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Virtual Hope Box mobile app grows in popularity

A free smartphone app that helps people in crisis remember good things in their lives has been downloaded 13,000 times in the past six months, according to data from app stores.

That’s good news for experts at the National Center for Telehealth & Technology (T2), which developed the Virtual Hope Box app to help users manage stress. The user-friendly app contains sections for relaxation, games for distraction and inspiring quotes. Users can upload photographs, music and messages to themselves about coping with particular challenges.

Given the positive response by those who have tried the app, it has the potential to be far more widely used, said Nigel Bush, Ph.D., T2 deputy chief of research, in a webinar hosted by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury.

Among the comments the center has received: “It helped manage distress at work when having memory issues.”

Another user said, “It is soothing and prevents me from doing things like yelling at people in line.”

Although the app is also a tool for therapists to use with their patients, providers have been slow to take advantage of it, Bush said. One reason may be that therapists don’t tend to think of smartphones as a tool for delivering care. Although 60 percent of therapists own a smartphone, only 7 percent use one in clinical practice.

To increase usage, T2 is seeking to introduce the app to therapists, said Amanda Edwards-Stewart, Ph.D., T2 deputy director of emerging technologies program.

In addition, the Department of Veterans Affairs started a randomized controlled trial using the Virtual Hope Box with 100 patients at risk of self-harm. The results of the trial may also help expand use among providers.

A pilot study by T2 found that service members, who are younger and more comfortable with technology than the average American, prefer a web app to the physical hope box by a margin of two to one. They said the app is more portable than a real box, and more private.

While most people only use mobile apps once or twice before they uninstall them, in the pilot study, users turned to the virtual hope box at least during the two weeks between therapy appointments, and a majority used it for at least six weeks. Users added hundreds of new photos, quotations and music files to their virtual hope boxes over time.

What is the Virtual Hope Box?

The Virtual Hope Box (VHB) is a free mobile application for behavioral health patients to use with guidance from their providers.

What is the purpose of the VHB?

The purpose of the VHB is to help patients decrease their experience of distress by encouraging and facilitating healthy coping and emotion regulation skills.

Who developed the VHB?

The VHB was developed by the National Center for Telehealth and Technology (T2), a US Department of Defense Center of Excellence for Psychological Health and Traumatic Brain Injury.

Who should use the VHB?

The VHB app has been developed specifically for use by patients who are engaged in treatment with a behavioral health provider.

How does the VHB work?

Patients download the free VHB app to their personal mobile devices, including smartphones and tablet computers. Beginning in the clinic, users work with their behavioral health providers to add individually tailored and customized content into various sections of the app. Once oriented to the process, patients may continue to add content at any time. That highly personalized content is then available to patients at any time they have access to their mobile device, which means that the VHB tools and content are highly portable and almost always available to a user in distress.

What kind of content and tools does VHB provide?

Patients can use the VHB to store a variety of rich multimedia content that they find personally supportive in times of need. For example, the patient can include family photos, videos and recorded messages from loved ones, inspirational quotes, music they find especially soothing, reminders of previous successes, positive life experiences and future aspirations, and affirmations of their worth in their VHB. A patient can also collaborate with their provider to create coping cards to use in response to personal problem areas they experience. Finally, the VHB provides the patient with positive activity planning, distraction tools, and interactive relaxation exercises including guided imagery, controlled breathing and muscle relaxation.

Are there any groups of patients for whom the Virtual Hope Box mobile app might be especially useful?

The VHB contains coping tools that may be helpful for addressing many issues. However, it may also have particular value in specific patient populations. For example, a grant from the Military Suicide Research Consortium funded a pilot project and a randomized controlled trial to study the potential of the VHB for helping patients at high risk of intentional self-harm. By helping high-risk patients cope with distress and urges to die, the VHB may offer providers a useful accessory to care.

(Information courtesy of the National Center for Telehealth and Technology)

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