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How Inclusive, User-Centered Design Research Can Improve Psychological Therapies for Psychosis: Development of SlowMo

BACKGROUND: Real-world implementation of psychological interventions for psychosis is poor. Barriers include therapy being insufficiently usable and useful for a diverse range of people. User-centered, inclusive design approaches could improve the usability of therapy, which may increase uptake, adh...

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Autores principales: Hardy, Amy, Wojdecka, Anna, West, Jonathan, Matthews, Ed, Golby, Christopher, Ward, Thomas, Lopez, Natalie D, Freeman, Daniel, Waller, Helen, Kuipers, Elizabeth, Bebbington, Paul, Fowler, David, Emsley, Richard, Dunn, Graham, Garety, Philippa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6300708/
https://www.ncbi.nlm.nih.gov/pubmed/30518514
http://dx.doi.org/10.2196/11222
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author Hardy, Amy
Wojdecka, Anna
West, Jonathan
Matthews, Ed
Golby, Christopher
Ward, Thomas
Lopez, Natalie D
Freeman, Daniel
Waller, Helen
Kuipers, Elizabeth
Bebbington, Paul
Fowler, David
Emsley, Richard
Dunn, Graham
Garety, Philippa
author_facet Hardy, Amy
Wojdecka, Anna
West, Jonathan
Matthews, Ed
Golby, Christopher
Ward, Thomas
Lopez, Natalie D
Freeman, Daniel
Waller, Helen
Kuipers, Elizabeth
Bebbington, Paul
Fowler, David
Emsley, Richard
Dunn, Graham
Garety, Philippa
author_sort Hardy, Amy
collection PubMed
description BACKGROUND: Real-world implementation of psychological interventions for psychosis is poor. Barriers include therapy being insufficiently usable and useful for a diverse range of people. User-centered, inclusive design approaches could improve the usability of therapy, which may increase uptake, adherence, and effectiveness. OBJECTIVE: This study aimed to optimize the usability of an existing psychological intervention, Thinking Well, which targets reasoning processes in paranoia using a basic digital interface. METHODS: We conducted inclusive, user-centered design research characterized by purposive sampling of extreme users from the margins of groups, ethnographic investigation of the problem context, and iterative prototyping of solutions. The UK Design Council’s double diamond method was used. This consisted of 4 phases: discover, including a case series of Thinking Well, stakeholder interviews, desk research, user profiling, system mapping, and a mood board; define, consisting of workshops to synthesize findings and generate the design brief; develop, involving concept workshops and prototype testing; and deliver, in which the final minimal viable product was storyboarded and iteratively coded. RESULTS: Consistent with our previous work, the Thinking Well case series showed medium to large effects on paranoia and well-being and small effects on reasoning. These were maintained at follow-up despite some participants reporting difficulties with the therapy interface. Insights from the discover phase confirmed that usability was challenged by information complexity and poor accessibility. Participants were generally positive about the potential of technology to be enjoyable, help manage paranoia, and provide tailored interpersonal support from therapists and peers, although they reported privacy and security concerns. The define phase highlighted that the therapy redesign should support monitoring, simplify information processing, enhance enjoyment and trust, promote personalization and normalization, and offer flexible interpersonal support. During the develop phase over 60 concepts were created, with 2 key concepts of thoughts visualized as bubbles and therapy as a journey selected for storyboarding. The output of the deliver phase was a minimal viable product of an innovative digital therapy, SlowMo. SlowMo works by helping people to notice their worries and fast thinking habits, and encourages them to slow down for a moment to find ways of feeling safer. A Web app supports the delivery of 8 face-to-face sessions, which are synchronized to a native mobile app. CONCLUSIONS: SlowMo makes use of personalization, ambient information, and visual metaphors to tailor the appeal, engagement, and memorability of therapy to a diversity of needs. Feasibility testing has been promising, and the efficacy of SlowMo therapy is now being tested in a multicentered randomized controlled trial. The study demonstrates that developments in psychological theory and techniques can be enhanced by improving the usability of the therapy interface to optimize its impact in daily life.
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spelling pubmed-63007082019-01-16 How Inclusive, User-Centered Design Research Can Improve Psychological Therapies for Psychosis: Development of SlowMo Hardy, Amy Wojdecka, Anna West, Jonathan Matthews, Ed Golby, Christopher Ward, Thomas Lopez, Natalie D Freeman, Daniel Waller, Helen Kuipers, Elizabeth Bebbington, Paul Fowler, David Emsley, Richard Dunn, Graham Garety, Philippa JMIR Ment Health Original Paper BACKGROUND: Real-world implementation of psychological interventions for psychosis is poor. Barriers include therapy being insufficiently usable and useful for a diverse range of people. User-centered, inclusive design approaches could improve the usability of therapy, which may increase uptake, adherence, and effectiveness. OBJECTIVE: This study aimed to optimize the usability of an existing psychological intervention, Thinking Well, which targets reasoning processes in paranoia using a basic digital interface. METHODS: We conducted inclusive, user-centered design research characterized by purposive sampling of extreme users from the margins of groups, ethnographic investigation of the problem context, and iterative prototyping of solutions. The UK Design Council’s double diamond method was used. This consisted of 4 phases: discover, including a case series of Thinking Well, stakeholder interviews, desk research, user profiling, system mapping, and a mood board; define, consisting of workshops to synthesize findings and generate the design brief; develop, involving concept workshops and prototype testing; and deliver, in which the final minimal viable product was storyboarded and iteratively coded. RESULTS: Consistent with our previous work, the Thinking Well case series showed medium to large effects on paranoia and well-being and small effects on reasoning. These were maintained at follow-up despite some participants reporting difficulties with the therapy interface. Insights from the discover phase confirmed that usability was challenged by information complexity and poor accessibility. Participants were generally positive about the potential of technology to be enjoyable, help manage paranoia, and provide tailored interpersonal support from therapists and peers, although they reported privacy and security concerns. The define phase highlighted that the therapy redesign should support monitoring, simplify information processing, enhance enjoyment and trust, promote personalization and normalization, and offer flexible interpersonal support. During the develop phase over 60 concepts were created, with 2 key concepts of thoughts visualized as bubbles and therapy as a journey selected for storyboarding. The output of the deliver phase was a minimal viable product of an innovative digital therapy, SlowMo. SlowMo works by helping people to notice their worries and fast thinking habits, and encourages them to slow down for a moment to find ways of feeling safer. A Web app supports the delivery of 8 face-to-face sessions, which are synchronized to a native mobile app. CONCLUSIONS: SlowMo makes use of personalization, ambient information, and visual metaphors to tailor the appeal, engagement, and memorability of therapy to a diversity of needs. Feasibility testing has been promising, and the efficacy of SlowMo therapy is now being tested in a multicentered randomized controlled trial. The study demonstrates that developments in psychological theory and techniques can be enhanced by improving the usability of the therapy interface to optimize its impact in daily life. JMIR Publications 2018-12-05 /pmc/articles/PMC6300708/ /pubmed/30518514 http://dx.doi.org/10.2196/11222 Text en ©Amy Hardy, Anna Wojdecka, Jonathan West, Ed Matthews, Christopher Golby, Thomas Ward, Natalie D Lopez, Daniel Freeman, Helen Waller, Elizabeth Kuipers, Paul Bebbington, David Fowler, Richard Emsley, Graham Dunn, Philippa Garety. Originally published in JMIR Mental Health (http://mental.jmir.org), 05.12.2018. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Mental Health, is properly cited. The complete bibliographic information, a link to the original publication on http://mental.jmir.org/, as well as this copyright and license information must be included.
spellingShingle Original Paper
Hardy, Amy
Wojdecka, Anna
West, Jonathan
Matthews, Ed
Golby, Christopher
Ward, Thomas
Lopez, Natalie D
Freeman, Daniel
Waller, Helen
Kuipers, Elizabeth
Bebbington, Paul
Fowler, David
Emsley, Richard
Dunn, Graham
Garety, Philippa
How Inclusive, User-Centered Design Research Can Improve Psychological Therapies for Psychosis: Development of SlowMo
title How Inclusive, User-Centered Design Research Can Improve Psychological Therapies for Psychosis: Development of SlowMo
title_full How Inclusive, User-Centered Design Research Can Improve Psychological Therapies for Psychosis: Development of SlowMo
title_fullStr How Inclusive, User-Centered Design Research Can Improve Psychological Therapies for Psychosis: Development of SlowMo
title_full_unstemmed How Inclusive, User-Centered Design Research Can Improve Psychological Therapies for Psychosis: Development of SlowMo
title_short How Inclusive, User-Centered Design Research Can Improve Psychological Therapies for Psychosis: Development of SlowMo
title_sort how inclusive, user-centered design research can improve psychological therapies for psychosis: development of slowmo
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6300708/
https://www.ncbi.nlm.nih.gov/pubmed/30518514
http://dx.doi.org/10.2196/11222
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