Abstracts of Volume 31 (2013) (1) (2) (3) of the Journal of Technology in Human Services

Volume 31/1: 2013, General Issue

How Psychological Telehealth Can Alleviate Society's Mental Health Burden: A Literature Review by Jonathan G. Perle, & Barry Nierenberg

KEYWORDS: telehealth, telepsychology, clinical care, online psychology, internet-based intervention, mental health burden, prevention, mHealth, tablet

ABSTRACT:  Mental health professionals must establish new means to reach those in need that face obstacles related to geographical location, time limitations, and health. With the high incidence of mental illness, as well as the hypothesized increase in coming years, telehealth modalities propose a novel and far-reaching alternative to traditional therapy. This article outlines the positive aspects of interdisciplinary possibilities when telehealth is incorporated into mental health practice. Novel outlets including mHealth and the utilization of computer tablets as mental health facilitators are outlined. Considerations for practice including training are discussed, as well as potential future directions for the field. Available data supports telehealth as an effective mode for the treatment of clients who are unable to pursue mental health services in their current form.  However, careful consideration and training for the mental health professional is needed if telehealth is to be effectively used to alleviate the mental health burden.


Online Counselling and Therapy for Mental Health Problems: A systematic Review of Individual Synchronous Interventions Using Chat by Mitchell Dowling and Debra Rickwood

KEYWORDS: online counselling and therapy, mental health, effectiveness, outcome.

ABSTRACT: Online interventions are increasingly seen as having the potential to meet the growing demand for mental health services. However, with the burgeoning of services provided online by psychologists, counsellors, and social workers it is becoming critical to ensure that the interventions provided are supported by research evidence. This article reviews evidence for the effectiveness of individual synchronous online chat counselling and therapy (referred to as ‘online chat’). Despite using inclusive review criteria, only six relevant studies were found. They showed that while there is emerging evidence supporting the use of online chat, the overall quality of the studies is poor, including few randomised control trials (RCTs). There is an urgent need for further research to support the widespread implementation of this form of mental health service delivery.


Power Distance, Uncertainty Avoidance, and Technology: Analyzing Hofstede’s Dimensions and Human Development Indicators by Jonathan Matusitz and George Musambira

KEYWORDS: cell phone, Hofstede, human development, Internet, power distance, technology, telephone, uncertainty avoidance, United Nations

ABSTRACT:  Correlations between Hofstede’s dimensions of power distance and uncertainty avoidance and selected indicators of the Human Development Report (HDR) were analyzed. Three communication technology indicators – i.e., cell phone subscription, Internet use, and the number of telephone mainlines – were predicted to measure the development of a nation. Results indicate a negative correlation between high power distance and communication technology in terms of the three technologies examined in this study. We found a negative correlation between power distance and human development. Negative correlations were also found between uncertainty avoidance and two cell phone subscription as well as internet use.

Brief Reports

Monitoring Student Internet Patterns:  Big Brother or Promoting Mental Health? by Frances H. Montgomery, Sriram Chellappan, Raghavendra Kotikalapudi, Donald C. Wunsch II, & Karl F. Lutzen

KEYWORDS:  monitoring internet behavior, Big Brother, technology and mental health

ABSTRACT:  A study showing that student internet behavior differed significantly for students with high scores on a test of depression is thought to be the first to consider the relationship between internet use and depression that focuses on patterns of online behavior rather than content.  Study findings  have the potential for use in the human services as a way to assess and/or promote mental health.  Although the data were collected anonymously with Institutional Review Board approval and participants’ informed consent, objections have been raised suggesting this type of data collection represents “Big Brother” or the monitoring of individuals’ behavior without their awareness as portrayed in George Orwell’s famous novel, 1984.  The importance of this type of research in furthering our understanding of the impact of internet use on human behavior is emphasized.  Additionally, the role of the university is stressed as a location for conducting ethical research which disseminates findings via publication to inform and spur policymakers to develop appropriate guidelines to prevent misuse of new knowledge and technology. 


Clinicians’ Experiences of a Podcast Series on Implementing a Manualized Treatment by Alison Salloum and Kristin Smyth

KEYWORDS:  evidence-based practice, implementation, Podcasts, Grief and Trauma Intervention (GTI) for Children

ABSTRACT:  The purpose of this qualitative study was to explore clinicians’ experiences of using Podcasts to assist with implementing an evidence-based practice (EBP). Twelve clinicians, including 8 student interns, at a human service organization were interviewed about their perceptions of using Podcasts about implementing an EBP called Greif and Trauma Intervention (GTI) for Children.  Major themes included that the Podcasts were helpful, liked the short length, fit their learning styles, useful teaching tool, wanted more clinical content and more engaging material, and that administrative support was important for use. Technology difficulties were a major barrier to use. There were some differences in experiences of the Podcasts between post master professionals and interns. Podcasts may be a useful technology to help clinicians implement EBPs, and future research on Podcast use is warranted.


A Survey of Australian Human Services Agency Software Usage by Judith Grundy & John Grundy

KEYWORDS: human services software survey, case notes management, inter-agency collaboration, client confidentiality and privacy.

ABSTRACT:  Human Services agencies use a wide range of software systems to manage caseloads, maintain records, deliver services to clients and for inter-agency communication.  Some systems are generic, such as Word or Excel, while some are specialised to the organisation, such as specialised databases for tracking case notes.  Some software systems are shared across organisations. We surveyed nearly forty Australian Human Services agencies to ascertain the range of software currently in use by agencies and their opinions on it, with a view to identifying promising new Human Services applications. We interviewed representatives from a selection of smaller agencies. This resulted in detailed feedback on key issues to consider when developing and deploying new Human Services software.

Volume 31/2: 2013, General Issue

Online mental health information seeking in young adults with mental health challenges by L. Kris Gowen

KEYWORDS: mental health, young adult, internet, information seeking

ABSTRACT:  Barriers such as stigmatization and access to health care may lead young adults with mental health conditions (YAMHC) to try to find alternatives to more traditional means of obtaining care. One possible alternative is to seek information online. The purpose of this paper is to better understand how YAMHC use the internet to access information about mental health, and the challenges they face when trying to access that information. Semi-structured focus groups were conducted to investigate how YAMHC use the internet for information and support regarding their mental health. Three major themes about mental health information seeking emerged from the data: (1) Topics searched; (2) Motivations for going online to search for information; and, (3) Barriers to successful searching. Findings indicate that YAMHC look up information related to their mental health for a variety of reasons that are unique to the online experience, and use that information to help them with their care, despite at times feeling overwhelmed by, and not always trusting of, the information available.


Ethics in an age of information seekers: A survey of licensed healthcare providers about online social networking by Shannon C. Anderson & Michelle R. Guyton

KEYWORDS: Facebook, social networking, ethics, technology, health care

ABSTRACT:  The present study explores how licensed health care providers use social media. The researchers utilized a survey to explore 88 licensed psychologists, physicians, and social workers average numbers of Facebook© friends, social groups, and photo albums as well as attitudes toward possible regulation of online social networking by professional organizations. Statistically significant differences were found among groups regarding the degree to which they wanted guidance on ethically managing this new technology, with psychologists and social workers desiring more guidance than physicians. Overall, this study shows that the majority of the psychologists, physicians, and social workers who participated in this study now frequently use Facebook, often providing information on profiles that may include that which is not generally disclosed in a client-therapist relationship.


The Evolution of Worker Connect: A Case Study of a System of Systems by Isidore Sobkowski and Roy S. Freedman. 

KEYWORDS.  Interoperability, system of systems, federation of systems, health and human services, Worker Connect, HHS-Connect

ABSTRACT.  We discuss the rationale, development, deployment, and evolution of Worker Connect, a federation of agency systems that is used by authorized health and human services workers in New York City.  We show how Worker Connect evolved with HHS-Connect, the organization that enables the integration and synergy of inter-agency health and human services systems.  We show how the system of systems framework provides a way to understand issues encountered and lessons learned in developing and deploying Worker Connect and similar inter-agency human services systems.  The first part of this paper provides a history of the Worker Connect project in the context of a case study on achieving interoperability.  The second part of this paper introduces the framework of system of systems, and describes Worker Connect and HHS-Connect within this framework.  The third part of the paper describes future work, and offers some lessons for others wanting to implement a system of systems project for human services.


Virtual Worlds: In-world Survey Methodological Considerations by Scott Anstadt, Shannon Bradley, & Ashley Burnette,

KEYWORDS: survey methodology, virtual world, Second Life

ABSTRACT:  Second Life (SL) offers unique opportunities for research and exploration in virtual environments. A review of current research regarding SL has examined the influence of real world social influences in online interactions and what the effects on users may be. This suggests the importance of developing an understanding of the relationship between users’ real life (RL) and their SL. Some research has begun to reveal the effectiveness of telecommunication and computer simulation with certain clients in the fields of mental health and human services, yet there is a lack of sufficient research done within the context of virtual worlds. This study illustrates a methodology which can be used for online and in-world survey data collection of participants in SL. Limitations encountered as well as suggestions for refinement are discussed. Implications for human services are discussed including engaging clients using incentives for social participation built into the SL milieu.

Application Review

DBT Self-Help Application for Mobile Devices.  Reviewed by Micki Washburn & Danielle E. Parrish

Volume 31/3: 2013, General Issue

Reaching Women Under Stress from a Partner’s Drinking Problem: Assessing Interest in Online Help by Robert G. Rychtarik, Neil B. Mcgillicuddy, & and Christopher Barrick

KEYWORDS:  coping skills training, development, eTherapy, online program design, spouses of alcoholics

ABSTRACT:  Assessing prospective program reach is an important step prior to any online-development effort. This study assessed, preliminarily, interest in a proposed online coping skills training program for women living with a partner with a drinking problem, including their (a) overall program interest; (b) relative preference for an online versus face-to-face format; (c) likely use of adjunctive, professional communications; and (d) use under alternate fee structures. In a community sample of women with problem-drinking partners (N =73), interest was high (73%); 46% preferred the online format; 31% preferred online and face-to-face formats equally. Interest in adjunctive contacts was high, but diminished with fees; interest-level predictors were few. Online skills training could potentially reach a large portion of this frequently hidden, underserved population, and be financially feasible.


Gamification for Behavior Change: Lessons from Developing a Social, Multiuser, Web-Tablet based Prevention Game for Youths by Dick Schoech, Javier F. Boyas, Ph.D., Beverly M. Black, Ph.D., & Nada Elias-Lambert

KEYWORDS:  gamification, healthy games, substance abuse, relationship violence, prevention, adolescents, youth

ABSTRACT:  Interest is growing in gamification, the use of game techniques and mechanics to engage and motivate.  Future predictions suggest that this interest will continue to grow especially in the use of games to change individual behavior.  However, applying gamification concepts and principles is challenging.  Despite the growing interest, few gamification efforts have documented the challenges associated with the game development and application process.  This article illustrates how gamification concepts and principles were applied to the development of an online, multiuser, substance abuse and relationship violence prevention game for youths.  We discuss challenges encountered during the efforts to develop and test a prototype version of the game and then present concrete and practical strategies for addressing these challenges.  This article provides guidance for other researchers and practitioners who may want to gamify human service processes and use gamification techniques within a behavior change framework.


Elderly People’s Perceptions of a Telehealthcare System: Relative Advantage, Compatibility, Complexity and Observability by Susanne Anna Frennert, Anette Forsberg, & Britt Östlund

KEYWORDS:  compatibility, complexity, GiraffPlus, observability elderly people, relative advantage, telehealthcare system

ABSTRACT:  The use of telehealthcare systems to promote independent living for elderly people is growing. The results presented in this article, derived from an initial user lab test of a telecare system—GiraffPlus—indicate that the crucial factor for adoption of tele-healthcare systems is not usability but the system’s ability to support autonomy in everyday life. Eleven users tested the usability and reported what they perceived as possible benefits of having such a system at home. To support autonomy, customization is crucial for the system to be perceived as meaningful for the individual. Our analysis confirms previous research.

Prompting Depression Treatment Seeking among Smokers: A Comparison of Participants from Six Countries in an Internet Stop Smoking RCT by Yan Leykin, Adrian Aguilera, Eliseo J. Pérez-Stable, & Ricardo f. Muñoz

KEYWORDS:  behavior change, cross-national, smoking cessation, treatment seeking

ABSTRACT:  Websites containing information and advice about health are increasingly common and popular. It is important to understand whether the material these sites contain can positively influence individual behavior, and whether populations differ in their response to that material. Participants in an international web-based stop smoking randomized controlled trial (RCT) were screened for major depression; participants whose history and/or depression symptoms were deemed of concern were offered one of two prompts (Strong and Mild) to seek treatment, depending on depression history. Participants from 3 predominantly English-speaking and 3 predominantly Spanish-speaking countries were analyzed. Individuals given a Strong prompt were more likely to seek treatment for depression than those given a weak prompt (16.6% vs. 10.2% of previously untreated individuals reported seeking treatment), controlling for symptom level and other variables. Country-specific differences were observed, with participants from South Africa and Spain departing from the common pattern of Strong prompt leading to higher likelihood of treatment seeking. Older age and female gender, but not symptom level predicted higher likelihood of seeking treatment following a prompt. The results suggest that information provided by the health websites can promote help seeking in affected individuals.


Evaluation of A Web-Phone Intervention System in Changing Smoking Behavior — A Randomized Controlled Trial by Wu-der Brian Peng, & Dick Schoech

KEYWORDS:  Smoking cessation, automated messaging, mobile phone, self-efficacy, stage-of-change

ABSTRACT:  This study evaluates the effectiveness of a web-phone intervention in changing smoking behavior.  One hundred and sixteen university student smokers were recruited to participate in a randomized-controlled-trial. Each participant used their own mobile phone to receive messages from an automated web-phone system. After 4 weeks the participants in both the experimental group and comparison group improved on self-efficacy (SE) and stage of change (SOC) toward smoking cessation. After another 5 weeks, their SE remained significantly improved, but SOC did not.  Participants in the control group did not improve.  The findings provide support for further research on and possible adoption of automated phone interventions as a tool in helping smokers move toward quitting, especially those who are at an earlier stage of change. Dosage in automated interventions was found to be an area requiring future research.

Brief Reports

Development Guidelines from a Study of Suicide Prevention Mobile Applications (Apps) by Regina T. P. Aguirre, Mary McCoy, & Michelle T. Roan

KEYWORDS:  Mobile applications, apps, app development guidelines, suicide

ABSTRACT:  Every day, Americans are inundated with advertisements and appeals to purchase the latest mobile technology in the form of smart phones, tablets, and their accompanying applications (apps). Human service organizations (HSOs) across the United States have begun to recognize that apps can provide a valuable resource for individuals and communities by addressing social issues. Additionally, forward-thinking HSOs are aware that apps are a fresh and important way of reaching a rapidly changing, tech-savvy population. But just like the marketplace at large yields a variety of apps that range from useful and engaging to poorly contrived and ineffective, HSOs’ foray into app development has achieved mixed results. This report analyzes existing mobile applications available for one specific field of HSO service delivery— suicide prevention—in order to describe what is currently available and to generate beginning guidelines for the development, implementation, and evaluation of new suicide prevention apps for underserved populations. Twenty-seven apps were analyzed and recommendations for HSOs and future research are presented.

Book Reviews

The creative destruction of medicine: how the digital revolution will create better health care, by E. Topol

New York, NY: Basic Books, 2012, 303 pp. ISBN-13: 9780465025503

Reviewed by Belinda Toole University of San Diego