Bringing Psychological Care Online

For many people suffering from disorders like insomnia, psychological treatment is not an option — specialized counseling can be costly and is not available everywhere. But Lee M. Ritterband, Ph.D., and Frances P. Thorndike, Ph.D., at the University of Virginia are working to change all that. Through their innovative software platform and new company, the clinical psychologists are working to bring expert psychological help from the therapist’s couch to your own.

As part of the Behavioral Health and Technology group within the School of Medicine’s Department of Psychiatry and Neurobehavioral Sciences, the clinician–scientists aim to make psychological care more widely available through what are called Internet-based interventions. Employing the cognitive-behavior therapy strategies widely used by clinicians, the Web-based programs provide guidance to patients within the comfort of their own homes.

“We turned to the Internet as a way to take what we typically do in the office and transform it for online delivery, to reach greater numbers of people and increase access to care,” Thorndike said.

For insomniacs, for instance, there’s Sleep Healthy Using the Internet, or SHUTiTM. Using the researchers’ BeStudy ManagerTM platform technology, the interactive, six-week-plus program offers users tailored recommendations based on their sleep habits, which they record in a detailed online sleep diary. As they make their way through the program’s interactive modules, users monitor their progress, track goals, unlock new program content, receive personalized feedback, take quizzes, play related games, and engage in multimedia vignettes that weave throughout the intervention.

In a clinical trial, 73 percent of SHUTi users reported no longer suffering from insomnia upon completion of the program. Following the trial, Ritterband said, “We were eager to find a way to make our interventions available, to get them out there, and that’s really what led to BeHealth SolutionsTM,” the researchers’ new company.

BeHealth licensed the BeStudy Manager platform, SHUTi and another intervention — UCanPoopTooTM, for children ages 5 to 12 struggling with encopresis, or “accidents” — from the U.Va. Patent Foundation in April 2011. Through BeHealth, the researchers are exploring various models to make their Internet interventions available.

The company also offers customization of the BeStudy Manager to those wishing to develop Internet interventions in additional areas. “That way, that particular researcher doesn’t have to re-create the wheel,” Thorndike said. “They can hit the ground running by taking advantage of the technology we already have in place.”

While Internet interventions hold promise, Ritterband and Thorndike don’t expect their technology to replace face-to-face therapy sessions as the standard of psychological care.

“We believe in the stepped-care model,” Thorndike said. “A fully automated Internet intervention can likely work for a certain group of people, and hopefully, with more research, we’ll be able to predict who might need another level of care.”

The researchers’ interventions have been funded by numerous institutes at the National Institutes of Health, including the National Institute of Mental Health.