Is technology and adventure therapy the new prescription for depression?

Current treatments for depression are often seen as inadequate, either in terms of accessibility or effectiveness. But what could the next step be for treatment? Research published today in Pilot and Feasibility Studies evaluated what barriers could impact the use of behavioral activation programs for major depressive disorders and here, co-author Dr Zainab Samaan discusses what this might mean for future research and practice.

As a psychiatrist seeing people with depression, I am disappointed by the underwhelming response rate to pharmacotherapy with two thirds of patients having inadequate response to antidepressants.

Years go by and patients become chronically depressed, suffer a decline in health and social functioning, become isolated and lose their connection to life around them.

Although many therapies can be effective, for example cognitive behavioral therapy (CBT), access to such therapies is limited, resource intensive and based at clinical settings.

Why is it the treatment for a common condition such as depression that affects up to 16% of the population, restricted to being delivered at clinical settings?

Why is it the treatment for a common condition such as depression that affects up to 16% of the population, restricted to being delivered at clinical settings?

A growing amount of evidence shows that recreational activities can help depression, such as adventure based therapy, where people are engaged with others, problem solving in the outdoors and developing social and physical skills. However, this type of therapy is rarely seen as a main method of treatment in clinics and hospitals.

What if the use of daily accessible tools such as smart phones, fitbits, electronic tablets and apps can be helpful for people with depression? Can these devices provide motivation to be active, track progress, and set goals for recovery?

We investigated the feasibility and acceptability of introducing a behavioral activation program with complementary adventure based therapy

In our paper published today in Pilot and Feasibility Studies, we investigated the feasibility and acceptability of introducing a behavioral activation program with complementary adventure based therapy, and technology for tracking physical activity, to treat patients with depression.

Patients and clinicians participated in focus groups to provide feedback and discussion on the proposed program. They were in agreement that a comprehensive behavioral activation program added to usual care is needed, and emphasized the importance of sustainability, where the gains achieved during the program needed to last beyond the 18 weeks proposed for the program.

The use of technology was seen by the clinicians as complicated and added financial burden for patients.

Patients, on the other hand, believed they will benefit from the use of technology for activating, monitoring progress, reminders and as they are inconspicuous and can be used daily without attracting attention. The use of technology was also seen by patients as flexible, used anywhere without the need for clinic visit.

This point of discrepancy between healthcare providers and receivers may point to the changing landscape of current healthcare users’ preferences for accessibility, and the lag of services adapting to these preferences.

Should depression treatment then move from the traditional clinic to the outdoor adventure, a canoe trip or a campsite, with a handheld device?

Should depression treatment then move from the traditional clinic to the outdoor adventure, a canoe trip or a campsite, with a handheld device?

I believe there is a need to change how we deliver treatment to catch up with the pace of our changing world and the needs of patients, in addition to providing traditional therapies.

With mobile technology in everyone’s pocket, it is time to incorporate it in treatment plans and perhaps soon the prescription for depression will read like this:

Rx
-Citalopram 20 mg qam po
-Rock climbing trip x 2 days
-Install mood gym app

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