TY  - JOUR
AU  - Bunnell, Brian E
AU  - Schuler, Kaitlyn R
AU  - Ivanova, Julia
AU  - Flynn, Lea
AU  - Barrera, Janelle F
AU  - Niazi, Jasmine
AU  - Turner, Dylan
AU  - Welch, Brandon M
PY  - 2024
DA  - 2024/12/12
TI  - Expanding a Health Technology Solution to Address Therapist Challenges in Implementing Homework With Adult Clients: Mixed Methods Study
JO  - JMIR Hum Factors
SP  - e56567
VL  - 11
KW  - mental health
KW  - mental illness
KW  - mental disease
KW  - mental disorder
KW  - homework
KW  - homework challenge
KW  - therapy
KW  - therapist
KW  - barriers
KW  - adult client
KW  - adult
KW  - technology-based solution
KW  - health technology
KW  - digital health
KW  - digital technology
KW  - digital intervention
KW  - mobile phone
AB  - Background: Homework is implemented with variable effectiveness in real-world therapy settings, indicating a need for innovative solutions to homework challenges. We developed Adhere.ly, a user-friendly, Health Insurance Portability and Accountability Act–compliant web-based platform to help therapists implement homework with youth clients and their caregivers. The initial version had limited functionality, was designed for youth clients and their caregivers, and required expanding available features and exercises to suit adult clients. Objective: The purpose of this study was to better understand barriers and potential solutions to homework implementation experienced by therapists seeing adult clients and obtain their input on new features and exercises that would enable Adhere.ly to better meet their needs when working with this population. Methods: This study used an exploratory, sequential mixed methods design that included 13 semistructured focus groups with mental health therapists and clinic leaders and a survey administered to 100 therapists. Analyses were performed using the NVivo qualitative analysis software and SPSS. Results: The findings revealed common barriers, such as clients and therapists being busy, forgetting to complete homework, managing multiple platforms and homework materials, and clients lacking motivation. Adhere.ly was perceived as a potential solution, particularly its user-friendly interface and SMS text-message based reminders. Therapists suggested integrating Adhere.ly with telemedicine and electronic health record platforms and adding more exercises to support manualized therapy protocols and therapy guides. Conclusions: This study highlights the importance of technology-based solutions in addressing barriers to homework implementation in mental health treatment with adult clients. Adhere.ly shows promise in addressing these challenges and has the potential to improve therapy efficiency and homework completion rates. The input from therapists informed the development of Adhere.ly, guiding the expansion of features and exercises to better meet the needs of therapists working with adult clients. 
SN  - 2292-9495
UR  - https://humanfactors.jmir.org/2024/1/e56567
UR  - https://doi.org/10.2196/56567
DO  - 10.2196/56567
ID  - info:doi/10.2196/56567
ER  -