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Preventive Information and Communication Technologies (ICTs)

• Preventive ICTs use such new technological forms as online education, email or text-based communication between clinicians and patients, and smartphone or video-linked social support tools.
• There is currently no scientific evidence suggesting that ICT-based psychosocial programs to promote resilience or prevent posttraumatic stress symptoms, depression, or anxiety are more effective than existing prevention methods.
• Instead, preventive interventions might prioritize problems of alcohol misuse and intimate partner violence.

Clinical Treatment ICTs

• ICT applications have been developed to enhance clinical treatment by educating and activating patients, improving decisionmaking by clinicians, providing a therapy, encouraging adherence to treatment, and maintaining treatment gains over time.
• There is little scientific evidence of the efficacy of most ICT applications in behavioral health treatment, in part because the development of new applications outpaces the conduct of rigorous scientific studies.
• One promising avenue is development of reliable methods for patient-clinician communication between therapy sessions; another is Internet-based cognitive behavioral therapy.

The dramatic evolution in information and communication technologies (ICTs) online and on smartphones has led to rapid innovations in behavioral health care. To assist the U.S. Air Force in developing a strategy for use of ICTs, the authors reviewed the scientific literature on their use to prevent and treat behavioral health conditions, such as major depression, posttraumatic stress disorder, and alcohol misuse. There is currently little scientific evidence supporting additional investment in ICT-based psychosocial programs for resilience or prevention of posttraumatic stress symptoms, depression, or anxiety. Instead, preventive interventions might prioritize problems of alcohol misuse and intimate partner violence. ICT applications that play a role in the treatment process may be used for patient education and activation, to improve decisionmaking by clinicians, to provide a therapy, to improve adherence to treatment, or to maintain treatment gains over time. However, partly due to the rapid pace of development of the technology, there is little or no evidence in the literature regarding the efficacy of the most recently developed types of ICTs, in particular those using smartphones. Despite the lack of solid research evidence to date, ICTs hold promise in addressing the challenges of mental health care. One promising avenue is development of reliable methods for patient-clinician communication between therapy sessions; another is Internet-based cognitive behavioral therapy. The authors recommend that the Air Force should take an incremental approach to adopting the use of ICTs — one that involves a program of measurement-based implementation and process and outcome monitoring rather than urgent dissemination.

• Chapter One

  Background

• Chapter Two

  Prevention: Universal and Targeted Approaches

• Chapter Three

  ICTs in the Clinical Process

• Chapter Four

  Conclusions and Recommendations