(PS12-74) Integrating a Wearable, Personalized Self-tracking Instrument into Psychotherapy for Refugees with CPTSD: A Data-driven Approach

Psychotherapy for refugees with Complex PTSD (CPTSD) poses distinct challenges, including heterogeneous treatment expectations, significant comorbidities, and high dropout rates. In recognition of these complex challenges, our study integrates a novel, single-purpose wearable self-tracking instrument, the One Button Tracker (OBT), into psychotherapy for refugees with CPTSD. The OBT enables patients to track one or more symptoms as they occur in their daily lives, supporting a personalized, data-driven approach to therapy. Unlike traditional methods, such as smartphone apps, the OBT significantly simplifies self-tracking. It allows patients to track a self-chosen and subjectively defined phenomenon (such as a symptom, behavior or intervention) relevant to their condition with a single press of a button. In turn, therapists and patients can explore real-world data enabling data-driven clinical decisions in sessions. The objective of this study was to co-create a preliminary concept for integrating the OBT into psychotherapy, aimed at personalizing psychotherapeutic strategies addressing patients’ specific needs.

The research was conducted at the Clinic for Trauma and Torture Survivors in Southern Denmark, employing a participatory action research (PAR) framework. It involved 21 participants from four key groups: Therapists, patients, clinical psychology researchers, and Human Computer Interaction researchers, all acting as co-creators throughout the research process. This collaborative research process spanned from November 2022 to April 2024 and was characterized by continuous iterative cycles of planning, action, and reflection. It combined qualitative data from logbooks, peer supervisions, workshops, and patient interviews with quantitative data from the OBT instruments used by patients.

Quantitative results showed that the OBT was integrated into the treatments of nine patients for 4 to 24 sessions. Qualitative findings underscored the OBT's contribution to therapy by fostering patient-therapist engagement and providing a method for maintaining focus within sessions. The instrument not only served as a material tool during the patient’s daily lives reminding them of their interventions and ongoing treatment, but also facilitated the analysis of self-tracking data in sessions, empowering patients in managing their mental health and enabling therapists to tailor interventions closely aligned with patients' daily symptom fluctuations. This adaptability highlights the OBT's applicability across diverse therapeutic approaches and settings.

Integrating the One Button Tracker into CBT for refugees with CPTSD offers a promising approach to overcome traditional treatment limitations, enhance patient engagement, and improve the precision of interventions. The OBT's role in facilitating a nuanced understanding of symptom patterns suggests a significant potential for data-driven, personalized psychotherapy to improve the care of vulnerable populations with complex mental health conditions.