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Top1. Introduction
Psychological interventions are efficacious for the treatment of a range of mental and physical health conditions (e.g., Hoffman, Papas, Chatkoff, & Kerns, 2007; Kahana, Drotar, & Frazier, 2008; Lipsey & Wilson, 1993). However, there remains a high level of unmet need for psychological services, with most individuals in need of mental health services failing to receive treatment (Kazdin, 2017; Clough, B. A., Zarean, M., Ruane, I., Mateo, N. J., Aliyeva, T. A., & Casey, L. M. ). Technological adjuncts to psychological interventions may provide greater outreach and increased cost-efficiency of current services (Barnett & Scheetz, 2003; Clough & Casey, 2011b, 2015). Short Messaging Service (SMS) may have an important role to play in enhancing patient adherence to treatment tasks and recommendations. These messages have been helpful in prompting attendance in physical health settings (Guy et al., 2012), however, appointments in these settings are usually infrequent. Mental health appointments are typically associated with greater frequency and different demand and task characteristics. As such, it remains unknown as to whether patients will accept this technology on a frequent basis during psychotherapy. The study examined patients’ responses to an adherence related SMS communication delivered on a daily basis during a psychotherapy program.
1.1. Adherence
Patient adherence in psychotherapy refers to the extent to which patients’ behaviours align with the advice given by the therapist or healthcare professional (Nose, Barbui, Gray, & Tansella, 2003). Despite the benefits associated with patient adherence to homework tasks, non-adherence is common. Whilst adherence to clinical medications has been estimated at approximately 50%, adherence with behavioural change programs is often even lower (Haynes, McDonald, & Garg, 2002). Poor patient adherence can result in increased costs associated with treatments, poor use of resources, and reduced treatment efficacy (Chen, 1991; Casey, L., & Clough, B., 2016). Use of adjunctive technologies in therapy has considerable potential to improve patient adherence (Clough & Casey, 2011c).