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Tailored Text Message Prompts to Increase Therapy Homework Adherence: A Single-Case Randomised Controlled Study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Clinical Psychology in Healthcare.ORCID iD: 0000-0003-4570-5891
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet.
2019 (English)In: Behaviour change, ISSN 0813-4839, E-ISSN 2049-7768, Vol. 36, no 3, p. 180-191Article in journal (Refereed) Published
Abstract [en]

Background: Psychotherapy homework completion is associated with positive treatment outcomes, but many patients show low adherence to prescribed assignments. Whether text-message prompts are effective in increasing adherence to assignments is unknown. Aims: To evaluate whether tailored daily text-message prompts can increase homework adherence in a stress/anxiety treatment. Method: This study used a randomised controlled single-case alternating treatment design with parallel replication in seven participants. Participants received a five-week relaxation program for stress and anxiety with daily exercises. The intervention consisted of daily text messages tailored for each participant. Phases with or without text messages were randomly alternated over the study course. Randomisation tests were used to statistically analyse differences in mean number of completed relaxation exercises between phases. Results: There was a significant (combined p = .018) effect of daily text messages on homework adherence across participants with weak to medium effect size improvements. No negative effects of daily text messages were identified. Conclusions: Tailored text messages can marginally improve adherence to assignments for patients in CBT. Further studies may investigate how text messages can be made relevant for more patients and whether text messages can be used to increase homework quality rather than quantity.

Place, publisher, year, edition, pages
2019. Vol. 36, no 3, p. 180-191
Keywords [en]
Homework assignments, treatment adherence, prompts, mobile phone, cognitive behaviour therapy
National Category
Psychiatry
Research subject
Psychiatry
Identifiers
URN: urn:nbn:se:uu:diva-393948DOI: 10.1017/bec.2019.10OAI: oai:DiVA.org:uu-393948DiVA, id: diva2:1355654
Available from: 2019-09-30 Created: 2019-09-30 Last updated: 2019-09-30

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