Molly Bird, Trainee Clinical Psychologist, Institute of Psychiatry, Psychology and Neuroscience (IoPPN) and South London and Maudsley Trust (SLaM)
A new piece of research has recently been published looking at different technologies for supporting people experiencing ‘paranoia’, or concerns about threats of harm from others. I’m Molly, one of the researchers who conducted the review and am excited to share a summary of what we found.
We were keen to review technologies that were used in addition to face-to-face care, such as virtual reality being used as part of talking therapy. This can be helpful to see how technology might improve current ways of assessing and treating paranoia. We were also interested to look at how people found using the technologies, such as if they experienced any difficulties.
To do this, we searched across different research databases to look for research papers in this exciting area; we found twenty-seven papers. Most of the studies were focused on using technology to assess paranoia (i.e. to understand more about someone’s experience and how this affects their day-to-day life). Four studies focused on using technology to treat paranoia (i.e. to help people overcome and manage paranoia in their day-to-day life).
The most common technology researched across the papers was virtual reality. This was mostly used for assessing paranoia, for example asking someone to enter a virtual scenario and see if and how this evoked any concerns about harm from others. Virtual reality was also integrated into treatment via talking therapy for paranoia in three studies. This involved working with a therapist to test out new ways of interacting with others while being immersed in a virtual environment (e.g. holding eye contact instead of looking down, approaching people instead of avoiding them, challenging suspicious thinking patterns by looking for or paying attention to evidence that they were safe etc).
Another technology used in the studies was electronic diaries completed in daily life (sometimes called ‘ecological sampling methodology’). These diaries tend to send an alert to someone’s phone several times a day, asking for them to respond to questions about their concerns of threats from others. This technology can be especially helpful in providing real-life information on certain situations that might bring on threat concerns.
Interestingly, we only found one study that used a mobile app to support with paranoid thoughts. The mobile app, called ‘SlowMo’ was focused on supporting people in slowing down fast thinking, which has been linked to paranoia. The app had interactive features for people to use, such as putting specific threat concerns into animated thought bubbles which could then be popped.
So what are the benefits of using technologies for assessing and treating paranoia?
A strength of using technologies is that they are more time sensitive than traditional methods, such as paper and pen weekly diaries, or breaking down real life situations retrospectively with a therapist in the clinic. This can allow for threat concerns to be captured closer to the moment they occur. In the case of virtual reality, the technology can also allow testing out paranoia in controlled environments. For example, virtual reality can support someone to test out their beliefs in a virtual environment that looks similar to a scenario a person might feel particularly threatened by. This might be a helpful stepping stone to help translation of new ways of responding to threats to generalise from the clinic environment to real life environment. These promising findings point to the potential future use of technologies in assessing and treating paranoia in attempt to reduce distress and improve wellbeing.
And, what are the challenges and considerations when using technologies for assessing and treating paranoia?
Most of the included studies were looking at groups in the general population who were not accessing mental health services for paranoia. More research is needed to see whether these technologies are safe, appropriate and helpful for those accessing mental health services, as this might represent a different group of people than those included in the studies to date. It is also important that researchers and clinicians ensure they are not accidentally excluding anyone who would like to access these technologies in the future. For example, some people may not have a smart phone or internet connection. If services offer an app-based treatment, it would be important to consider ways to support using technologies, such as lending people phones rather than relying on people having their own.
Overall, we found that the technologies were practical and seemed appropriate for those experiencing paranoia. The treatment studies also showed promising results in reducing paranoia, although more research is needed.
If you are interested in reading more, our open access review paper can be accessed here.
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