Applications

Applications

A piece of news caught my attention last year. Jay Buckey,, Jr an American NASA astronaut and surgeon who also holds a degree in electrical engineering and who was in a 16 day Spacelab flight having done 381 hours in space, launched an online self-help toolkit based on his experience of being isolated with a small group of people in space. It is free. Yes, it is free.
My (short) trial went like this: After you fill up your information online (name, password, country, reCAPTCHA), it takes you to a page where you can choose any one of four options (1) conflict (2) mood (3) guided self-assessment (4) stress. At the end of the page is a crisis hotline number (1-800). I selected “conflict” and was led to a page that asked for my informed consent to participate in a study. I’m always up to participate in studies. It then took me to an introductory video with clear subtitles being delivered by a Prof of management and psychology. Next, there is a video introducing you to conflict simulation. An actor in the video gives you a situation and you have to choose how you would respond. Based on your response, the simulation proceeds. If you choose mood, it asks you to take an assessment and depending on your level of assessment suggests six sessions of a web-based training and treatment program. Exercises that are interactive and use the principles of cognitive behaviour therapy, an evidence-based treatment are demonstrated. Another cool feature is an evidence-based downloadable PDF document that gives you a detailed blueprint and sequence of the treatment plan, with detailed instructions. In order to keep track of progress I was prompted to take guided self assessments. I also had free access to resources and material under the “E-library” and “other material” tabs.
Tech Specs Where ? Available on www (the net)
By whom ? Developed by Dartmouth
Language ? Only in English
Costs ? Free
Other cool stuff The program is being tested in research stations within extreme environments such as the Antarctica and space. It is rare to find randomised controlled studies on effectiveness especially with mobile applications. This one however has a few and is therefore quite credible.
My concerns Cannot be used with children The videos did not have racial, ethnic or gender diverse actors
My Recommendations I would definitely recommend this as an adjunct to therapy especially for stress, depression and conflict.
A piece of news caught my attention last year. Jay Buckey,, Jr an American NASA astronaut and surgeon who also holds a degree in electrical engineering and who was in a 16 day Spacelab flight having done 381 hours in space, launched an online self-help toolkit based on his experience of being isolated with a small group of people in space. It is free. Yes, it is free.
My (short) trial went like this: After you fill up your information online (name, password, country, reCAPTCHA), it takes you to a page where you can choose any one of four options (1) conflict (2) mood (3) guided self-assessment (4) stress. At the end of the page is a crisis hotline number (1-800). I selected “conflict” and was led to a page that asked for my informed consent to participate in a study. I’m always up to participate in studies. It then took me to an introductory video with clear subtitles being delivered by a Prof of management and psychology. Next, there is a video introducing you to conflict simulation. An actor in the video gives you a situation and you have to choose how you would respond. Based on your response, the simulation proceeds. If you choose mood, it asks you to take an assessment and depending on your level of assessment suggests six sessions of a web-based training and treatment program. Exercises that are interactive and use the principles of cognitive behaviour therapy, an evidence-based treatment are demonstrated. Another cool feature is an evidence-based downloadable PDF document that gives you a detailed blueprint and sequence of the treatment plan, with detailed instructions. In order to keep track of progress I was prompted to take guided self assessments. I also had free access to resources and material under the “E-library” and “other material” tabs.
Tech Specs
Where
Available on www (the net)
By whom
Developed by Dartmouth
Language
Only in English
Costs
Free
Other cool stuff The program is being tested in research stations within extreme environments such as the Antarctica and space. It is rare to find randomised controlled studies on effectiveness especially with mobile applications. This one however has a few and is therefore quite credible.
My concerns Cannot be used with children.
The videos did not have racial, ethnic or gender diverse actors
My Recommendations I would definitely recommend this as an adjunct to therapy especially for stress, depression and conflict.
The National Health Service (NHS) in the United Kingdom is a publicly funded healthcare system. In order to cope with the sheer numbers of people (adults) seeking mental health treatment and given the limitations of finances and time, they recommended this computer-based cognitive behaviour therapy (CBT) program for depression and anxiety. The 8 session, 50 minute per session “course” is recommended by physicians and psychiatrists. I had seen a presentation by Tony Attwood (famous for his work with Asperger’s), where he had used this for treatment with his clients. This is what piqued my interest in exploring this web-based “application” / program.
My (short) trial went like this: At first, I tried accessing the web based interface on my iPhone, but it did not look the same as it did on my computer. Once there, I took a mood checker assessment that gave me a depression and anxiety score with the advice that it has to be corroborated by a health professional. It encouraged me to make an appointment with a general practitioner or call the NHS. Naturally, this is not applicable to the Indian consumer. Next, three options were provided (1) for service providers (2) for patients like myself (3) for employers. I clicked on the option (2) which was immediately available. It cost £60 (approx. INR 6,500), and one can pay with PayPal. It claimed to have peer-reviewed publications and an evidence base. This is something that I have a personal issue with, because you can do research on whatever your government decides to fund. So, for instance, if the NHS decided to fund a program called “Eat Chocolate”, researchers would be paid to study it, and by the end of it we would have peer-reviewed literature on the efficacy and effectiveness of eating chocolate for mood (a personal favourite of mine). Nevertheless, publication is 100% better than no publication.
The sessions showed videos of actual (British) patients, with a voice-over from an expert clinician. It guided you through some basic concepts, the very same concepts that are taught to students in psychology colleges. Personally, I find the lack of inclusion of culture a grave omission. (But premier institutes in India, needs to come up with their own high quality material, in local languages). After a concept was taught in these videos, examples were given, model patients then demonstrated how to use the concept being discussed (which is more than what colleges do for psychology students). Several situations were completely irrelevant to the Indian scenario (for instance, a senior citizen in India does not have similar institutional support as someone in the UK).
Tech Specs
Where
Available on the www
(Web-based interface)
Language
English
Costs
£ 60 (presently approx. INR 6,500/-)
Other cool stuff It was cool to see detailed case vignettes and how an application of frameworks and principles of CBT was shown. The focus being always on the “here and now.” There were videos that explained the cognitive model of emotions and interpretations of events. They demonstrated how to record thoughts and how to be aware of automatic thoughts. There was a lot of homework between sessions (something I did not do). At one point they also shifted focus to the behavioural therapy aspects of CBT. There was an explanation of thinking errors/ cognitive distortions. Behavioural experiments were highlighted. Deeper belief systems were targeted with an attempt to use the “downward arrow technique” (which I assume will be too much for some people to DIY i.e. do it yourself). There was an explanation of the negative biases that we might have with the suggestion to focus on the good stuff (sigh).
My concerns The applicability of this program to the Indian diaspora in the UK, but also to Indians in India is a true concern for me. Indian therapists should take note, because I suspect they use a similar model and indeed neglect cultural frameworks altogether. This isn’t surprising because afterall, this isn’t taught in college. A “One size fits all” therapy does not appeal to me, personally. I do however understand that some therapy is better than no therapy, especially when you need it but cannot afford it. Sitting in front of a computer, and being lectured loses the element of emotional resonance. [On a sidenote, Ultrasis Group Plc, the healthcare company that develops computerised healthcare products declared bankruptcy in 2015. It was bought by 365 Health and Wellbeing, a subsidiary of Hexagon care services.]
My Recommendations Ironically, I would recommend this to Indian teachers and students of psychology, who seldom have access to videos and demonstrations of techniques such as cognitive behaviour therapy (other than the free stuff found online).
CogniFit is a training application for adults and the geriatric population to enhance cognitive skills via training sessions that you can choose or that are chosen by the program. The program offers performance feedback in order to monitor progress in the form of graphs and progress bars. It targets cognitive functions such as attention, concentration, memory, response time, etc via games and other retraining activities.
My (short) trial went like this After registering my email online and filling in details like my birthdate, the program asked me to take an initial assessment and discover how my cognitive skills stack up against others. The estimated time it would take was 20 minutes. The program then took me to a screen which was labelled task one of seven and it tested my response time. (Tasks will seem familiar to all those who administer neuropsychological batteries). In the first task given to me, I was supposed to press down on the rectangle as many times and as fast as I could until the time ran out. I expected the rectangles to be coming at me like missiles, but instead there was just one big block in the centre of the page that I was supposed to click repeatedly. The second task was harder. I had to click on a circle and not the hexagon both of which appeared across the screen in random order. For the third task circles on the screen lit up in a specific order and I had to memorise the order. Next, I was asked to memorise a pattern, given a purposeful distraction and then asked to retrace this pattern. The fourth task was actually having to do two tasks at the same time. (a) I had to track a ball with my finger/ mouse (b) At the same time, I had to press down (click) on words that corresponded to the color names they were shown in i.e. click down when presented with the word “green” when it is written in green ink but not in red ink. For the fifth task I was asked to click on the bigger shape as quickly as possible. However, if and when prompted, I had to choose the bigger number. For the second part of the task, I had to press on the highest number as fast as I could. For the sixth task the computer would present a series of numbers. I had to pay attention to the order of the numbers and repeat them, to test short-term memory. My last and seventh task was to test spatial perception -I would see three shapes for a short period of time, pay close attention and memorise a sequence. I was then shown several possible sequences and had to choose the exact same sequence as was first shown. My final score meant nothing in absolute terms, but might be relatively useful to compare me to me, before and after the training schedule.
Tech Specs
Where Web-based, iphone
(11 or later) & android (6.0)
By whom
CogniFit Ltd. A venture capital backed privately held start-up founded in 1999 by Shlomo Breznitz who is an Israeli psychologist and author of Maximum Brainpower : Challenging the Brain for Health and Wisdom.
Language
English, Arabic, Catalan, Dutch, French, German, Greek, Hebrew, Italian, Japanese, Korean, Polish, Portuguese, Russian, Serbian, simplified Chinese, Spanish, Turkish
Costs
Following a free trial personalised training is divided into basic and premium. The basic training plan includes video coaching sessions, 20+ games, assessments and access to your ranking. This plan costs approx. INR 1,861 every month or 11,166 per annum. If you choose a premium plan you get access to all training programs and 60+ games for INR approx. 2,791 month or 11,865 a year or 17,448 for three years. There are additional plans for professionals, schools and researchers.
Other cool stuff I thought the visual presentation i.e. aesthetic and usability features of the program were pretty good (If only they could only come up with an Indian English, Hindi and culturally relevant version). I also liked the neat and instant report that came alongside a weekly plan. I read in one peer-reviewed study that 8-10 weeks of personalised brain training with this program improved attention and executive functions in healthy older adults (but not necessarily other populations). So there’s published data that you can find that use this program, which is better than “no data.”
My concerns I do feel there’s not enough research done to validate this program as effective or efficacious. It is too expensive for the Indian client. It is also culturally irrelevant and of little use. For instance, in one naming paradigm I could not identify the first alphabet from drawings of most of the objects that they presented because they were culturally unfamiliar – raccoons, pitayas, maracas, yams, larks, toucans, hedgehogs, oryx, lovebirds, eggplants, anthuriums, vriesea – although I did know some of these words in Marathi. Also, in its recommendation it asked me to get personalised training on certain tasks, by giving me my cognitive age and cognitive strengths – the norms (cut-offs) for which can be arbitrary. This might give people the idea that they need help when they don’t causing significant distress.
Disclaimers There is a disclaimer at the end of the program which says that CogniFit is intended to be used for assessing cognitive well-being and the results when interpreted by a qualified healthcare provider, may be used in determining whether further tests are required. The program is not meant to offer medical diagnosis or treatment. The products can be used for research purposes provided the research is in compliance with ethical guidelines and regulations of the country where it is being used.