Active Assistance for Psychological Therapy (Actissist): Using mobile technology to deliver cognitive behaviour therapy for psychosis
National clinical guidelines recommend a treatment known as Cognitive Behavioural Therapy (CBT) for people who have experienced psychosis. However, only around 1 in 10 people with psychosis actually receive CBT. To help address this our research aims to; develop a CBT-informed mobile phone app (Actissist) for people who have experienced a first episode of psychosis; and to assess the feasibility and acceptability of the app.
We have conducted qualitative research with both staff and service users to inform the development of the Actissist app in user-informed iterative design. We then asked five NHS staff members and five clients to trial a Beta version of the app. We are currently conducting a randomised controlled trial in which participants are randomly assigned to use either the Actissist app, or the symptom monitoring ClinTouch app for 12 weeks in addition to their treatment as usual.
Start: May 2014
End: July 2016
Funded by: Medical Research Council
Disease Area Impacted
The primary outcome measures are feasibility and acceptability. Feasibility will be assessed via compliance. We are hoping that 50% (or more) of participants will complete more than 33% of data points over the 12 weeks (72 out of 216 possible entries). The acceptability of the Actissist app will be determined by qualitative interview with studies participants to explore their perceptions of the app.
This investigation will utilise a randomised controlled study design in which participants will be assigned to use either the CBT-informed Actissist app (treatment group), or the symptom monitoring ClinTouch app (control group). Participants will be asked to complete assessments (clinical interviews and questionnaires), prior to being assigned to use Actissist or Clintouch, after they have finished using the app (12 weeks), and once again 10 weeks later (22 weeks). These assessment points will allow us to draw comparison between the treatment and control groups on important factors related to mental health (e.g. symptom severity, quality of life).
The Actissist intervention (and ClinTouch) draw upon Experience Sampling Methodology (ESM). ESM is a ‘micro-longitudinal’ method in which participants submit multiple data entries, (typically) a few times a day for several days or weeks, in a naturalistic environment.
Benefits and Outcomes
The Actissist project has the potential to have a personal benefit to people in the early stages of psychosis. Moreover, the Actissist app could also potentially reduce NHS costs by providing a timely intervention which may prevent chronic illness. Consequently, any person who contributes to the NHS (i.e. by paying taxes) or accesses NHS services could potentially benefit from this project.
The project aims to establish if it is feasible to develop a CBT-informed mobile phone application for early psychosis that people will use, and which they are happy to use.
We are currently writing up the findings from our qualitative research (in which we asked staff and service users about their requirements for Actissist), when we have published this research we will place a link to the articles on this page. We have recently published an article in which we detail the Actissist trial protocol. You can download a free version of the article by visiting the Journals website.
Dr Rohan Morris
Dr Sandra Bucci
Prof. Christine Barrowclough
Dr John Ainsworth
Prof. Gillian Haddock
Prof. Iain Buchan
Prof. Shôn Lewis
Dr Dawn Edge
Dr Katherine Berry
Dr Richard Emsley.