Single-Session Mobile-Augmented Intervention in Serious Mental Illness: A Three-Arm Randomized Controlled Trial.
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Abstract
Psychosocial interventions for serious mental illness are resource intensive and poorly accessible Brief interventions eg single session that are augmented by follow on automated mobile health intervention may expand treatment access This was a randomized single blind controlled trial with 255 individuals diagnosed with schizophrenia or bipolar disorder Participants were randomized to one of three conditions CBT2go which combined one individual session of cognitive behavioral therapy with automated thought challenging adaptive behavior delivered through mobile devices Self Monitoring SM which combined single session illness psychoeducation with self monitoring of symptoms and treatment as usual TAU Participants were assessed at baseline 6 weeks midpoint 12 weeks posttreatment and 24 weeks follow up with our primary outcome global psychopathology Brief Psychiatric Rating Scale expanded version BPRS 24 and secondary outcomes community functioning Specific Level of Function SLOF and defeatist performance beliefs DPBs We also collected data on adverse events Outcome analyses on the primary outcome BPRS Total score indicated a significant time 0 24 wk by group interaction with significant but modest improvement comparing two active conditions CBT2go and SM relative to TAU Effects of CBT2go were not different from SM There was a significant time group interaction with better SLOF scores in CBT2go across 24 weeks but not in SM There were no time by group effects on DPBs DPBs decreased in the CBT2go condition but not in SM These results indicated that single intervention augmented by mobile intervention was feasible and associated with small yet sustained effects on global psychopathology and when inclusive of CBT community function compared with usual care