WASHINGTON, June 21, 2012 – Human to human interaction is basic to mental health care, but smartphones can extend therapy’s reach and help potential suicide victims stay alive, a presenter said yesterday at the annual suicide prevention conference jointly sponsored here by the Defense and Veterans Affairs departments.
Hundreds of researchers, clinicians mental health professionals and military and VA leaders are participating in sessions on core skills in suicide prevention training, learning the findings of the latest clinical and research studies, and hearing about practical application of preventive approaches.
Nigel Bush, a doctor of psychology and research psychologist at the Defense Centers of Excellence National Center for Telehealth and Technology, known as T2, presented a conference session on the use of a smartphone application for “virtual hope boxes” with patients at risk for suicide.
Bush noted the smartphone usage rate among active-duty service members is as high as 93 percent, and that about 60 percent have downloaded free apps. T2 is a Defense Department organization formed to develop technologies useful in maintaining psychological health and combating traumatic brain injury and suicide. The center has developed and tested a smartphone app that adapts the hope box tool often used in cognitive therapy and dialectical behavioral therapy with potentially suicidal patients, Bush said.
More about the MSRC-Funded Virtual Hope Box
Those therapies focus on redirecting patients toward positive thoughts and increasing their focus on reasons to live, rather than reasons to die, he explained. The hope box itself is just that, Bush said: a “box of stuff” that patients can use to distract, relax or inspire themselves in times of stress. Typical contents may include photos, messages from loved ones, a CD of favorite music and other positive objects, he added.
These therapies have shown promise in treating suicidal patients, and they use the hope box often, Bush said. But because military members are highly mobile, and physical boxes are cumbersome, a virtual hope box that can be carried in a pocket seemed promising, he told the conference participants.
Bush emphasized that patients put their virtual hope boxes together during therapy sessions and with the help of a therapist. The app includes a small link for contact numbers, a main screen and four smaller clickable areas.
The main screen area is labeled “remind me,” and is intended for photos, videos or music that evoke good memories, he said. The other options also can include multimedia content, but are intended to meet specific circumstances, he added.
By default, the “distract me” option contains photo and word-search puzzles and an activity planner, while “inspire me” is intended for motivational quotes and other messages patients can customize to their liking.
“Relax me” takes the user to screens with instructions for breathing and muscle relaxation exercises, and “coping cards” offer what Bush called “antidote thoughts” to negative emotions. For example, he said, for patients who feel they just can’t go on with school, the coping antidote could point out that summer vacation is approaching.
The app is designed so users can integrate and refresh their own content at will, he said, ensuring the hope box items are “all contextually relevant.” Bush said the T2 staff will test the app beginning next month, enrolling 20 patients already in dialectical behavioral therapy for a six- to eight-week field test. Clinicians working with the patients will evaluate their results with the app, and those mental health professionals also will measure patient progress using physical hope boxes, he added.
Bush said he expects the results will show that having both physical and virtual hope boxes is preferable.
“I’m thinking [the virtual hope box] is an accessory,” he added, noting the smartphone-based approach puts therapy in reach of patients even when they’re not in a counselor or psychologist’s office.