Pocket Therapist supports therapy independent of place and time

Support and sense of safety between therapy sessions

The pandemic changed psychotherapeutic work in many ways. Mental health issues are on the rise – and so is the demand for therapy services.

The demand for remote therapy services has increased, and mental health issues are on the rise. Emerging technologies offer opportunities to create new solutions such as remote therapy services to support psychotherapeutic work. At the same time, however, data leaks have eroded trust in digital services globally and in Finland. The starting point of the project was to completely renew the already outdated Pocket Therapist app so that it would better meet the current needs both technically and in terms of content.

Stress, anxiety and trauma symptoms are often accompanied by emotion regulation issues stemming from the autonomic nervous system, which often lead to hypo- or hyperarousal. Prolonged stress or trauma can make regulating your own arousal level and strong emotions extremely challenging at times. The aim of the project was to develop a modern mobile phone app that could safely support the regulation of stress, arousal level and emotions outside therapy sessions and increase the client’s understanding of the mechanisms behind symptoms related to the regulation of autonomic nervous system arousal.

Understanding both therapists and clients offered the right focus for the therapy process

Pocket Therapist is based on the polyvagal theory of the autonomic nervous system by neurophysiologist Stephen W. Porges and its application to psychotherapy in practice. Among the main goals of psychotherapy are to learn to recognise and identify changes in your level of arousal and emotions caused by your autonomic nervous system and to find suitable methods and exercises to support their regulation. Clinical experience has shown that the development of self-observation and self-regulation skills requires systematic practice.

The idea of Pocket Therapist was born from a practical need in therapy work to assist the client in coping with, for example, the effects of trauma on their ability to self-regulate and uncontrollable fluctuations of autonomic nervous system arousal. The key idea behind the project was to provide the client with actual, active tools for self-regulation and the management of symptoms, regardless of time and place, easily and unnoticed.

From the outset, it was clear that both healthcare professionals and clients had to be involved in the work. As the project aimed to completely redesign an existing app, it was also necessary to understand the users of the old app and investigate the usage patterns and background of the previous version. In addition to inclusive design, a technical evaluation plan was prepared to be used to select the right technical solution based on the needs.

Thanks to feedback from the healthcare professionals and customers, the design and development work could focus on the right aspects in terms of the therapeutic process at all stages of the project. Three key goals for the app were identified based on the insights gained from the inclusive design process:

The Pocket Therapist exercises are only available when the app is being used with a therapist as part of a therapy process.

The therapist customises the exercises based on the client’s situation and needs. The other features of Pocket Therapist are available to all users.

Uncompromising attitude to reliability and privacy

The app was designed by combining qualitative understanding, inclusive methods and iterative design. Healthcare professionals and therapy clients were involved in the design process, and the vision of the technical and conceptual solutions was constantly refined with the help of prototypes.

The therapists offered information on what kind of content and features could support the clients’ daily lives – without burdening the therapist outside the agreed sessions or other agreed forms of communication. The customers offered information on the right content and features from the perspectives of psychological security, information security and accessibility.

The design phase gave way to the pilot phase, where a working pilot app was created based on the understanding gained in order to gather feedback from therapy clients before packaging the actual release version. The web-based implementation method of the old app had proved to be insufficient in terms of reliability. Separate native versions for iOS and Android were therefore selected as the technical approach for the new app to make the app as reliable as possible and to minimise dependence on third-party software.

Mental health services and apps are of particular interest to hackers because the information they contain is especially suitable for extortion and doing damage. Both in Finland and globally, mental health service providers have been subject to high-profile security breaches. To avoid data leaks, a radical decision was made not to save any personally identifiable information about the clients outside the customer’s own smartphone. The service does not collect any user analytics or save the user’s actions or personal data in any back-end system. The app is also easy to use in your daily life without worrying about spying, because when using the app, the user can lift the phone to their ear as if they were making a phone call.

With Pocket Therapist, the therapist can encourage the client to practise the regulation of their autonomic nervous system and emotions outside therapy sessions as well. Pocket Therapist offers functional video and audio exercises in an easily accessible format, and the recommended exercises can be customised as the client’s therapy process progresses. Pocket Therapist also assists the client to identify factors that trigger stress and trauma symptoms, and to find suitable regulation tools for such situations, regardless of time and place. The app encourages the client to monitor the quality of their sleep and to record their thoughts, emotions and insights during the therapy process.

Pocket Therapist helps healthcare professionals meet growing demand

Thousands of clients have already used Pocket Therapist as part of their treatment relationship. The client’s quality of life can be improved between appointments, even when treatment resources do not allow more frequent therapy appointments.

Clients have found the use of Pocket Therapist easy and inconspicuous. When you get a sudden onset of symptoms, help is available to regulate them without the people around you paying any attention to what you are doing, even if you happen to be sitting on a bus. With Pocket Therapist, clients have been able to perform exercises that support the regulation of their autonomic nervous system outside therapy sessions at a time that suits them.