Nia is a digital application for individualised therapy support and aftercare for patients with recurring illnesses.
Why?
How?
Around 50 % to 85 % of patients with a depressive episode experience a relapse.
Möller et al.
The starting point for this thesis was a statistic on the relapse rate for unipolar depression. The relapse rate is the frequency with which an illness recurs after successful treatment.
From there we learnt that unipolar depressive patients often suffer from comorbidity. This means that unipolar depression is not the only illness they are diagnosed with. 50% of patients suffering from a depressive episode have another mental illness. The most common comorbidities include alcohol and drug addiction and anxiety disorders. These comorbidities, as well as the high relapse rate, pose numerous challenges for both the patients and those treating them.
Therapy stages
Based on the high rate of relapse in depression, our research focused on recurring illnesses and analysing possible causes of relapse. We began by looking at the treatment process for recurrent illnesses, which are treated in three treatment phases. These stages include acute therapy, maintenance therapy and prophylactic therapy. The figure shows a schematic representation of a possible course of treatment.
Blended care
Established forms of therapy are generally based on two players, the therapist and the patient. However, we now live in the age of digitalisation and are experiencing the research and development of digital products and services in almost all areas of life, including psychotherapy. The integration of digital products into psychotherapy is referred to as "blended care".
Due to their practical nature and the use of methods and exercises, many blended care solutions and digital applications are based on cognitive behavioural therapy, which is why most studies are based on this form of therapy and have been researched for depression, anxiety disorders and addictions.
We considered blended care to be exciting, because an online module for therapy support or aftercare could be a possible option for supporting those affected by recurring diseases. Additionally, we saw a great opportunity in the prevention of recurrences and support for those affected during or after their therapy.
Key insights
Experiences with mental illness are very individual, so we wanted to get to know the perspectives of people who are affected by it themselves. We conducted a survey with 68 participants, 5 in-depth interviews with patients and 6 discussions with psychotherapists and experts in the field of blended care. We asked them explicitly about their therapy experience, existing aftercare programmes, the causes of relapses and the opportunities offered by digital products in psychotherapy.
Therapy process
We used the information from the research to create the following diagram, the aim of which was to illustrate an exemplary process from the onset of the first symptoms and development of a mental disorder to the conclusion of therapy. The diagram is highly simplified and does not depict all possible phases, as these can vary greatly from person to person. We opted for this simplified representation to provide an overview of possible hurdles that could lead to loops in the process or "vicious circles". The term "vicious circle" refers to moments when, for example, a person's condition worsens and they are unable to help themselves or get the help they need.
Question Zero
A digital product to maintain therapy success and support self-efficacy for former patients after psychotherapy. The aim is to enable independent use after therapy in order to continue therapy content and incorporate individual needs.
Solution space
In good ambulatory psychotherapy, the content and interventions are oriented towards the patient's personality and needs. How can the knowledge and content gained during the therapy be used for independent work after the therapy has ended?
We recognised that, on the one hand, independent work on itself is essential to strengthen therapy success and self-efficacy. On the other hand, it is important to remind patients of what they have learnt and the skills they have acquired during therapy. Both psychotherapy and self-help services require a high degree of personalisation in order to be effective. With the help of these results, we formulated the core aspects of our solution space and designed a product that takes these aspects into account.
This is Nia
Nia is a digital application that offers comprehensive support and aftercare for patients with recurring illnesses. Nia serves as a bridge between therapists and patients. Therapists can use the application to share resources and content from therapy and thus make them permanently accessible to patients.
The app combines cognitive-behavioural therapy methods with digital accessibility and was specially developed to accompany behavioural therapy. Patients can use Nia after therapy to deepen and practically apply the techniques they have learnt.
Final solution