Cognitive Behavioral Therapy (CBT) is a well succeeded psychological therapy that relies on concrete methods of assessment and intervention. Its application ranges from depression and anxiety disorders, phobias, control of obesity, pain, etc., and combinations (e.g., cancer patients often suffer from pain and depression).
The CBT method intermingles sessions and home-works. Sessions join therapists with one (individual therapy) or several patients (group therapy). Home-works are activities performed by therapists and patients in an isolated manner. The formers´ homework comprises diagnosing and planning of next sessions, including home-works to be delivered to patients. Patients´ homework includes self-monitoring and registration of plans, behaviors, thoughts and emotions, which will be discussed in the following sessions. During sessions, besides oral and written communication, homework-like activities are done in collaboration. Sessions take place in the therapist office or in controlled meeting rooms (group therapy), with participants present (sameplace), during a specific amount of time (same-time), with a regular schedule.
However, situations arise where these classical-sessions are not best-suited or not even possible. In-vivo exposure techniques, where patients are directly confronted with the actual eliciting stimuli (e.g. a subway station), are known to be more effective for some disorders, especially if involving groups. The problem with these "outdoor sessions", is the inexistence of a controlled setting, which might raise information access difficulties (e.g. no patient data), infrastructure unavailability (e.g. no large board) and ethical issues such as patient privacy (e.g. no oral communication possible).
Non-classical sessions are also required when co-presence is impossible, as a result of an intervenient absence. The problem, apart from those inherited from the uncontrolled session-setting (e.g. patient on the subway), is communication. Three situations can be envisaged: (1) communication is available through heterogeneous infrastructures - "remote same-time/different-place sessions" can occur; (2) no communication is available but can be temporarily postponed (e.g. the success of entering the subway should be broadcasted to the group, when possible) - "remote different-time/different-place sessions" can occur; and (3) no communication is available but help/comfort is needed immediately (e.g. anxiety grows because the patient has doubts when registering an emotion) - "disconnected sessions" must be available.
This project aims at providing a solution for mobile, time/space distributed, therapy sessions, complementing SCOPE and JoinTS projects. SCOPE targeted psychological diagnosis, thus covering part of the therapist´ homework, namely patient-data management and analysis. JoinTS provided enhanced homework tools that allow patients to fill multifaceted static artifacts and enable therapists to create them. It also addressed group-sessions, in different controlled-setting arrangements, but within the "same-time/same-place" scenario.
InSiThe expands the Information and Communication (IC) platform of JoinTS, to cope with remote and outdoors settings. It will contribute to a definitive set of models, a specification language and an IC platform that fully covers CBT in all scenarios. The definition of new therapeutic approaches, supported by the adequate technology, particularly for the envisioned scenarios is also a major goal.
Capitalizing on the knowledge of previous projects, a Design Methodology for Critical Interactive Mobile Applications will be conceived and applied. InSiThe tools and the adversity of the envisaged scenarios, constitute a major opportunity to evaluate and validate such methodology that is absent from the current state-of-the-art.
Remote session tools for therapist and patients, on outdoor settings, will be developed having in mind the critical usability, communication and resource requirements. The project will also provide tools for "disconnected sessions". The "disconnected patient simulation" will reproduce patient hesitations on registering and communication tasks. The "disconnected therapist simulation" comprises: (1) a tool where the therapist specifies the behavior of the patient´s artifacts (e.g. when to provide help, when to reassure) mimicking its own behavior on a classic session; and (2) a patient tool that interprets that specification. Rule-specifications for non-programming-experts are in it a major challenge and overall these tools raise expectation for prominent HCI and CSCW contributions.
Finally, InSiThe will promote three real-case pilot installations that will contribute to the psychological dimension of the project, as well as to the validation of the solution. One will be applied by FCUL within its psychological support unit (GaPsi) provided for students and another within FPCE/UL.
The project will start on 01-01-2010 and has the duration of 36 months.
InSiThe project is funded by Fundação da Ciência e Tecnologia.