Developing a motivational smartphone app to enhance CBT for OCD
Obsessive-Compulsive Disorder (OCD) is a common anxiety disorder. People with OCD are affected by repetitive, upsetting thoughts and/or distressing actions they feel they have to repeat. OCD can affect the ability to work, socialise and have a family life. Cognitive-Behavioural Therapy (CBT) is an effective talking therapy for OCD. However, up to half of patients do not fully recover after treatment, and up to a third stop treatment before the final session.
Therefore, it is important to improve CBT for OCD. Improving treatment could benefit around 15,000 people with OCD in the UK per year (who seek treatment). Experts have suggested that a key way to improve CBT for OCD is to help patients engage more with tasks between therapy sessions.
The aim of this research is to find out if a smartphone app could help patients with OCD engage with between-session tasks. The app would be a digital tool clinicians and patients use together in and between sessions. This could improve recovery rates.
The between-session tasks involve the person with OCD doing something to test out their fear, find out what happens when they test that fear, and learn to tolerate anxiety. Because these tasks involve facing fear, they are understandably challenging.
Some apps have already been developed in the USA, but these are for a different type of between-session task. Another problem is that these apps do not use any methods to make it easier to engage with the difficult tasks.
The app developed by this research will draw on what is called ‘persuasive technology’ and ‘gamification’. These use technology to increase motivation to carry out tasks by making them more fun, rewarding and easier. Motivational techniques include:
· making use of levels and challenges;
· rewards and feedback;
· a narrative and advice;
· sharing accomplishments with others.
Motivational apps have shown promise for Depression, Mindfulness and Compassionate Mind Training.
What do I plan on doing?
I will review the research literature. Clinicians and service users will be interviewed to find out how they think a motivational app could be beneficial.
I would give a plan for an app, based on these ideas, to a developer. Clinicians and service users would take part in focus groups to comment on the app as it is developed.
I would use the app with 12 patients with OCD at different points in their therapy. This allows me to see whether the introduction of the app into therapy makes a difference, without needing to recruit large numbers of patients.
If the findings suggest enough people are willing to try the app, and if it is acceptable and useful to a reasonable number of patients, future research would test its effectiveness with a larger group of patients. The finished app would make it easier for patients to follow their therapy plan, so more people would get better. This would also save the NHS money: if the app means 5% more patients recover, this would save the NHS £1M per year.
Sharing the Findings
The findings would be published in academic journals and conferences, as well as workshops for NHS clinicians, OCD charities and the app industry.
Please let me know what you think of this project plan at: https://forms.gle/EmoSRANDdy8p77Et7