A Smarter Pathway for Delivering Cue Exposure Therapy? The Design and Development of a Smartphone App Targeting Alcohol Use Disorder

Angelina Isabella Mellentin; Elsebeth Stenager; Bent Nielsen; Anette Søgaard Nielsen; Fei Yu

doi:10.2196/mhealth.6500

A Smarter Pathway for Delivering Cue Exposure Therapy? The Design and Development of a Smartphone App Targeting Alcohol Use Disorder

JMIR Mhealth Uhealth. 2017 Jan 30;5(1):e5. doi: 10.2196/mhealth.6500.

Authors

Angelina Isabella Mellentin^{1

2}, Elsebeth Stenager², Bent Nielsen¹, Anette Søgaard Nielsen¹, Fei Yu³

Affiliations

¹ Unit of Clinical Alcohol Research, Unit of Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark.
² Unit of Psychiatric Research, Institute of Regional Health Services Research, University of Southern Denmark, Aabenraa, Denmark.
³ Technology Entrepreneurship and Innovation section, Mads Clausen Institute, University of Southern Denmark, Soenderborg, Denmark.

Abstract

Background: Although the number of alcohol-related treatments in app stores is proliferating, none of them are based on a psychological framework and supported by empirical evidence. Cue exposure treatment (CET) with urge-specific coping skills (USCS) is often used in Danish treatment settings. It is an evidence-based psychological approach that focuses on promoting "confrontation with alcohol cues" as a means of reducing urges and the likelihood of relapse.

Objective: The objective of this study was to describe the design and development of a CET-based smartphone app; an innovative delivery pathway for treating alcohol use disorder (AUD).

Methods: The treatment is based on Monty and coworkers' manual for CET with USCS (2002). It was created by a multidisciplinary team of psychiatrists, psychologists, programmers, and graphic designers as well as patients with AUD. A database was developed for the purpose of registering and monitoring training activities. A final version of the CET app and database was developed after several user tests.

Results: The final version of the CET app includes an introduction, 4 sessions featuring USCS, 8 alcohol exposure videos promoting the use of one of the USCS, and a results component providing an overview of training activities and potential progress. Real-time urges are measured before, during, and after exposure to alcohol cues and are registered in the app together with other training activity variables. Data packages are continuously sent in encrypted form to an external database and will be merged with other data (in an internal database) in the future.

Conclusions: The CET smartphone app is currently being tested at a large-scale, randomized controlled trial with the aim of clarifying whether it can be classified as an evidence-based treatment solution. The app has the potential to augment the reach of psychological treatment for AUD.

Keywords: alcohol use disorder; exposure therapy; mobile application; smartphone.

©Angelina Isabella Mellentin, Elsebeth Stenager, Bent Nielsen, Anette Søgaard Nielsen, Fei Yu. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 30.01.2017.