Co-designing technology to improve psychological therapy for psychosis: SloMo, a blended digital therapy for fear of harm from others

TY - JOUR

T1 - Co-designing technology to improve psychological therapy for psychosis

T2 - SloMo, a blended digital therapy for fear of harm from others

AU - Hardy, Amy

AU - Taylor, Kathryn M.

AU - Grant, Amy

AU - Christie, Louie

AU - Walsh, Lucy

AU - Gant, Thomas

AU - Gheerawo, Rama

AU - Wojdecka, Anna

AU - Westaway, Adrian

AU - Münch, Alexa

AU - Garety, Philippa

AU - Ward, Thomas

N1 - Publisher Copyright: © 2024 The Authors

PY - 2024/11/22

Y1 - 2024/11/22

N2 - Digital technology is positioned as a potential solution to improving access, experience, and outcomes of psychological therapies for psychosis. Digital solutions need to be fit for purpose and tailored to context to deliver real world benefits. To address this, co-production is often used, where stakeholder involvement informs intervention development. However, co-production in clinical research tends to limit involvement to refining previously identified solutions to known problems. This is not an optimal approach to innovation and risks maintaining inequities. An alternative is inclusive co-design, where the needs of a diverse range of people are collaboratively explored using ethnography, and solutions to address these iteratively developed through user testing. In healthcare, we propose an evidence-based approach to co-design (‘hybrid waterfall-agile’) is required. This is because ‘agile’ exploration of needs and solutions is necessarily constrained by clinical guidelines and regulatory requirements (the ‘waterfall’). This paper provides an overview of evidence-based co-design. We use the example of SloMo, a blended digital therapy for paranoia. We describe our transdisciplinary team collaboration and how this facilitates inclusive lived experience involvement. Our therapy development method is outlined, illustrated by reflections from lived experience team members. Iterative divergent (‘zooming out’) and convergent (‘honing in’) cycles are used to co-design therapy functionality, aesthetics, interactions, and content, supported by stakeholder engagement. We conclude by reflecting on common challenges including sustaining lived experience involvement, adherence to evidence base, regulatory compliance, funding, and project management. Recommendations for navigating these obstacles are provided, with the aim of encouraging innovation in mental healthcare for psychosis.

AB - Digital technology is positioned as a potential solution to improving access, experience, and outcomes of psychological therapies for psychosis. Digital solutions need to be fit for purpose and tailored to context to deliver real world benefits. To address this, co-production is often used, where stakeholder involvement informs intervention development. However, co-production in clinical research tends to limit involvement to refining previously identified solutions to known problems. This is not an optimal approach to innovation and risks maintaining inequities. An alternative is inclusive co-design, where the needs of a diverse range of people are collaboratively explored using ethnography, and solutions to address these iteratively developed through user testing. In healthcare, we propose an evidence-based approach to co-design (‘hybrid waterfall-agile’) is required. This is because ‘agile’ exploration of needs and solutions is necessarily constrained by clinical guidelines and regulatory requirements (the ‘waterfall’). This paper provides an overview of evidence-based co-design. We use the example of SloMo, a blended digital therapy for paranoia. We describe our transdisciplinary team collaboration and how this facilitates inclusive lived experience involvement. Our therapy development method is outlined, illustrated by reflections from lived experience team members. Iterative divergent (‘zooming out’) and convergent (‘honing in’) cycles are used to co-design therapy functionality, aesthetics, interactions, and content, supported by stakeholder engagement. We conclude by reflecting on common challenges including sustaining lived experience involvement, adherence to evidence base, regulatory compliance, funding, and project management. Recommendations for navigating these obstacles are provided, with the aim of encouraging innovation in mental healthcare for psychosis.

KW - Co-design

KW - Digital health

KW - Inclusive design

KW - Lived experience

KW - Paranoia

KW - Psychosis

KW - Therapy

UR - https://www.scopus.com/pages/publications/85209736474

U2 - 10.1016/j.schres.2024.11.004

DO - 10.1016/j.schres.2024.11.004

M3 - Review article

C2 - 39579660

AN - SCOPUS:85209736474

SN - 0920-9964

VL - 274

SP - 526

EP - 534

JO - Schizophrenia Research

JF - Schizophrenia Research

ER -