Preventing Relapse with Personalised Smart-Messaging After Cognitive Behavioural Therapy: A Proof of Concept Evaluation

Objectives. Cognitive Behavioural Therapy (CBT)
can improve symptoms of anxiety and depression, but also reduces the risk of
future relapse after therapy completion. However, current CBT relapse
prevention methods are resource intensive and can be limited in clinical
practice. This paper investigates a personalised means of reducing relapse
using smart-messaging in two settings; research and routine care.

Design. Study 1 presents a cohort study
comparing a cohort of smart-messaging users versus non-users. Study 2 presents
time series follow up data from a case series of smart-messaging users from
clinical practice.

Methods. Fifteen of 56 CBT completers who
participated in a trial for the treatment of health anxiety wrote advice they
would want if in future they were doing well, experiencing early warning signs
of relapse, or experiencing full relapse. Following CBT, participants received
weekly text-message requests to rate their wellbeing. Dependent upon their
response, participants received tailored advice they had written, appropriate
to the wellbeing level reported after recovery from health anxiety.
Smart-messaging was also trialled in a routine practice sample of 14 CBT
completers with anxiety and depression.

Results. Across a 12-month follow-up,
participants receiving smart-messaging showed greater health improvements than
those who did not. Wellbeing scores showed stability between CBT completion and
six-month follow-up among routine care patients.

Conclusions. These findings suggest that a
low-intensity, personalised relapse prevention method can have a clinical
benefit following CBT for common mental health problems.