Technology UPGRADITIS: The Behavioral Health System’s Road to Recovery
Alice J. WashingtonLori Ford, PhD, CIBHS Blogger
Just saying … The 18th Annual Behavioral Health Informatics Conference and Exposition will feature some helpful sessions which will help counties make informed choices about technology and most notably apps. I believe counties need to make informed information technology choices to continue to promote recovery and wellness for all behavioral health clients and family members.
This statement rings with truth, because of many factors, including major advances in technology, i.e., the creation of smartphones, laptops and netbooks, iPods, tablets, and wearables. Behavioral health treatment and services are using these devices. I write this blog in the hope that our behavioral health system will identify any signs of their suffering from upgraditis:
Upgraditis -A terminal condition, the main symptom of which presents as the insatiable desire to upgrade. A word originally coined by Isaac Sibson (year), and now increasingly prevalent in internet-based discussions.
Putting this aside, a few questions for the behavioral health field are, “Is this the best way to develop a therapeutic alliance when providing therapy?” or “Will a technology mode of treatment, build a successful road to recovery for behavioral health clients?”
A Review of Technology-based Youth and Family-focused Interventions, authored by Kathleen Watson MacDonnell and R. J. Prinz, shows the following,
In the past 10 years, mental and behavioral health has seen a proliferation of technology-based interventions in the form of online and other computer-delivered programs. Their paper focused on technology-based treatment and preventive interventions aimed at benefitting children and adolescents via either involving the parents and families, or only the youth. The review considered only technology-based interventions that had at least one published study with a randomized controlled trial design. Questions being addressed include: (1) What are the technology-based interventions in the mental/behavioral health area that have been systematically evaluated in published studies? (2) What are the common and unique characteristics of these interventions and their application with respect to sample characteristics, target problems, and technology characteristics (platforms, structures, elements, and communication formats)? and (3) Which intervention approaches and strategies have accrued the greatest evidence? The review identified 30 technology-based psychosocial interventions for children and families, 19 of which were parent or family-focused (32 studies) and 11 of which were youth-focused (in 13 studies).
For the parent/family-focused interventions, the greatest promise was found in those that addressed either youth behavioral problems or depressive/anxious symptoms, as well as a more general bolstering of parenting efficacy. The youth-focused interventions showed some promise in reducing depressive/anxious symptoms. (MacDonell, 2017)
Now the questions become about screen addiction and Internet Addiction Disorder that is defined by authors Gary Chapman and Arlene Pellicane in Growing Up Social: raising relational kids in a screen-driven world. Will we jeopardize the recovery and wellness of our clients using apps, thus encouraging screen-driven treatment and services? Excerpts from Chapman and Pellicane’s book may show us what this type of recovery journey looks like if the behavioral health field goes down this path.
Excerpts from Chapman and Pellicane’s book:
With increased screen use, the neural circuits that control the more traditional learning methods used for reading, writing, and sustained concentration are neglected. Jeremy, eleven, spends his time after school and soccer practice playing video games. He doesn’t bother to learn his vocabulary words because he knows spell-check can fix the words and texting doesn’t require spelling…
Dr. Archibald Hart and Dr. Sylvia Hart Frejd write in their book The Digital Invasion: Many of our Internet behaviors, such as gambling or gaming on the Internet, or even Facebooking, can do as much damage to the pleasure center as any powerful drug. The pleasure center can become so flooded that only the ‘big’ stimulants can get a message to the pleasure center. Little, ordinary pleasures are ignored because they do not have the power to overcome the flooding … What this all means is that the thrills of our digital world if abused, can be as addicting as any drug and rob you of the simple joys of life…
What is screen addiction? It’s a relatively new term but one that is increasingly used by physicians…One study asked a thousand students in ten countries to stop using technology and media for just one day. At the end of that twenty-four-hour period, many students repeatedly used the word addiction…
In extreme cases, computer addiction has turned deadly. A 28-year-old man in Korea played for fifty hours, taking just a few breaks. After he collapsed in an Internet café, he was rushed to the hospital where he died shortly after, presumably of heart failure due to exhaustion…
Many experts would agree: When children overuse technology, the constant stimulation of the brain causes the stress hormone cortisol to rise. Too much cortisol can inhibit a child from feeling calm and comforted. Dr. Archibald Hart says, “A part of cortisol’s functions is to block the tranquility receptors to make you more anxious and prepare you to deal with an emergency. Only, it isn’t a real emergency but instead a game-induced emergency. This loss of tranquility can lead to more serious anxiety disorders…”
(Chapman & Pellicane, 2014)
Based on this information, what would be the benefits and risks to our clients if behavioral health systems continue to use screen-driven treatment and services?
Benefits of using screen-driven, artificial intelligence treatment and services:
Access to logical thinking in treatment
Less stigma where there is no need to deal with human values
No judgment- or emotional-based solutions to mental illnesses and substance use issues
Risks associated with using screen driven, artificial intelligence treatment and services:
Clients risk no emotional growth
Clients can become more isolated
Clients can become less social and may not be able to navigate human relationships
Clients may have no human accountability around serious criminal and predatory behaviors
Essentially, the behavioral health system may be setting up our clients to be like the scenes where Wall-E movie characters who ride around viewing screens all day and are suddenly knocked away from the screens, they can see the world around them and don’t know what to do in this new situation.
One final thought, we are all affected by upgraditis, so the final question is: Am I suffering from screen addiction and am I imposing my potential addiction onto behavioral health clients?
My initial thought would be, “Quick! Turn off the apps and robot therapists before our clients’ brains are sucked out of their heads” … but we can’t as technology is now institutionalized into our society. So, my final thoughts are … remember that we must always maintain an effective and productive therapeutic alliance when using information technology in treatment and services, and make informed choices that … are all about that hope.”
Chapman, G. & Pellicane. (2014). Growing up social: raising relational kids in a screen-driven world. Northfield Publishing: Chicago, IL.
Wall-E Images. Various sites on Google search.
Covolo, L., Ceretti, E., Moneda, M., Castaldi, S., & Gelatti, U. (2017). Does evidence support the use of mobile phone apps as a driver for promoting healthy lifestyles from a public health perspective? A systematic review of randomized control trials. Patient Education and Counseling. Advance online publication. http://dx.doi.org/10.1016/j.pec.2017.07.032
Firth, J., Torous, J., Nicholas, J., Carney, R., Rosenbaum, S., & Sarris, J. (2017). Can smartphone mental health interventions reduce symptoms of anxiety? A meta-analysis of randomized controlled trials. Journal of Affective Disorders, 218, 15-22. http://dx.doi.org/10.1016/j.jad.2017.04.046
Witt, K., Spittal, M. J., Carter, G., Pirkis, J., Hetrick, S., Currier, D., . . . Milner, A. (2017). Effectiveness of online and mobile telephone applications (‘apps’) for the self-management of suicidal ideation and self-harm: A systematic review and meta-analysis. BMC Psychiatry, 17, Article ID 297.