessions. It also changed the way we deal with different mental health issues today. Examples of these techniques include Exposure Therapy via Virtual Reality (VR) which other clinicians use in their treatment for cases such as trauma-related disorders, phobia, etc. Artificial Intelligence (AI) also appears to be the next frontier for psychology but is not being used in the mainstream as of the moment. (Gottsegen, 2019)


However, some of these new technologies actually were present way back, but only a few included this in their practice and were only popularized because of this pandemic. A new form of technology emerges, providing web-based applications and software that will help clinicians and clients tackle their mental health issues.


The Digital Space



WOEBOT


  • Woebot was created in 2017 by Standford psychologist and AI experts. It was then considered the world’s first chatbot designed to help improve mental health.

  • The chatbot used an accessible medium in the form of Facebook Messenger. It was designed as a conversational chatbot that uses Cognitive Behavioral techniques to provide solutions and help people suffering from less severe mental health issues.

  • Studies have already shown that the Woebot works in relieving depression and anxiety (Fitzpartick et al., 2017). It also showed potential to help with Post-Partum symptoms (Suharwardy et al., 2021 & Ramachandran et al., 2020) and may also help reduce substance abuse (Prochaska et.al., 2021)

  • Woebot Health created WB001, a digital therapeutic designed to reduce Postpartum depression. Recently, it was granted the Breakthrough Device Designation to the company’s digital therapeutic to treat postpartum depression (PPD) by the U.S. Food and Drug Administration (FDA). (Woebot Health, 2021)


SLEEPIO and DAYLIGHT



  • Both were developed by Big Health and use Cognitive Behavior techniques as a 6-week intervention. Sleepio was designed for insomnia and is lead by an animation in The Prof, the virtual assistant and expert on insomnia, and his narcoleptic dog, Pavlov. These two help with the intervention; Theseet et al., studies have shown a significant improvement in the symptoms of individuals who completed their course. (Barnes, et.al, 2017; Luik, et.al., 2017)

  • On the other hand, Daylight is used to help with worry and anxiety. It was designed to provide strategies that reduce symptoms of fear and anxiety. Similar to Sleepio, Daylight has studies that show a reduction of symptoms to those who were able to compete with 6-week intervention. (Big Health, 2020)


PEAR THERAPEUTICS reSET, reSET-O, and SOMRYST




  • Pear Therapeutics developed these apps, which are considered the First prescription digital therapeutics for disease treatment cleared by the FDA. These can only be prescribed to the client and use under the supervision of their clinician.

  • reSET works well with individuals with substance use disorders. The app works as a medium to track the individual’s progress, usage, triggers, and cravings. On the other hand, reSET-O is a variation used for opioid-used disorders.

  • While Somryst is used to help treat chronic insomnia. Unlike with the previous apps, Somyst is intended for individuals aged 22 above and has a grade 7 level. A study presented in Virtual Sleep 2020 supports that Somyrst was able to improve the individual’s sleep and reduce symptoms of depression and insomnia (Batterham et al., 2020)



Other mental health and mindfulness apps are also starting to make noise in the digital stream and download from any app store. Unlike the others, clinicians sometimes use these apps and don’t need a prescription to use them.



Today, technology continues to develop and emerge new ways to improve health services even, towards psychological services. Digital Psychotherapy has so much potential to be explored to help future clinicians and patients deal with psychological issues. However, despite the advantages that are present, there are also limitations that clinicians and experts need to address, especially towards ethics and legal concerns such as confidentiality and privacy issues, as well as regulation of the laws towards these programs, and raising awareness and educating both patients and clinicians on these innovations.



SOURCES:


  • Barnes CM, Miller JA, Bostock S. (2017). Helping employees sleep well: Effects of cognitive-behavioral therapy for insomnia on work outcomes. J Appl Psychol. 2017 Jan;102(1):104-113. DOI: 10.1037/apl0000154. Epub 2016 Oct 3. PMID: 27690480.


  • Batterham, P.J., Christensen, H., Thorndike, F. P., Ritterband, L.M., Gerwien, R., Enman, N., Botbyl, J., Maricich, Y. (2020). Web-delivered CBT for Insomnia Intervention Improves Sleep Among Adults with Insomnia and Depressive Symptoms. Virtual SLEEP 2020.



  • Fitzpatrick K., Darcy A., Vierhile M., (2017). Delivering Cognitive Behavior Therapy to Young Adults With Symptoms of Depression and Anxiety Using a Fully Automated Conversational Agent (Woebot): A Randomized Controlled Trial. JMIR Ment Health 2017;4(2):e19. URL: https://mental.jmir.org/2017/2/e19. DOI: 10.2196/mental.7785



  • Luik, A., Bostock, S., Chisnall, L., Kyle, S., Lidbetter, N., Baldwin, N., & Espie, C. (2017). Treating Depression and Anxiety with Digital Cognitive Behavioural Therapy for Insomnia: A Real World NHS Evaluation Using Standardized Outcome Measures. Behavioral and Cognitive Psychotherapy, 45(1), 91-96. doi:10.1017/S1352465816000369


  • Prochaska JJ, Vogel EA, Chieng A, Kendra M, Baiocchi M, Pajarito S, Robinson A. (2021) A Therapeutic Relational Agent for Reducing Problematic Substance Use (Woebot): Development and Usability Study. J Med Internet Res 2021;23(3):e24850. doi: 10.2196/24850PMID: 33755028PMCID: 8074987




  • Woebot Health. (2021). Retrieved from: https://woebothealth.com/woebot-health-receives-fda-breakthrough-device-designation/

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