Brian E Bunnell1,2, Lynne S Nemeth3, Leslie A Lenert2, Nikolaos Kazantzis4, Esther Deblinger5, Kristen A Higgins2, Kenneth J Ruggiero6. 1. Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA. 2. Biomedical Informatics Center, College of Medicine, Medical University of South Carolina, Charleston, SC, USA. 3. Department of Nursing, College of Nursing, Medical University of South Carolina, Charleston, SC, USA. 4. Cognitive Behavior Therapy Research Unit and School of Psychological Sciences, Monash University, Clayton, VIC, Australia. 5. Child Abuse Research Education & Service (CARES) Institute, Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA. 6. Technology Applications Center for Healthful Lifestyles, College of Nursing, Medical University of South Carolina, Charleston, SC, USA.
Abstract
BACKGROUND: Homework, or between-session practice of skills learned during therapy, is integral to effective youth mental health TREATMENTS. However, homework is often under-utilized by providers and patients due to many barriers, which might be mitigated via mHealth solutions. METHODS: Semi-structured qualitative interviews were conducted with nationally certified trainers in Trauma Focused Cognitive Behavioral Therapy (TF-CBT; n=21) and youth TF-CBT patients ages 8-17 (n=15) and their caregivers (n=12) to examine barriers to the successful implementation of homework in youth mental health treatment and potential mHealth solutions to those barriers. RESULTS: The results indicated that many providers struggle to consistently develop, assign, and assess homework exercises with their patients. Patients are often difficult to engage and either avoid or have difficulty remembering to practice exercises, especially given their busy/chaotic home lives. Trainers and families had positive views and useful suggestions for mHealth solutions to these barriers in terms of functionality (e.g., reminders, tracking, pre-made homework exercises, rewards) and user interface (e.g., easy navigation, clear instructions, engaging activities). CONCLUSIONS: This study adds to the literature on homework barriers and potential mHealth solutions to those barriers, which is largely based on recommendations from experts in the field. The results aligned well with this literature, providing additional support for existing recommendations, particularly as they relate to treatment with youth and caregivers.
BACKGROUND: Homework, or between-session practice of skills learned during therapy, is integral to effective youth mental health TREATMENTS. However, homework is often under-utilized by providers and patients due to many barriers, which might be mitigated via mHealth solutions. METHODS: Semi-structured qualitative interviews were conducted with nationally certified trainers in Trauma Focused Cognitive Behavioral Therapy (TF-CBT; n=21) and youth TF-CBT patients ages 8-17 (n=15) and their caregivers (n=12) to examine barriers to the successful implementation of homework in youth mental health treatment and potential mHealth solutions to those barriers. RESULTS: The results indicated that many providers struggle to consistently develop, assign, and assess homework exercises with their patients. Patients are often difficult to engage and either avoid or have difficulty remembering to practice exercises, especially given their busy/chaotic home lives. Trainers and families had positive views and useful suggestions for mHealth solutions to these barriers in terms of functionality (e.g., reminders, tracking, pre-made homework exercises, rewards) and user interface (e.g., easy navigation, clear instructions, engaging activities). CONCLUSIONS: This study adds to the literature on homework barriers and potential mHealth solutions to those barriers, which is largely based on recommendations from experts in the field. The results aligned well with this literature, providing additional support for existing recommendations, particularly as they relate to treatment with youth and caregivers.
Authors: Holly R Wethington; Robert A Hahn; Dawna S Fuqua-Whitley; Theresa Ann Sipe; Alex E Crosby; Robert L Johnson; Akiva M Liberman; Eve Mościcki; Leshawndra N Price; Farris K Tuma; Geetika Kalra; Sajal K Chattopadhyay Journal: Am J Prev Med Date: 2008-09 Impact factor: 5.043