TICKETED SESSIONS | Clinical Intervention Training

The number of mobile apps for mental health is regularly growing, with estimates that over 10,000 to 15,000 of such products exist. These tools are also more frequently entering into therapy, either by being introduced by providers or brought in by consumers. However, training in how to understand and use these tools in cognitive and behavioral practices is lagging beyond their development. As such, many clinicians report a desire to use these tools but an uncertainty around which tools to use and how. This training will provide clinicians with an overview of mobile apps for mental health and will focus on how to evaluate these tools and integrate them into clinical practice. Furthermore, this overview will be supplemented with presentations from several app companies to illustrate the functionality, evidence, and utility of these products. This training will address general competencies for the use of such tools while using specific tools as examples. Different models of integration into care will also be considered, including tools that add new treatment strategies, tools that extend treatment strategies, and ways to use tools, such as introducing consumers to cognitive and behavioral strategies or assisting in termination and booster sessions.

At the end of this session, the learner will be able to:

• Identify evaluation criteria related to the adoption of mobile apps for mental health.
• List different ways in which apps can be integrated into their clinical workflow.
• Identify common features present in mobile apps for mental health.
• Identify commons barriers and facilitators to uptake of mobile apps for mental health.
• Explain factors to assess when considering the adoption of mobile apps for mental health.

Recommended Readings:

Armstrong, C. M., Edwards-Stewart, A., Ciulla, R. P., Bush, N. E., Cooper, D. C., Kinn, J. T., Pruitt, L. D., Skopp, N. A., Blasko, K. A., & Hoyt, T. V. (2017). Department of Defense Mobile Health Practice Guide (3rd ed.). Defense Health Agency Connected Health, U.S. Department of Defense.

Neary, M., & Schueller, S. M. (2018). State of the field of mental health apps. Cognitive and Behavioral Practice, 25(4), 531-537.

Schueller, S. M., & Adkins, E. C. (2019). Mobile Health Technologies to Deliver and Support Cognitive-Behavioral Therapy. Psychiatric Annals, 49(8), 348-352.

Wilhelm, S., Weingarden, H., Ladis, I., Braddick, V., Shin, J., & Jacobson, N. C. (2020). Cognitive-behavioral therapy in the digital age: Presidential address. Behavior Therapy, 51(1), 1-14.

Despite advances in treatment for childhood anxiety and related disorders, current treatments are not effective in up to 50% of cases. In recent years, there has been rapidly increasing interest in family accommodation, or the changes that parents make to their own behavior to help a child avoid or alleviate distress related to anxiety. Although it is intended to reduce anxiety in the short term, family accommodation is associated with greater symptom severity and impairment.

SPACE (Supportive Parenting for Anxious Childhood Emotions) is a theory-driven intervention informed by research into parental entanglement in the symptoms of childhood anxiety and by the biology of mammalian parental behavior. SPACE teaches parents to recognize their accommodating behaviors, and to implement specific plans for reducing the accommodation while maintaining a supportive attitude towards the child. SPACE also includes tools for the following: increasing parents' ability to work cooperatively together; coping with responses to the reduced accommodation, including anger and distress; and enlisting the support of family and friends in what can sometimes be a difficult process. This session will present an overview of family accommodation and its associations with child anxiety, introduce SPACE and its treatment components, and review findings from clinical trials demonstrating the efficacy of SPACE.

At the end of this session, the learner will be able to:

• Explain associations between family accommodation and child anxiety.
• Assess levels of family accommodation.
• Describe the treatment of process of SPACE.
• Apply tools to reduce family accommodation and increase parental support.
• Describe the research findings on the efficacy of SPACE treatment.

Recommended Readings:

Lebowitz, E. R., & Majdick, J. M. (2020). The space program, a parent-based treatment for childhood and adolescent anxiety: Clinical case illustration. Journal of Cognitive Psychotherapy. doi: 10.1891/jcpsy-d-19-00028

Lebowitz, E. R., Marin, C., Martino, A., Shimshoni, Y., & Silverman, W. K. (2020). Parent-based treatment as efficacious as cognitive-behavioral therapy for childhood anxiety: A randomized noninferiority study of supportive parenting for anxious childhood emotions. Journal of the American Academy of Child and Adolescent Psychiatry, 59(3), 362-372. doi: 10.1016/j.jaac.2019.02.014

Lebowitz, E. R., & Shimshoni, Y. (2018). The space program, a parent-based treatment for childhood and adolescent OCD: The case of Jasmine. Bulletin of the Menninger Clinic, 82(4), 266-287.

Salloum, A., Andel, R., Lewin, A. B., Johnco, C., McBride, N. M., & Storch, E. A. (2018). Family accommodation as a predictor of cognitive-behavioral treatment outcome for childhood anxiety. Families in Society, 99(1), 45-55. doi: 10.1177/1044389418756326

Storch, E. A., Salloum, A., Johnco, C., Dane, B. F., Crawford, E. A., King, M. A., . . . Lewin, A. B. (2015).

Phenomenology and clinical correlates of family accommodation in pediatric anxiety disorders. Journal of Anxiety Disorders, 35, 75-81. doi: 10.1016/j.janxdis.2015.09.001

Zavrou, S., Rudy, B., Johnco, C., Storch, E. A., & Lewin, A. B. (2018). Preliminary study of family accommodation in 4-7 year-olds with anxiety: Frequency, clinical correlates, and treatment response. Journal of Mental Health (Abingdon, England), 1-7.