Digital Opportunities for Outcomes in Recovery Services (DOORS): A Pragmatic Hands-On Group Approach Toward Increasing Digital Health and Smartphone Competencies, Autonomy, Relatedness, and Alliance for Those With Serious Mental Illness

J Psychiatr Pract. 2020 Mar;26(2):80-88. doi: 10.1097/PRA.0000000000000450.


Digital health technologies such as smartphones present the potential for increased access to care and on-demand services. However, many patients with serious mental illnesses (eg, schizophrenia) have not been offered the digital health training necessary to fully utilize these innovative approaches. To bridge this digital divide in knowledge and skills, we created a hands-on and interactive training program grounded in self-determination theory, technology use cases, and the therapeutic alliance. This article introduces the need and theoretical foundation for and the experience of running the resulting Digital Opportunities for Outcomes in Recovery Services (DOORS) group in the setting of 2 programs: a first-episode psychosis program and a clubhouse for individuals with serious mental illness. The experience of running these 2 DOORS groups resulted in 2 publicly available, free training manuals to empower others to run such groups and adapt them for local needs. Future work on DOORS will expand the curriculum to best support digital health needs and increase equity of access to and knowledge and skills related to technology use in serious mental illness.

MeSH terms

  • Digital Divide
  • Health Services Accessibility*
  • Humans
  • Inventions*
  • Mental Disorders / therapy
  • Mobile Applications*
  • Personal Autonomy*
  • Psychotic Disorders / therapy
  • Schizophrenia / therapy*
  • Smartphone*
  • Teaching*
  • Therapeutic Alliance