Mobile Health (mHealth) Versus Clinic-Based Group Intervention for People With Serious Mental Illness: A Randomized Controlled Trial

Ben-Zeev, Dror; Brian, Rachel M.; Jonathan, Geneva; Razzano, Lisa; Pashka, Nicole; Carpenter-Song, Elizabeth; Drake, Robert E.; Scherer, Emily A.

doi:10.1176/appi.ps.201800063

Cited by 173Digital Mental Health InterventionsMobile Health and mHealth ApplicationsMental Health and Patient Involvement

Mobile Health (mHealth) Versus Clinic-Based Group Intervention for People With Serious Mental Illness: A Randomized Controlled Trial

Ben-Zeev, Dror, Brian, Rachel M., Jonathan, Geneva, Razzano, Lisa, Pashka, Nicole, Carpenter-Song, Elizabeth, Drake, Robert E., Scherer, Emily A.·2018·Psychiatric Services

DOI 10.1176/appi.ps.201800063

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Abstract

OBJECTIVE: mHealth approaches that use mobile phones to deliver interventions can help improve access to care for people with serious mental illness. The goal was to evaluate how mHealth performs against more traditional treatment. METHODS: A three-month randomized controlled trial was conducted of a smartphone-delivered intervention (FOCUS) versus a clinic-based group intervention (Wellness Recovery Action Plan [WRAP]). Participants were 163 clients, mostly from racial minority groups and with long-term, serious mental illness (schizophrenia or schizoaffective disorder, 49%; bipolar disorder, 28%; and major depressive disorder, 23%). Outcomes were engagement throughout the intervention; satisfaction posttreatment (three months); and improvement in clinical symptoms, recovery, and quality of life (assessed at baseline, posttreatment, and six months). RESULTS: Participants assigned to FOCUS were more likely than those assigned to WRAP to commence treatment (90% versus 58%) and remain fully engaged in eight weeks of care (56% versus 40%). Satisfaction ratings were comparably high for both interventions. Participants in both groups improved significantly and did not differ in clinical outcomes, including general psychopathology and depression. Significant improvements in recovery were seen for the WRAP group posttreatment, and significant improvements in recovery and quality of life were seen for the FOCUS group at six months. CONCLUSIONS: Both interventions produced significant gains among clients with serious and persistent mental illnesses who were mostly from racial minority groups. The mHealth intervention showed superior patient engagement and produced patient satisfaction and clinical and recovery outcomes that were comparable to those from a widely used clinic-based group intervention for illness management.

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New initiatives targeting transdiagnostic symptoms in psychiatric disorders, in which intervention content is tailored to daily assessments, have shown positive results.
“Indeed, new initiatives targeting transdiagnostic symptoms in psychiatric disorders, in which intervention content is tailored to daily assessments, have shown positive results (Ben-Zeev et al. 2018).”
From Evaluating the quality, safety, and functionality of commonly used smartphone apps for bipolar disorder mood and sleep self-management (2022) · cites this paper as Ben-Zeev et al. 2018

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A telemedicine platform to improve clinical parameters in paranoid schizophrenia patients: Results of a one-year randomized study
Krzystanek, M., Borkowski, M., Skałacka, K., & Krysta, K. (2018) · Schizophrenia Research · doi:10.1016/j.schres.2018.08.016 · Cited by 49 · see citing works
Digital technology for health promotion: opportunities to address excess mortality in persons living with severe mental disorders
Naslund, J. A., & Aschbrenner, K. A. (2019) · Evidence Based Mental Health · doi:10.1136/ebmental-2018-300034 · Cited by 44 · see citing works
“30 Similarly, the Actissist smartphone application developed in the UK for early psychosis supports self-management and shared decision making by monitoring symptoms and providing real-time active management strategies.”
Background
Smartphone‐based interventions in bipolar disorder: Systematic review and meta‐analyses of efficacy. A position paper from the International Society for Bipolar Disorders ( ISBD ) Big Data Task Force
Anmella, G., Faurholt‐Jepsen, M., Hidalgo‐Mazzei, D., Raduà, J., Passos, I. C., Kapczinski, F. P., Minuzzi, L., Alda, M., Meier, S. M., Hájek, T., et al. (2022) · Bipolar Disorders · doi:10.1111/bdi.13243 · Cited by 47 · see citing works
Using behavioral rhythms and multi-task learning to predict fine-grained symptoms of schizophrenia
Tseng, V. W.-S., Sano, A., Ben-Zeev, D., Brian, R., Campbell, A. T., Hauser, M., Kane, J. M., Scherer, E. A., Wang, R., Wang, W., et al. (2020) · Scientific Reports · doi:10.1038/s41598-020-71689-1 · Cited by 44 · see citing works
Self-citation
Smartphone apps for mental health: systematic review of the literature and five recommendations for clinical translation
Almuqrin, A., Hammoud, R., Terbagou, I., Tognin, S., & Mechelli, A. (2025) · BMJ Open · doi:10.1136/bmjopen-2024-093932 · Cited by 52 · see citing works
“We identified 31 articles reporting on 27 mental health apps for treatment, self-monitoring and multiple clinical purposes.”
Reducing the rate of psychiatric re‐admissions in bipolar disorder using smartphones—The RADMIS trial
Faurholt‐Jepsen, M., Tønning, M. L., Fros, M., Martiny, K., Tuxen, N., Rosenberg, N., Busk, J., Winther, O., Thaysen‐Petersen, D., Andreasson, K., et al. (2020) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.13274 · Cited by 46 · see citing works
Life with FOCUS: A qualitative evaluation of the impact of a smartphone intervention on people with serious mental illness.
Jonathan, G., Carpenter-Song, E. A., Brian, R. M., & Ben-Zeev, D. (2019) · Psychiatric Rehabilitation Journal · doi:10.1037/prj0000337 · Cited by 45 · see citing works
Self-citation
Systematic review and meta-analysis of adverse events in clinical trials of mental health apps
Linardon, J., Fuller-Tyszkiewicz, M., Firth, J., Goldberg, S. B., Anderson, C., McClure, Z., & Torous, J. (2024) · npj Digital Medicine · doi:10.1038/s41746-024-01388-y · Cited by 44 · see citing works
Brief, Web-Based Interventions to Motivate Smokers With Schizophrenia: Randomized Trial
Brunette, M. F., Ferron, J. C., McGurk, S. R., Williams, J. M., Harrington, A., Devitt, T. S., & Xie, H. (2019) · JMIR Mental Health · doi:10.2196/16524 · Cited by 40 · see citing works
“Similar to other studies of digital tools for people with schizophrenia and other SMIs [65,66], this study suggests that carefully designed, automated, digital interventions are feasible and acceptable among people with schizophrenia.”
Engaging With a Web-Based Psychosocial Intervention for Psychosis: Qualitative Study of User Experiences
Arnold, C., Williams, A., & Thomas, N. (2020) · JMIR Mental Health · doi:10.2196/16730 · Cited by 42 · see citing works
“Both internet- and mobile-based interventions (hereafter named web-based interventions) appear feasible, acceptable, and potentially effective in improving clinical outcomes for individuals with psychotic disorders [12-15].”
Background
Methodological challenges in randomized controlled trials on smartphone-based treatment in psychiatry: systematic review
Tønning, M. L., Kessing, L. V., Bardram, J. E., & Faurholt-Jepsen, M. (2019) · Journal of Medical Internet Research · doi:10.2196/15362 · Cited by 40 · see citing works
“A total of 5 trials based their diagnosis solely on clinical-based information [24,33,35,37,41].”
BackgroundMethodInfluential
Coaching to Support Mental Health Apps: Exploratory Narrative Review
Meyer, A., Wisniewski, H., & Torous, J. (2022) · JMIR Human Factors · doi:10.2196/28301 · Cited by 34 · see citing works
“…included a scheduled coaching component (14 scheduled or clinical) [22,23,25,26,28,29,31,33,36,38,40,45-47]; 12 scheduled or nonclinical [24,29,32,33,35,38,41,45,46]) compared to an on-demand coaching component (8 on demand or clinical [22,24,27,29,30,37-39]; 9 on demand or nonclinical…”
Background
A technology-assisted life of recovery from psychosis
Ben‐Zeev, D., Buck, B., Kopelovich, S. L., & Meller, S. (2019) · Schizophrenia · doi:10.1038/s41537-019-0083-y · Cited by 38 · see citing works
Self-citation
Engagement with online psychosocial interventions for psychosis: A review and synthesis of relevant factors
Arnold, C., Farhall, J., Villagonzalo, K.-A., Sharma, K., & Thomas, N. (2021) · Internet Interventions · doi:10.1016/j.invent.2021.100411 · Cited by 34 · see citing works
“A growing evidence base suggests that online interventions are both feasible and acceptable to individuals with psychotic disorders and may be effective in assisting with clinical and social outcomes amongst this population (Ben-Zeev et al., 2018; Berry et al., 2016; Schlosser et al., 2018).”
Background
A systematic review and meta-analysis of digital health technologies effects on psychotic symptoms in adults with psychosis.
Clarke, S., Hanna, D., Mulholland, C., Shannon, C., & Urquhart, C. (2019) · Psychosis · doi:10.1080/17522439.2019.1632376 · Cited by 36 · see citing works
“Only one study (Ben-Zeev et al., 2018) compared a novel DHT (FOCUS) with an evidence-based intervention (WRAP), and thus it is not possible to state which DHTs may be most e ﬀ ective.”
Background
Machine learning analysis to identify digital behavioral phenotypes for engagement and health outcome efficacy of an mHealth intervention for obesity: Randomized controlled trial
Kim, M., Yang, J., Ahn, W.-Y., & Choi, H. J. (2021) · Journal of Medical Internet Research · doi:10.2196/27218 · Cited by 41 · see citing works
“Previous studies assessed motivation at several time points but only one dimension (ie, usability or satisfaction with digital intervention) [33,34].”
Background
A meta-analysis of persuasive design, engagement, and efficacy in 92 RCTs of mental health apps
Valentine, L., Hinton, J. D. X., Bajaj, K., Boyd, L., O’Sullivan, S., Sorenson, R. P., Bell, I., Vega, M. S., Liu, P., Peters, W., et al. (2025) · npj Digital Medicine · doi:10.1038/s41746-025-01567-5 · Cited by 43 · see citing works
Transdiagnostic Mobile Health: Smartphone Intervention Reduces Depressive Symptoms in People With Mood and Psychotic Disorders
Ben‐Zeev, D., Buck, B., Chu, P. V., Razzano, L. A., Pashka, N. J., & Hallgren, K. A. (2019) · JMIR Mental Health · doi:10.2196/13202 · Cited by 37 · see citing works
“FOCUS is a multimodal, smartphone-delivered intervention that was originally designed to support the recovery of people with schizophrenia [30] but has since been deployed among multiple diagnostic groups [29,31,32].”
BackgroundResultSelf-citation
Persuasive features for patient engagement through mHealth applications in managing chronic conditions: A systematic literature review and meta-analysis
Almutairi, N., Vlahu‐Gjorgievska, E., & Win, K. T. (2023) · Informatics for Health and Social Care · doi:10.1080/17538157.2023.2165083 · Cited by 37 · see citing works
Assessing the potential of longitudinal smartphone based cognitive assessment in schizophrenia: A naturalistic pilot study
Liu, G., Henson, P., Keshavan, M. S., Onnela, J.-P. “., & Torous, J. B. (2019) · Schizophrenia Research Cognition · doi:10.1016/j.scog.2019.100144 · Cited by 36 · see citing works
“Prior research has demonstrated that those with schizophrenia are interested in digital health tools and are willing to engage with apps they find useful (Achtyes et al., 2018; Ben-Zeev et al., 2018).”
Opportunities and challenges in leveraging digital technology for mental health system strengthening: a systematic review to inform interventions in the United Arab Emirates
Dweik, R. A., Ajaj, R., Kotb, R. E., Halabi, D. E., Sadier, N. S., Sarsour, H. H. H., & Elhadi, Y. A. M. (2024) · BMC Public Health · doi:10.1186/s12889-024-19980-y · Cited by 39 · see citing works
A Smartphone-Based Intervention as an Adjunct to Standard-of-Care Treatment for Schizophrenia: Randomized Controlled Trial
Ghaemi, S. N., Sverdlov, O., van Dam, J., Campellone, T. R., & Gerwien, R. W. (2021) · JMIR Formative Research · doi:10.2196/29154 · Cited by 36 · see citing works
Real-World Technology Use Among People With Mental Illnesses: Qualitative Study
Carpenter-Song, E. A., Noel, V. A., Acquilano, S. C., & Drake, R. E. (2018) · JMIR Mental Health · doi:10.2196/10652 · Cited by 34 · see citing works
“[5-8 5-8,15 Accumulating evidence on technology use by people with SMI has found that those with SMI use technology in comparable ways to the general population for communication, social connection, and access to information, including health-related information [17-20].”
Self-citation
Preliminary Outcomes of an Ecological Momentary Intervention for Social Functioning in Schizophrenia: Pre-Post Study of the Motivation and Skills Support App
Fulford, D., Gard, D. E., Mueser, K. T., Mote, J., Gill, K., Leung, L., & Mow, J. (2021) · JMIR Mental Health · doi:10.2196/27475 · Cited by 33 · see citing works
“FOCUS has demonstrated similar efficacy to standard in-person psychosocial approaches to care for people with schizophrenia, including in reducing symptoms and improving broadly defined recovery outcomes [15].”
Connected Mental Health: Systematic Mapping Study
(2020) · doi:10.2196/19950 · Cited by 33 · see citing works
Ecological Momentary Interventions in Public Mental Health Provision
Schulte‐Strathaus, J. C. C., Rauschenberg, C., Baumeister, H., & Reininghaus, U. (2022) · Studies in neuroscience, psychology and behavioral economics · doi:10.1007/978-3-030-98546-2_25 · Cited by 29 · see citing works
Bridging the Digital Divide in Psychological Therapies: Observational Study of Engagement With the SlowMo Mobile App for Paranoia in Psychosis
Hardy, A., Ward, T., Emsley, R., Greenwood, K., Freeman, D. H., Fowler, D. G., Kuipers, E., Bebbington, P., & Garety, P. A. (2022) · JMIR Human Factors · doi:10.2196/29725 · Cited by 31 · see citing works
Individualized Intervention to Support Mental Health Recovery Through Implementation of Digital Tools into Clinical Care: Feasibility Study
Carpenter-Song, E. A., Acquilano, S. C., Noel, V. A., Al‐Abdulmunem, M., Torous, J. B., & Drake, R. E. (2021) · Community Mental Health Journal · doi:10.1007/s10597-021-00798-6 · Cited by 32 · see citing works
Self-citation
Improving Self-Esteem With Motivational Quotes: Opportunities for Digital Health Technologies for People With Chronic Disorders
Bedrov, A., & Bulaj, G. W. (2018) · Frontiers in Psychology · doi:10.3389/fpsyg.2018.02126 · Cited by 29 · see citing works
“Positive findings in recent clinical studies of mobile health interventions for depression (Mantani et al., 2017; Ben-Zeev et al., 2018; Berger et al., 2018; Silva Almodovar et al., 2018) emphasize new opportunities to improve treatments of mental disorders.”
Background
Remote CBT for Psychosis During the COVID-19 Pandemic: Challenges and Opportunities
Kopelovich, S. L., & Turkington, D. (2020) · Community Mental Health Journal · doi:10.1007/s10597-020-00718-0 · Cited by 29 · see citing works
Technology use and interest in digital apps for mental health promotion and lifestyle intervention among young adults with serious mental illness
Naslund, J. A., & Aschbrenner, K. A. (2021) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2021.100227 · Cited by 29 · see citing works
Effects of smartphone-based interventions and monitoring on bipolar disorder: A systematic review and meta-analysis
Liu, J., Xu, K.-K., Zhu, G.-L., Zhang, Q.-Q., & Li, X. (2020) · World Journal of Psychiatry · doi:10.5498/wjp.v10.i11.272 · Cited by 28 · see citing works
Digital Technology for Suicide Prevention
Braciszewski, J. M. (2021) · Advances in Psychiatry and Behavioral Health · doi:10.1016/j.ypsc.2021.05.008 · Cited by 28 · see citing works
User engagement in mobile apps for people with schizophrenia: A scoping review
de Almeida, R. S., & Marques, A. J. (2023) · Frontiers in Digital Health · doi:10.3389/fdgth.2022.1023592 · Cited by 29 · see citing works
“(28) Notifications/prompts Brief weekly calls from an mHealth support specialist who assisted them in all technical and clinical aspects of the intervention Demographic and clinical variables were assessed for each participant (Symptom Checklist, Beck Depression Inventory, Psychotic Symptom Rating Scales, Recovery Ass…”
BackgroundMethod
Cost of mHealth Versus Clinic-Based Care for Serious Mental Illness: Same Effects, Half the Price Tag
Ben‐Zeev, D., Razzano, L. A., Pashka, N. J., & Levin, C. (2021) · Psychiatric Services · doi:10.1176/appi.ps.202000349 · Cited by 27 · see citing works
Self-citation
Engagement with a digital therapeutic for smoking cessation designed for persons with psychiatric illness fully mediates smoking outcomes in a pilot randomized controlled trial
Browne, J., Halverson, T. F., & Vilardaga, R. (2021) · Translational Behavioral Medicine · doi:10.1093/tbm/ibab100 · Cited by 27 · see citing works
Workshop on Implementation Science and Digital Therapeutics for Behavioral Health
Lord, S., Campbell, A. N. C., Brunette, M. F., Cubillos, L., Bartels, S. M., Torrey, W. C., Olson, A. L., Chapman, S. H., Batsis, J. A., Polsky, D. E., et al. (2020) · JMIR Mental Health · doi:10.2196/17662 · Cited by 28 · see citing works
“Digital therapeutic tools developed with foundations in evidence-based principles such as motivational enhancement, behavioral and cognitive behavioral therapies, and mindfulness have demonstrated positive impact on symptom management and behavior change for substance use [21-33] and mental health conditions [34-43].”
Background
Mobile-assisted cognitive-behavioral social skills training in older adults with schizophrenia
Granholm, E. L., Holden, J. L., Dwyer, K., & Link, P. C. (2020) · Journal of Behavioral and Cognitive Therapy · doi:10.1016/j.jbct.2020.03.006 · Cited by 25 · see citing works
Artificial Intelligence-Based Digital Biomarkers for Type 2 Diabetes: A Review.
Jabara, M., Kose, O., Perlman, G., Corcos, S., Pelletier, M., Possik, E., Tsoukas, M., & Sharma, A. (2024) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2024.07.028 · Cited by 31 · see citing works
“9,58 A recent cost-effectiveness analysis by the philan-thropic think tank, the Peterson Health Technology Institute, identi ﬁ ed that 5 remote continuous glucose monitoring programs in the United States did not meaningfully decrease costs and may have increased costs without delivering meaningful…”
An mHealth Approach to Extend a Brief Intervention for Adolescent Alcohol Use and Suicidal Behavior: Qualitative Analyses of Adolescent and Parent Feedback
O’Brien, K. H. M., Wyman Battalen, A., Sellers, C. M., Spirito, A., Yen, S., Maneta, E., Ryan, C. A., & Braciszewski, J. M. (2019) · Journal of Technology in Human Services · doi:10.1080/15228835.2018.1561347 · Cited by 22 · see citing works
“New data indicate the same can be said for adults, as a technology-based intervention for adults with severe mental illness resulted in higher engagement and treatment retention when compared to clinic-based care (Ben-Zeev et al., 2018).”
Background
Evaluating the quality, safety, and functionality of commonly used smartphone apps for bipolar disorder mood and sleep self-management
Morton, E., Nicholas, J., Yang, L., Lapadat, L., Barnes, S. J., Provencher, M. D., Depp, C., Chan, M., Kulur, R., & Michalak, E. E. (2022) · International Journal of Bipolar Disorders · doi:10.1186/s40345-022-00256-6 · Cited by 20 · see citing works
“targeting transdiagnostic symptoms in psychiatric disorders, in which intervention content is tailored to daily assessments, have shown positive results (Ben-Zeev et al. 2018).”
Background
Advancing Health Equity in Digital Mental Health: Lessons From Medical Anthropology for Global Mental Health
Kozelka, E. E., JENKINS, J. H., & Carpenter-Song, E. A. (2021) · JMIR Mental Health · doi:10.2196/28555 · Cited by 26 · see citing works
“It has accelerated processes of patient and provider acceptance of this form of care as well as the institutionalization of digital health within the US health care system [2,3].”
BackgroundSelf-citation
Music-Enhanced Analgesia and Antiseizure Activities in Animal Models of Pain and Epilepsy: Toward Preclinical Studies Supporting Development of Digital Therapeutics and Their Combinations With Pharmaceutical Drugs
Metcalf, C. S., Huntsman, M., Garcia, G., Kochanski, A. K., Chikinda, M., Watanabe, E., Underwood, T. K., Vanegas, F., Smith, M. D., White, H. S., et al. (2019) · Frontiers in Neurology · doi:10.3389/fneur.2019.00277 · Cited by 21 · see citing works
“Other clinical opportunities to combine non-pharmacological modalities with pharmaceutical drugs and biologics include Parkinson’s and Alzheimer’s diseases (21), asthma (147), arthritis (148) and affective disorders (143, 149).”
Background
New Path to Recovery and Well-Being: Cross-Sectional Study on WeChat Use and Endorsement of WeChat-Based mHealth Among People Living With Schizophrenia in China
Yu, Y., Li, Y., Li, T., Xi, S., Xiao, X., Xiao, S., & Tebes, J. K. (2020) · Journal of Medical Internet Research · doi:10.2196/18663 · Cited by 21 · see citing works
“A large number of mHealth programs have been found to promote recovery for people with mental illness, including PLS [12-17].”
Background
Effectiveness of mobile applications for patients with severe mental illness: A meta‐analysis of randomized controlled trials
Kim, S. K., Lee, M., Jeong, H. C., & Jang, Y. M. (2022) · Japan Journal of Nursing Science · doi:10.1111/jjns.12476 · Cited by 20 · see citing works
Digitally supported CBT to reduce paranoia and improve reasoning for people with schizophrenia-spectrum psychosis: the SlowMo RCT
Garety, P. A., Ward, T., Emsley, R., Greenwood, K., Freeman, D. H., Fowler, D. G., Kuipers, E., Bebbington, P., Dunn, G., & Hardy, A. (2021) · Efficacy and Mechanism Evaluation · doi:10.3310/eme08110 · Cited by 18 · see citing works
Educating the CBIS user: a case analysis
Nelson, R. R., & Cheney, P. H. (1986) · ACM SIGMIS Database the DATABASE for Advances in Information Systems · doi:10.1145/24673.24675 · Cited by 18 · see citing works
Effectiveness of Peer Support Programs for Severe Mental Illness: A Systematic Review and Meta-Analysis
Lee, S.-N., & Yu, H.-J. (2024) · Healthcare · doi:10.3390/healthcare12121179 · Cited by 20 · see citing works
Simple Mobile technology health management tool for people with severe mental illness: a randomised controlled feasibility trial
Röhricht, F., Padmanabhan, R., Binfield, P., Mavji, D., & Barlow, S. H. (2021) · BMC Psychiatry · doi:10.1186/s12888-021-03359-z · Cited by 21 · see citing works
Perceptions of mental health providers of the barriers and facilitators of using and engaging youth in digital mental-health-enabled measurement based care
Bassi, E. M., Bright, K. S., Norman, L., Pintson, K., Daniel, S., Sidhu, S., Gondziola, J., Bradley, J., Fersovitch, M., Stamp, L. K., et al. (2024) · Digital Health · doi:10.1177/20552076241253093 · Cited by 19 · see citing works
“79,80 In this study, while participants preferred selectively using dMH only with youth whom they deemed appropriate, restricting dMH to youth with mild mental health symptoms may exclude many youth who may otherwise bene ﬁ t greatly from dMH interventions.”
Background
Digital interventions in adult mental healthcare settings: recent evidence and future directions
Dülsen, P., Bendig, E., Küchler, A., Christensen, H. M., & Baumeister, H. (2020) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000614 · Cited by 18 · see citing works
Examining Potential Barriers to mHealth Implementation and Engagement in Schizophrenia: Phone Ownership and Symptom Severity
Luther, L., Buck, B., Fischer, M. W., Johnson-Kwochka, A. V., Coffin, G., & Salyers, M. P. (2020) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-020-00162-7 · Cited by 18 · see citing works
“This smartphone ownership increase also supports the potential viability of using personal mobile phones to deliver smartphone-based mHealth apps (Ben-Zeev et al. 2018; Schlosser et al. 2018) among those with schizophrenia.”
Background
Perspectives on Mobile Health Versus Clinic-Based Group Interventions for People With Serious Mental Illnesses: A Qualitative Study
Carpenter-Song, E. A., Jonathan, G., Brian, R., & Ben‐Zeev, D. (2019) · Psychiatric Services · doi:10.1176/appi.ps.201900110 · Cited by 18 · see citing works
Self-citation
Developing the Workforce of the Digital Future: Leveraging Technology to Train Community-Based Mobile Mental Health Specialists
Buck, B., Kopelovich, S. L., Tauscher, J. S., Chwastiak, L., & Ben‐Zeev, D. (2022) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-022-00270-6 · Cited by 15 · see citing works
“FOCUS has demonstrated feasibility and acceptability among individuals with SMI (Ben-Zeev et al., 2014), similar clinical benefits to clinic-based evidence-based treatments (Ben-Zeev et al., 2018), cost-efficiency (Ben-Zeev et al., 2021), and high levels of engagement (Buck et al., 2020)”
BackgroundSelf-citation
Efficacy of Remotely Delivered Evidence-Based Psychosocial Treatments for Schizophrenia-Spectrum Disorders: A Series of Systematic Reviews and Meta-Analyses
Best, M. W., Romanowska, S., Zhou, Y., Wang, L., Leibovitz, T., Onno, K. A., Jagtap, S., & Bowie, C. R. (2023) · Schizophrenia Bulletin · doi:10.1093/schbul/sbac209 · Cited by 15 · see citing works
Exploring Perceptions and Needs of Mobile Health Interventions for Nutrition, Anemia, and Preeclampsia among Pregnant Women in Underprivileged Indian Communities: A Cross-Sectional Survey
Choudhury, A., Shahsavar, Y., Sarkar, K., Choudhury, M., & Nimbarte, A. D. (2023) · Nutrients · doi:10.3390/nu15173699 · Cited by 16 · see citing works
Clinical and demographic predictors of engagement in mobile health vs. clinic-based interventions for serious mental illness
Buck, B., Chander, A., & Ben‐Zeev, D. (2020) · Journal of Behavioral and Cognitive Therapy · doi:10.1016/j.jbct.2020.03.004 · Cited by 15 · see citing works
Self-citation
Telemental Health Care: A Review of Efficacy and Interventions
Schaffer, C. T., Nakrani, P., & Pirraglia, P. A. (2020) · Telehealth and Medicine Today · doi:10.30953/tmt.v5.218 · Cited by 17 · see citing works
FOCUS mHealth Intervention for Veterans With Serious Mental Illness in an Outpatient Department of Veterans Affairs Setting: Feasibility, Acceptability, and Usability Study
Buck, B., Nguyen, J., Porter, S. A., Ben‐Zeev, D., & Reger, G. M. (2021) · JMIR Mental Health · doi:10.2196/26049 · Cited by 13 · see citing works
“A recent randomized trial comparing FOCUS with an evidence-based in-clinic group intervention for symptom self-management demonstrated comparable positive clinical effects between the 2 interventions, and those randomized into FOCUS remained engaged at higher rates than those randomized into typical in-person care [27…”
BackgroundMethodInfluentialSelf-citation
Trusting the bot: Addressing the ethical challenges of consumer digital mental health therapy
Martinez‐Martin, N. (2020) · Developments in neuroethics and bioethics · doi:10.1016/bs.dnb.2020.03.003 · Cited by 14 · see citing works
mHealth-Assisted Detection of Precursors to Relapse in Schizophrenia
Buck, B., Hallgren, K. A., Campbell, A. T., Choudhury, T., Kane, J. M., & Ben‐Zeev, D. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.642200 · Cited by 14 · see citing works
“Indications of risk from EMA could trigger clinician outreach, indicate an increase in inperson sessions, or be used to encourage deployment of evidence-based mHealth self-management interventions directly to patients (39, 40).”
BackgroundSelf-citation
Absolute and relative rates of treatment non-initiation, dropout, and attrition in internet-based and face-to-face cognitive-behavioral therapy: a meta-analysis of randomized controlled trials
Linardon, J., Messer, M., Reid, R., Bolger, T., & Andersson, G. (2025) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2025.2542364 · Cited by 16 · see citing works
Prescription Digital Therapeutics: An Emerging Treatment Option for Negative Symptoms in Schizophrenia
Fulford, D., Marsch, L. A., & Pratap, A. (2024) · Biological Psychiatry · doi:10.1016/j.biopsych.2024.06.026 · Cited by 13 · see citing works
Mediators of Intervention Effects on Depressive Symptoms Among People Living With HIV: Secondary Analysis of a Mobile Health Randomized Controlled Trial Using Latent Growth Curve Modeling
Zhu, M., Cai, W., Li, L., Guo, Y., Monroe‐Wise, A., Li, Y., Zeng, C., Qiao, J., Xu, Z., Zhang, H., et al. (2019) · JMIR mhealth and uhealth · doi:10.2196/15489 · Cited by 13 · see citing works
“…what is learned in face-to-face sessions or seeking clinicians’ suggestions in traditional interventions, participants in mHealth interventions are able to read, listen to, and review materials related to positive coping skills whenever they encounter challenges in their daily lives [53,54].”
mHealth for Young Adults with Early Psychosis: User Preferences and Their Relationship to Attitudes About Treatment-Seeking
Buck, B., Chander, A., Tauscher, J. S., Nguyen, T., Monroe‐DeVita, M., & Ben‐Zeev, D. (2021) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-021-00223-5 · Cited by 12 · see citing works
Self-citation
Effect of Mobile Health on In-person Service Use Among People With Serious Mental Illness
Ben‐Zeev, D., Buck, B., Hallgren, K. A., & Drake, R. E. (2019) · Psychiatric Services · doi:10.1176/appi.ps.201800542 · Cited by 12 · see citing works
Self-citation
Telemedical care and quality of life in patients with schizophrenia and bipolar disorder: results of a randomized controlled trial
Stentzel, U., van den Berg, N., Moon, K., Schulze, L. N., Schulte, J., Langosch, J. M., Hoffmann, W. U., & Grabe, H. J. (2021) · BMC Psychiatry · doi:10.1186/s12888-021-03318-8 · Cited by 13 · see citing works
“al) compared the mHealth intervention FOCUS with a widely used group self-management intervention called WRAP [32].”
Promoting meaningful recovery with digital mental health care
Carpenter-Song, E. A. (2020) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796020000165 · Cited by 11 · see citing works
“In numerous studies, digital mental health tools have been found to be acceptable (Ben-Zeev et al., 2014) and some show promise in reducing psychiatric symptoms (Ben-Zeev et al., 2018).”
BackgroundSelf-citation
m-RESIST, a Mobile Therapeutic Intervention for Treatment-Resistant Schizophrenia: Feasibility, Acceptability, and Usability Study
Grasa, E., Seppälä, J., Alonso-Solís, A., Haapea, M., Isohanni, M. K., Miettunen, J., Mendivelso, J. C., Almazán, C., Rubinstein, K., Caspi, A., et al. (2023) · JMIR Formative Research · doi:10.2196/46179 · Cited by 10 · see citing works
“This percentage is similar to that obtained in other digital interventions tailored for patients with schizophrenia (FOCUS [42], PEAR-004 [43], PeerFIT [44], WellWave [45]).”
Result
Development of the First Episode Digital Monitoring mHealth Intervention for People With Early Psychosis: Qualitative Interview Study With Clinicians
Stefančić, A., Rogers, R. T., Styke, S., Xu, X., Buchsbaum, R., Nossel, I. R., Cabassa, L. J., Stroup, T. S., & Kimhy, D. (2022) · JMIR Mental Health · doi:10.2196/41482 · Cited by 10 · see citing works
“Furthermore, the “real-world” characterization of experiences of patients via mHealth technologies may also enhance shared decision-making (SDM) and therapeutic relationship by providing both clinicians and patients with more accurate clinical data that are more directly related to experiences of patients, potentially…”
Feasibility, Acceptability, and Preliminary Impacts of Web-Based Patient Education on Patients With Schizophrenia Spectrum Disorder: Quasi-Experimental Cluster Study
Laine, A., Valimaki, M. A., Pekurinen, V., Löyttyniemi, E., MARTTUNEN, M. J., & Anttila, M. (2019) · Journal of Medical Internet Research · doi:10.2196/13073 · Cited by 10 · see citing works
“The difference in the number of dropouts between the intervention and control groups was not statistically significant (48% [16/33] vs 58% [14/24]; P =.46).”
Strategies to Address Racial and Ethnic Disparities in Health and Health Care for Chronic Conditions
Lamina, T., Abdi, H. I., Behrens, K. L., Parikh, R. R., Call, K. T., Claussen, A. M., Dill, J., Grande, S. W., Houghtaling, L. M., Jones‐Webb, R., et al. (2024) · Annals of Internal Medicine · doi:10.7326/annals-24-01262 · Cited by 9 · see citing works
“This ﬁ nding underscores the need for expanded research into mental health issues (31 – 37) and other diseases that were too scarce to represent a distinct category in our evidence map, including liver disease, metabolic syndrome, chronic obstructive pulmonary disease, chronic pain not related to…”
Leveraging Personal Technologies in the Treatment of Schizophrenia Spectrum Disorders: Scoping Review
D’Arcey, J., Torous, J. B., Asuncion, T.-R., Tackaberry-Giddens, L., Zahid, A., Ishak, M., Foussias, G., & Kidd, S. A. (2024) · JMIR Mental Health · doi:10.2196/57150 · Cited by 10 · see citing works
“Finally, 2 interventions engage various communication strategies, such as SMS text messaging and phone calls [35,56] and a smartphone app, SMS text messaging, and telemedicine [42] [28,29,33-36,64 ], 9 (23”
Background
Evaluating the Service Quality of Mobile Health Versus Clinic Based Intervention in Hearing Healthcare. A Comparative Study
Ross, F., & Wohllebe, A. (2021) · International Journal of Interactive Mobile Technologies (iJIM) · doi:10.3991/ijim.v15i10.21725 · Cited by 10 · see citing works
“The level of satisfaction was comparable in both groups and the mhealth treatment showed superior level of patient engagement [34].”
Result
Emotion Recognition in the Real World: Passively Collecting and Estimating Emotions From Natural Speech Data of Individuals With Bipolar Disorder
Provost, E. M., Sperry, S. H., Tavernor, J., Anderau, S., Yocum, A. K., & McInnis, M. G. (2024) · IEEE Transactions on Affective Computing · doi:10.1109/taffc.2024.3407683 · Cited by 10 · see citing works
“…research efforts have focused on modeling the illness-related behavior of individuals with mental health conditions [62], including BD [18], [19], [20], [63], [64], [65], [66], [67], [67], [68], [69], [70] and the behavior of individuals with schizophrenia [1], [66], [71], [72], [73], [74], [75].”
Characteristics and Outcomes of mHealth Interventions in Psychosis: Systematic Mapping Review
Loh, P. Y., Martinengo, L., Heaukulani, C., Tan, X., Hng, M., Cheah, Y. Y., Morris, R. J. T., Car, L. T., & Lee, J. (2024) · Journal of Medical Internet Research · doi:10.2196/55924 · Cited by 8 · see citing works
“We observed multiple studies using mHealth-enabled nascent tools to pick up objective data, such as EMAs [27,30,31,34,35,37,43,50,51] and embedded sensors [41].”
Mapping mad maps and recovery tools developed by mental health service users and survivors of psychiatry: a scoping review
Sampietro, H. M., Carmona, V. R., Rojo, E., & Gómez‐Benito, J. (2022) · BMJ Open · doi:10.1136/bmjopen-2022-061692 · Cited by 8 · see citing works
Symptom monitoring based on digital data collection during inpatient treatment of schizophrenia spectrum disorders – A feasibility study
Herpertz, J., Richter, M. F., Barkhau, C., Storck, M., Blitz, R., Steinmann, L. A., Goltermann, J., Dannlowski, U., Baune, B. T., Varghese, J., et al. (2022) · Psychiatry Research · doi:10.1016/j.psychres.2022.114773 · Cited by 7 · see citing works
A study protocol for an ongoing multi-arm, randomized, double-blind, sham-controlled clinical trial with digital features, using portable transcranial electrical stimulation and internet-based behavioral therapy for major depression disorders: The PSYLECT study
Borrione, L., Cirillo, P. C., Aparicio, L. V. M., Cavendish, B. A., Valiengo, L. D. C. L., Moura, D. O., de Souza, J. P., Luethi, M. S., Klein, I., Bariani, B., et al. (2022) · Expert Review of Neurotherapeutics · doi:10.1080/14737175.2022.2083959 · Cited by 6 · see citing works
“found higher engagement and acceptability with the appbased intervention, and with similar clinical outcomes [24].”

Perspectives on Mobile Health Versus Clinic-Based Group Interventions for People With Serious Mental Illnesses: A Qualitative Study
Carpenter-Song, E. A., Jonathan, G., Brian, R., & Ben‐Zeev, D. (2019) · Psychiatric Services · doi:10.1176/appi.ps.201900110 · Cited by 18 · see citing works
Self-citation
Clinical and demographic predictors of engagement in mobile health vs. clinic-based interventions for serious mental illness
Buck, B., Chander, A., & Ben‐Zeev, D. (2020) · Journal of Behavioral and Cognitive Therapy · doi:10.1016/j.jbct.2020.03.004 · Cited by 15 · see citing works
Self-citation
E-mental health – An untapped opportunity in Nepal
Adhikari, T. B., & Rijal, A. (2018) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2018.10.021
Effect of Mobile Health on In-person Service Use Among People With Serious Mental Illness
Ben‐Zeev, D., Buck, B., Hallgren, K. A., & Drake, R. E. (2019) · Psychiatric Services · doi:10.1176/appi.ps.201800542 · Cited by 12 · see citing works
Self-citation
Life with FOCUS: A qualitative evaluation of the impact of a smartphone intervention on people with serious mental illness.
Jonathan, G., Carpenter-Song, E. A., Brian, R. M., & Ben-Zeev, D. (2019) · Psychiatric Rehabilitation Journal · doi:10.1037/prj0000337 · Cited by 45 · see citing works
Self-citation

Authors: Ben-Zeev, D., Brian, R. M., Jonathan, G., Razzano, L., Pashka, N., Carpenter-Song, E., Drake, R. E., & Scherer, E. A.
Affiliations: Dr. Ben-Zeev and Ms. Brian are with the Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle. Ms. Jonathan is with the Department of Psychiatry and Behavioral Sciences, Northwestern University, Evanston, Illinois. Dr. Razzano is with the Department of Psychiatry, University of Illinois at Chicago and with Thresholds, Chicago. Ms. Pashka is with Thresholds, Chicago. Dr. Carpenter-Song is with the Department of Anthropology, Dartmouth College, Hanover, New Hampshire. Dr....
Dartmouth College (US)
ORCID: Brian, Rachel M.
Jonathan, Geneva
Razzano, Lisa
Pashka, Nicole
Carpenter-Song, Elizabeth
Drake, Robert E.
Scherer, Emily A.
Venue: Psychiatric Services
Publisher: American Psychiatric Association Publishing
Published: 2018-09-01
Volume: 69
Issue: 9
Pages: 978-985
ISSN: 0022-1597 (ISSN-L)
1075-2730
1557-9700
DOI: 10.1176/appi.ps.201800063
OpenAlex: W2803173466
Cited by: 173
References: 50
Citations by year: 2026: 11 · 2025: 24 · 2024: 23 · 2023: 17 · 2022: 16 · 2021: 32 · 2020: 19 · 2019: 20 · 2018: 10
FWCI: 25.54
Type: journal article
Language: en
Open access: closed
Locations: Psychiatric Services (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Health Sciences › Health Professions › General Health Professions › Mental Health and Patient Involvement
Keywords: mobile health, severe mental illness, smartphone-based intervention, Wellness Recovery Action Plan, treatment engagement, patient satisfaction, recovery, quality of life, schizophrenia, bipolar disorder, major depressive disorder, racial minorities, health care access, illness management
MeSH terms: Smartphone, Adult, Ambulatory Care Facilities, Mental Disorders, Female, Humans, Male, Middle Aged, Psychotherapy, Group, Quality of Life, Self Care, Patient Satisfaction, Telemedicine

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Mobile Health (mHealth) Versus Clinic-Based Group Intervention for People With Serious Mental Illness: A Randomized Controlled Trial

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