System for providing psychotherapy and method thereof
The system enhances user motivation and continuity in ACT-based interventions by providing tailored intervention processes and metaphoric content, addressing the challenge of maintaining engagement in psychotherapy apps.
Patent Information
- Application Number
- JP2024128597
- Authority / Receiving Office
- JP · JP
- Patent Type
- Applications
- Current Assignee / Owner
- Priority Date
- 2024-04-09
- Filing Date
- 2024-08-04
- Publication Date
- 2025-10-22
AI Technical Summary
Existing psychotherapy apps, particularly those based on Acceptance and Commitment Therapy (ACT), face challenges in maintaining user motivation and continuity due to weak motivation to continue therapy over a long period, leading to ineffective behavioral change.
A system and method that incorporates a motivational function to provide intervention processes through questions and metaphoric content tailored to the user's symptoms and coping strategies, enhancing user engagement and continuity in ACT-based interventions.
The system strengthens user motivation and continuity in implementing psychotherapy-based interventions, improving the effectiveness of self-care by addressing the core processes of ACT.
Smart Images

Figure 2025160079000001_ABST
Abstract
Description
[Technical Field]
[0001] The present invention relates to a system and method for providing psychotherapy, and in particular, acceptance and commitment therapy (ACT). [Background technology]
[0002] In recent years, advances in information processing devices such as smartphones have enabled a wide range of functions to be realized on the smartphones we carry. Healthcare apps, which use software programs to manage health, have also been developed, and among these, application programs (therapeutic apps) aimed at treating illnesses are being developed. Therapeutic apps include those that utilize cognitive behavioral therapy (CBT), which treats illnesses through lifestyle improvements such as reviewing daily behaviors and ways of thinking. Recently, the adaptation of Acceptance and Commitment (ACT), a third type of cognitive behavioral therapy, to smartphone apps has been considered. ACT differs from traditional psychotherapies in that it is based on six core processes: acceptance, the present moment, defusion, self-context, values, and commitment.
[0003] Patent Document 1 describes a method for evaluating a patient's ACT proficiency based on one or more indicators corresponding to all or part of the six core processes of ACT. Based on the evaluation results, an intervention scenario based on the six core processes is set, and multiple interventions based on the six core processes are sequentially performed based on the set adjusted intervention scenario or a preset basic intervention scenario. After a series of interventions are performed based on the intervention scenario, an evaluation is performed to determine whether the interventions have had the expected improvement effect. Improvement evaluation information indicating the results of the evaluation is recorded for each patient, along with the patient's attribute information and ACT evaluation information indicating the results of evaluations performed before and after the series of interventions. Furthermore, the cited invention uses the attribute information and ACT evaluation information of multiple patients whose improvement evaluation information indicates that the expected improvement effect has been achieved, to identify attribute-related factors from the attribute information that are presumed to be related to improvement for each change pattern in ACT proficiency before and after the series of interventions. The technology disclosed sets up an adjusted intervention scenario that includes intervention processing to improve ACT proficiency in line with the identified change pattern by comparing the evaluation results and attribute information regarding the patient's ACT proficiency with the change pattern in ACT proficiency and attribute-related factors when setting up an intervention scenario for a patient. [Prior art documents] [Patent documents]
[0004] [Patent Document 1] International Publication No. 2023 / 204239 (WO / 2023 / 204239) Summary of the Invention [Problem to be solved by the invention]
[0005] The invention in Patent Document 1 describes having patients carry out a scenario that includes action content corresponding to the core processes of ACT, and then modifying the action content of the scenario based on the evaluation results before and after the execution. However, even if intervention processing corresponding to the core processes with low proficiency was added to the action content based on the evaluation results, the therapeutic effect of the improvement scenario did not necessarily improve. After examining the causes of these problems, the inventors discovered that although psychotherapy is carried out continuously over a relatively long period of time and promotes behavioral change in users, motivation to continue the therapy over such a long period of time or to concentrate on the work and exercises is weak. Therefore, the objective of the present invention is to provide a means of motivating users to continue using ACT intervention processing. [Means for solving the problem]
[0006] (Invention 1) In a system for mental health self-care, A motivational function that provides an intervention process to motivate the implementation of a psychotherapy-based self-care scenario; a self-care function that provides a user with an intervention process of a self-care scenario based on the psychotherapy, The motivational function is Asking the user questions regarding how to deal with their current symptoms; and providing metaphoric content to the user. By using this system, users can increase their continuity and concentration in implementing psychotherapy-based interventions, thereby improving the effectiveness of self-care. (Invention 2) The system of Invention 1, wherein the psychotherapy is ACT (Acceptance and Commitment Therapy) or mindfulness. ACT and mindfulness are a good match because they both have acceptance as their core process. (Invention 3) The system of Invention 1 or 2 further includes a step of acquiring a user's answer to the question acquired in the step of evaluating the question, and then determining the content of the metaphor to be provided based on the result of the answer or the analysis result thereof, and providing the content to the user in an actionable manner. This system can provide metaphors that match the avoidance behavior of the user's past experiences, allowing the user to further increase their continuity and concentration in implementing psychotherapy-based interventions, thereby improving the effectiveness of self-care. [Effects of the Invention]
[0007] According to the information processing terminal, system or method of the present invention, the step of creative despair can be introduced to strengthen the user's motivation to continue using the ACT-based intervention scenario. [Brief explanation of the drawings]
[0008] [Figure 1] 1 is a conceptual diagram showing a system of the present invention. [Figure 2] 1A-1C are screen images of the motivation steps of the present invention. [Figure 3] FIG. 1 is a diagram showing an example of a treatment and self-care scenario of the present invention. [Figure 4] FIG. 1 is a diagram showing a flow of an embodiment of the present invention. DETAILED DESCRIPTION OF THE INVENTION
[0009] The present invention is based on the inventors' finding that when providing psychotherapy, particularly an intervention scenario based on ACT, it is necessary to set the core process to be initially provided to the user, taking into consideration the user's suitability for the core process. (System 1 of the present invention) One embodiment of the present invention is a software program installed on a user's information processing terminal, such as a PC, laptop, or typically a smartphone or tablet. This system 1 is described using FIG. 1 . The system comprises an information processing terminal 110. The information processing terminal 110 includes a control device 101 that controls a healthcare program, a storage device 102, a display device 103 such as an LCD monitor (however, output is not limited to display and can be audio, etc.), an input device 104 such as a touch panel or keyboard, a communication device 105 for communicating with an external network, and a measurement device 106 that measures vital signs. Furthermore, a measurement device 116, which may be a wearable device such as a wristwatch, earphone, band, or body-attached device, or a stationary measurement device such as a blood glucose measurement device installed in a toilet or an imaging device mounted on a smart mirror, may be used in place of the measurement device 106 built into the information processing terminal, via a network 120, which may be the Internet, a wireless connection, or a wired connection, connected to the information processing terminal 110. The functions of this software program are realized by the cooperative operation of the devices included in the system.
[0010] (System 2 of the present invention) One embodiment of the present invention is a software program installed in a system consisting of a user's information processing terminal, such as a PC, laptop, or typically a smartphone or tablet, and a server connected via a network such as the Internet, a wireless communication network, or a CATV network. This system 2 is described using Figure 1. The system comprises an information processing terminal 110 and a network-connected server 130. The information processing terminal 110 includes a control device 101 that controls the programs on the information processing terminal, which coordinates the functions (devices) of the information processing terminal 110 and communicates with network-connected devices (server functions, devices, etc.), a storage device 102, a display device 103 for output such as an LCD monitor (however, output is not limited to display and can also be audio), an input device 104 such as a touch panel, keyboard, or microphone for audio input, a communication device 105 for communication with an external network, and a measuring device 106 that measures user input and vital data. The monitoring device 106 may be implemented not only as a hardware device within the information processing terminal, but also as a functional module installed as a functional module of software or an application program. Furthermore, a measuring device 116, which is a wearable device such as a wristwatch-type, earphone-type, band-type, or body-attached type, connected to the information processing terminal 110 via a network 120, which is a network such as the Internet, CATV, wireless telephone, wireless connection, or wired connection, or a stationary measuring device such as a blood glucose measuring device installed in a toilet or an imaging device installed in a smart mirror, may be used instead of the measuring device 106 built into the information processing terminal. The server 130 also includes a storage device 133, a communication device 131 for linking with external devices such as the information processing terminal 110 via the network 120, and a control device 132 that controls the server 130, executes control programs, controls server-side programs, controls network-connected devices (including functions and devices of the information processing terminal 110, etc.), and in this system, links with the information processing terminal 110.Furthermore, in the above-mentioned system 1, the present software program, the provided program, necessary data and information, etc. are installed in the information processing terminal 110 and operate as a stand-alone system. However, in system 2, the present software program, the provided program, and necessary data and information are stored in the storage device 133 of the server 130, and the control device 132 of the server 130 controls the entire system including the information processing terminal 110. The present program and the provided program are stored in the storage device 133 and / or the storage device 102, and necessary data and information are stored in the storage device 133 and / or the storage device 102. The program may be stored in the server 130 and the information processing terminal 110, and the control device 101 and / or the control device 132 execute the program in cooperation with the respective devices; the program and data may be stored in a distributed manner in the respective storage devices of the server 130 and the information processing terminal 110, or may be stored in either one of them, and the control devices of the server 130 and the information processing terminal 110 may cooperate with each other, or one of the control devices may be the main control device and cooperate with the other to control the functions included in each; or the program and data may be aggregated in the server 130, and the information processing terminal may simply use a web browser or touch panel as an input / output device. Furthermore, while the program is intended to be a software program, it is also possible to replace some or all of the functions of the program with hardware that performs the functions corresponding to each function. These configurations can be selected and determined as appropriate by those skilled in the art.
[0011] Examples of the measuring device 106 include devices capable of directly measuring vital data such as heart rate, heart rate variability, respiratory rate, blood pressure, body temperature, voice, sleep, and body surface temperature; integrators that integrate conversation volume (e.g., voice calls) and tweets on social media; accelerometers; and calculation means or devices that can calculate distance traveled using GPS and then measure vital data calculated secondarily from the calculated activity level and walking speed. Examples of vital data include, but are not limited to, walking speed, heart rate, and measurements of phone calls and human voice. Needless to say, various vital data known to those skilled in the art can also be used in the present invention. Furthermore, it is particularly convenient for the measuring device 106 to measure passive data such as vital data that can be measured without the subject's awareness, such as walking speed, analysis of conversations, blood glucose level measurement when using the toilet, heart rate measurement using an image sensor built into a smart bathroom mirror, and weight measurement using a floor-mounted scale. Furthermore, it would be convenient if the device were resident and running on the user's mobile device, allowing for continuous measurement or unconscious measurement of various vital data in a smart house. Measurement of stress levels using vital data can be achieved, for example, by measuring stress levels from the user's voice (human voice) (e.g., a well-known method such as JP 2011-167323), measuring stress levels from walking speed (e.g., a well-known method such as JP 2018 / 190384), measuring stress levels from heart rate (e.g., a well-known method such as JP 2023-117940), or measuring stress levels from facial images (e.g., a well-known method such as JP 2023-031520), but is not limited to these. Needless to say, any well-known method can be used. Furthermore, a means for identifying user characteristics by analyzing the usage status of the information processing device (including usage history, input information on social media, etc.) can also be used. The functions of this software program are realized by the cooperative operation of each device included in the system.
[0012] (The process of motivating people through creative despair) Traditionally, in medical and counseling settings, creative despair counseling has been offered prior to medical treatment. However, its complexity has made it difficult to implement in therapeutic or self-care apps via digital devices. (Here, "hopeless" does not mean that the user is hopeless, nor that the possibility of a more effective lifestyle is hopeless. Rather, it is the user's past coping strategies that are hopeless. Furthermore, clinging to futile and bleak strategies to control emotions is doomed to failure and is hopeless. In other words, the motivational process of creative despair involves helping the user understand that their own solutions are part of the problem (i.e., their solutions reduce their psychological flexibility and have a negative effect), and providing motivation (or justification) for continued psychotherapy.) In other words, traditional apps collect users' personal data and then provide therapeutic interventions tailored to their symptoms. By the way, when the inventors analyzed counseling for creative despair, they discovered that it is possible to categorize it by disease (typically including a step of acquiring information about the user's symptoms, the user's coping strategies, their effectiveness, and the sacrifices they have made to achieve them, as well as a step of presenting a long-term perspective, including metaphors, regarding the coping strategies, and helping the user understand that there is no hope of improvement if the current situation continues). Based on this discovery, they developed a technology that provides this information via an app on an information processing terminal. Here, an example is shown for chronic pain. This example consists of a chatbot and video content. The software program that controls its operation, as well as the necessary data and content, are stored in the storage device 133 when using System 2, for example, and are provided to the user via the information processing terminal 110 in System 100 in an executable format. In System 100, the control device 101 works in conjunction with the core device to carry out processing according to the program instructions.When the program is launched, the control device 132 first reads the question information to be provided to the user in chatbot format from the storage device 133 and transmits it to the information processing terminal 110. The control device 132 then instructs the control device 101 to perform chatbot display processing and user input processing via the touch panel (input device 104) on the display device 103 of the information processing terminal 110 (note that input processing may also be performed using voice output or voice recognition technology from the information processing terminal). This procedure is specifically explained using Figure 2. First, when this function is invoked, questions about symptoms are asked to the user, as shown in Figure 2(a) 201Q. Note that these question information are stored in the storage device 133, and in accordance with the program that operates this function, the control device included in the system works in cooperation with each function to read the question, present it to the user, input the user's answer, evaluate the answer, and proceed to the next process. Next, the user inputs answer information via an input box (not shown) on the screen, as shown in 201A. Here, as an example, the user inputs, "My lower back hurts when I move." Subsequently, when the control device 101 recognizes the input of this information, it transmits this information to the server 130, and the information is stored in the storage device 133 together with the user data. Next, as shown in 202Q, the control device 132 reads out information for the next question from the storage device 133, transmits it to the information processing terminal 110, and provides it to the user via the display device 103 of the information processing terminal 110. That is, the system asks the user in chatbot format, "What have you tried?" In response, the user uses the input device 104 to input information such as "I try not to go out as much as possible" into a character input box displayed on the display device 103 as shown in 202A. When the control device 101 recognizes this information input, it transmits it to the server 130, and the control device 132 stores this information in the storage device 133 together with the user data. Next, the control device 132 reads the information for the next question from the memory device 133, and in the same procedure as described above (chatbot-style processing is the same below), asks the user a question such as 203Q, "Was it helpful?", and the user inputs, as in 203A, "It didn't move, so it wasn't too painful."The system then recognizes the input information and asks the user, "What price did you pay for that?" as in 204Q, to which the user responds, "I no longer go out with my friends," as in 204A. The system then recognizes the input information, stores the answer in the system as described above, and the program proceeds to a step of presenting a metaphor to the user. The metaphor is, for example, a "whiteboard" metaphor. This metaphor is video content that depicts a person writing "pain" on a whiteboard, holding it with both hands, and trying to avoid the pain by moving the whiteboard away from them, becoming so preoccupied with the pain that they are unable to focus on anything else. The content is stored in storage device 133, and control device 132 reads it from storage device 133 according to the program flow and transmits it to information processing terminal 110. The video content is then displayed on display device 103 so that it can be viewed by the user, and provided to the user. Here, content is not limited to video; text content can also be configured as appropriate, such as chatbot content, voice-to-speech content, game content, or a combination of these. Next, after these provisioning operations are completed, the control device 132 further reads out question information from the storage device 133 and transmits it to the information processing terminal 110. Then, as with other operations, the control device 101 instructs the control device 101 to perform subsequent operations. Accordingly, the control device 101 displays a question on the display device 103, such as 205Q, asking, "What you've done so far seems to be effective in the short term, but what do you think about the long term?" After the user confirms the question (e.g., touches the "Next" button), the control device 101 then displays, via the display device 103, further question information such as "A seems effective, B doesn't seem effective," as shown in 205A, prompting the user to input their answer. Here, for example, if the user selects B using the touch panel (input device 104) (it is assumed that the previous coping methods have been ineffective and the user is motivated to try new self-care), the control device 101 further displays, on the display device 103, "Try to learn a new coping method." After this series of motivational processes is completed, the control device 101 proceeds to the next predetermined operation, for example, a psychotherapy-based intervention procedure.Furthermore, if A is selected (assuming the user did not understand the metaphor's intended meaning and thus was motivated), a message is displayed saying, "Even if it appears effective at first glance, it may actually have been psychologically burdensome. Let's try a new way of coping." (This message provides alternative information in case the metaphor does not provide any insight.) After this series of motivational processes is completed, the system proceeds to a predetermined process, such as a psychotherapy-based intervention. Alternatively, different metaphors may be provided (until the user realizes that their previous approach was incorrect) until the user's response is B (i.e., returning to the next process in 204A and repeating the process). However, in case the metaphor does not provide insight, different metaphors may be provided a predetermined number of times even if B is not provided. After the predetermined number of times, the system may proceed to a psychotherapy-based intervention process, saying, "Even if it appears effective at first glance, it may actually have been psychologically burdensome. Let's try a new way of coping." One example of the motivational process of the present application is to write a software program to perform the above-described processes, and the system may execute each process according to the program description and provide a dialogue with the user.
[0013] The above processing example is the most typical example, but a modified example is shown below (the procedure for processing questions to the user is the same as above, so details are omitted). For example, instead of any of questions 201Q-204Q, a question such as "How do you deal with it? A. Distract yourself, B. Leave, C. Think of a way to get out, D. Become dependent on something, resort to self-harm" (stored in memory device 133) can be provided to the user via display device 103 of information processing terminal 110, the user's answer can be obtained via input device 104, the answer results can be sent to server 130, a metaphor to be provided for each option can be specified, control device 132 can evaluate the answer results based on this information, and video content corresponding to the metaphor corresponding to the answer can be selected from a group of multiple metaphor contents stored in memory device 133 (multiple video contents corresponding to each option and information (such as a list) associating the options with the video content are stored in advance in memory device 133 or in the video content itself, and the corresponding video content can be selected from multiple video contents based on the answered option and the association information), and can be modified to be provided to the user. The questions can be set by the system designer as appropriate according to the symptoms of stress-related disorders and corresponding metaphors, and information on the set questions is stored in the storage device 133. As metaphors, well-known metaphors (or new metaphors can be created) such as the "tiger metaphor of anxiety" (a metaphor that expresses the idea that if you are afraid of a tiger and keep feeding it, the tiger will grow and become even more frightening, i.e., if you try to avoid anxiety out of fear, the anxiety will only increase) and the "bottomless swamp metaphor" (a metaphor that expresses the idea that the more you struggle, the deeper you sink into the bottomless swamp, i.e., the more you resist anxiety, the worse the situation becomes) can be set according to the expected situation of the user, and the content of these metaphors is stored in the storage device 133. Furthermore, rather than acquiring the user's situation through answers to questions, it is also possible to set up a system in which the user's current coping methods and sacrifices are grasped and these metaphors are provided.In other words, the user's answers in 202A, 203A, and 204A may be subjected to natural language processing using well-known text mining techniques, divided into words and segments, and analyzed by comparing them with a word list prepared for each disease, so that a metaphor can be provided based on the user's coping method and the sacrifices made by the user. Furthermore, since there are patterns in which the user tries to control uncontrollable events, avoid events, or both in order to avoid unwanted personal events, the system analyzes which of these patterns the user is engaging in (because there are patterns of behavior for each disease (multiple example sentences for each pattern of behavior are stored in a storage device), the correlation between these behaviors and the user's behavior (information on answers to questions about how the user is treated and sacrifices, etc.) can be evaluated, and the one with the highest correlation can be determined to be the person's pattern), and provides metaphors corresponding to these patterns (information indicating the correspondence between patterns and metaphors (for example, a list or DB) is stored in storage device 133, and this information is read out during analysis, and based on that information, the determined pattern and the metaphor corresponding to that pattern are selected from the multiple metaphors stored in storage device 133). By providing a metaphor that is more suited to the user in this way, the user's motivation to execute the subsequent scenario can be strengthened. Alternatively, an analysis format may be adopted in which likely patterns for each of these diseases (typically the above-mentioned event control type, event avoidance type, and both types) are simply categorized, examples of behavior for each type are stored in a plurality of storage devices 133, and the examples are read and presented to the user, who then selects their own type. In this case, metaphors are provided for information regarding the type and the metaphors associated with that type (for example, the information may be associated with a tiger metaphor for the event control type and a swamp metaphor for the event avoidance type; for example, well-known methods may be used, such as storing and searching corresponding metaphors in a list, database, or storage area (folder, etc.) divided by type, or adding type information to the header of the video content file of the metaphor and searching that information).Other analysis methods include well-known analysis methods such as type classification analysis using conditional branching, and the metaphor can be determined based on the results.
[0014] In the above example, a metaphor was provided to promote the user's awareness that continuing with the current coping method will hinder the user's long-term freedom of action, thereby strengthening motivation for the subsequent scenario. However, instead of or in addition to the above metaphor, the question in 205Q can be changed to "What you have done so far seems to be effective in the short term, but what do you think will happen in the long term?", and an explanation of the effect of the user's coping and sacrifices, "The more you try to avoid the pain, the more you focus on it and the less you can do other things," can be added, providing "The more you try to avoid the pain, the more you focus on it and the less you can do other things. What you have done so far seems to be effective in the short term, but what do you think will happen in the long term?". Furthermore, typical sentences used in counseling can be stored in the storage device 133 and read out, or multiple sentences can be stored and the system can select and provide the one that best suits the user's situation. Furthermore, for example, the generation AI can be connected using an API or the like, and configured to input prompts such as the user's input solution or sacrifices and what catastrophic consequences would result if they were made in ChatGPT, request an answer, and when the answer is obtained from the generation AI, the answer can be added to the metaphor or provided to the user in place of the metaphor.
[0015] (Acceptance and Commitment Therapy Techniques) In recent years, Acceptance and Commitment Therapy (ACT) has been developed as a third-generation cognitive behavioral therapy. ACT has six core processes: (1) acceptance (attempting to observe one's thoughts and emotions as they are), (2) defusion (distancing one's thoughts and weakening the automatic connection between thoughts and actions), (3) present-moment awareness (paying attention to the present moment without being distressed by reliving the past or endlessly worrying about the future), (4) self-context (reducing preconceptions and attachments about oneself and being able to distinguish between the thoughts and emotions that arise within oneself and the self that is experiencing them), (5) values (becoming aware of and verbalizing the direction one wants one's life to take), and (6) committed action (setting goals and taking action to move toward the direction one wants one's life to take). ACT is a psychotherapy based on modern behavioral psychology, including relational frame theory, that applies the acceptance or mindfulness process together with the commitment and behavioral change process ((1)-(4) are said to be related to mindfulness). By acquiring the skills corresponding to each of these, psychological flexibility is cultivated and the ability to cope with stress is acquired. The inventors of this application believe that because ACT separates these processes and has established training methods for each process, it is suitable for use on information processing devices, and therefore propose a method using ACT. It should be noted that the above classification is not strictly necessary; different classifications are acceptable as long as each objective is achieved, and it goes without saying that not all of the steps need to be implemented. Furthermore, since one of the characteristics of ACT and mindfulness is acceptance of things as they are, they are well suited to the creative despair intervention process mentioned above.
[0016] (Self-care app example (example scenario)) This self-care app is a software program that operates using system 2 and is intended for self-care of chronic pain. It can also be configured as a functional module that is called from other software programs, and in the system of the present invention, it is used from a software program that is an integrated program that operates on the system. While it is realized as a software program, it can also be configured using hardware, a DSP (Digital Signal Processor), or software. This software program is stored in storage device 133, and when it is launched from control device 101 of information processing terminal 110, control device 101 and control device 133 work together to execute the program.Memory device 133 or 102 contains the following: psychoeducation on "self as context" and work to acquire it (well-known exercises such as the observer exercise, MCT (Metacognitive Therapy) free association task, and the chessboard metaphor to understand the self as observer / perspective = the self as field / context); psychoeducation on "acceptance" and work to acquire it (well-known exercises such as the ice squeeze exercise to open up to painful internal events and take the time to do so); psychoeducation on "value clarification" and work to acquire it (10 to clarify the values of what actions you will take on an ongoing basis); The database contains a variety of well-known exercises, including those for choosing areas of personal value (such as work / career and friend / social life exercises), psychoeducation and work to master "defusion" (such as the Bass exercise and the "I have this thought" exercise, which are designed to distance oneself from or detach oneself from and observe one's internal events), psychoeducation and work to master "here and now" (such as exercises to connect with and immerse oneself in what is happening in the present moment, such as the sound of an orchestral instrument, the appearance, taste, smell, and texture of gummy candy, and sensations in various parts of the body), and psychoeducation and work to master "committed action" (such as exercises to encourage value-based commitments to take effective action guided by one's values). Each work or exercise is stored as data in an appropriate trusted format, including video, audio, text, chatbot, or other interactive formats, or a combination of these. In this example, ten exercises are provided for "Self as Context," "Acceptance," "Defusion," and "Now, This Moment," and one work each for "Clarifying Values" and "Committed Action" (it goes without saying that the number of exercises and works is not specified and can be changed as appropriate).In addition, the program (software program) is programmed to process each step included in a scenario for treatment and self-care, and executes the processing by linking the system's calendar function with the schedule included in the scenario.
[0017] Next, the self-care provision flow will be described based on the scenario in Figure 3(a). First, when an app or self-care function (301) is started, (302) the system (program) makes a request to the control device 132, recording the start of the program in the calendar function of the storage device 133. The control device 132 then sends instructions to the storage device 133, which retrieves the acceptance psychoeducation content stored in the storage device 133 according to the schedule specified in the program and provides it via the display device 103, such as the LCD display device of the information processing terminal 110. The acceptance step in chronic pain is a step (a treatment / improvement theme) for acquiring the sense of accepting pain without excess or deficiency. It is preferable to provide the significance of self-care for chronic pain in a predetermined format, like other content, during the psychoeducation or at the end of this flow. If added at the end, it may be provided to the user in the form of a simple comprehension test (multiple choice), and the result (i.e., comprehension level) may be made recognizable to the user (in this case, if the comprehension level is not at the reference point, the process of 302 may be repeated). Next, the control device 132 provides the user with the exercises specified by the scenario via the information processing terminal 110 in accordance with the schedule (typically, a period of about one week is assigned to each step of the flow, and within that week, dates for providing psychological education and dates for providing exercises are specified, and exercises etc. are provided according to the schedule in cooperation with the calendar function), and stores in the calendar function whether or not the user has performed the exercises. Here, in the case of interactive exercises, a display device 103 such as an LCD monitor and an input device 104 such as a touch panel may be used to have a dialogue between the user and the program as specified in the program. Here, if the user performs the exercises according to the schedule, the program proceeds to the next step.If the user does not implement the psychological education content or perform the exercise, the control device 101 will proceed to the next process according to the date specified in the schedule, or will execute the educational content or exercise again after a specified number of days.Furthermore, a maximum number of repetitions can be specified, and the process of providing the content again up to the maximum number of repetitions can be executed, and even if the content is not executed, the control device 101 will process the program so that it operates according to the specified schedule.
[0018] (303) Next, the system provides a value worksheet according to a schedule based on the calendar function. The value worksheet involves psychological education about values and the creation of a value orientation worksheet. The worksheet evaluates the importance and satisfaction of 10 areas that people generally value (family relationships, friendships, career, health, etc.). The control device 132 and the control device 101 work together to create the worksheet interactively via the display device 103 and the input device 104 according to the specifications of the scenario. The value step is a step for reaffirming what the user values by creating this worksheet. The other processes are the same as those in 302.
[0019] (304) The system provides psychoeducation on defusion and exercises to master defusion. These processes are similar to those in (302). The defusion step allows the patient to simply pay attention to the thoughts, emotions, and physical sensations that arise with pain, allowing them to move forward (toward values) without being distracted by them. Next, (305) the system provides psychoeducation on the present moment and exercises to master the present moment. These processes are similar to those in (302). The present moment step allows the patient to become aware that they are daydreaming about future pain or ruminating about past events, thereby losing touch with the present. Next, (306) the system provides psychoeducation on committed action and exercises for committed action. Committed action is a step to encourage the patient to set long-, medium-, and short-term goals based on values and to continue to perform tasks that they were unable to perform before the application of this app, for example, due to pain fusion. Specifically, a worksheet for inputting and storing these goals is stored in the storage device 133 by the user. When this exercise is read in flow 306, the control device 132 reads the worksheet and transmits it to the information processing device 110. The control device 101 then presents it to the user via the display device 103. The user then enters each of the user's goals, typically in text input boxes on the worksheet using the input device 104. The input information is then stored in the storage device 133 along with the worksheet. For example, if "walk the dog to the station" is entered as a short-term goal, a pop-up window appears every day displaying this information set as the short-term goal and a checkbox indicating whether or not the goal should be carried out. The user can then enter the results of the walk. The daily checkboxes, i.e., the status of the walk, are then displayed in a table. This process is performed in conjunction with the calendar function according to the scenario schedule.Typically, the implementation of these committed actions lasts about a week, so the display is limited to short-term goals. However, if core process exercises for values and committed actions are performed early in the scenario, they may be provided in parallel with other core process exercises during subsequent scenario execution. In this case, the implementation of mid-term goals may also be recorded and displayed. Furthermore, these committed action exercises may be provided continuously even after the scenario ends (in this case, the calendar function and schedule for short-term, mid-term, and long-term goals are linked, and the system handles management such as recording and display). Then, once each step and all exercises included in each step are completed according to the schedule specified in the scenario, the execution of the self-care app and functional module will end. It goes without saying that the themes of each flow step are appropriately associated with core processes and are set appropriately during the design of the treatment scenario.
[0020] Figure 3(b) shows a different scenario from the one described above, in which the self-care app / self-care function module starts with the core process of defusion, and the execution order of the core processes is different from that of Figure 3(a). However, the processing is the same as in Figure 3(a), and exercises for each step are provided to the user.
[0021] Figure 3(c) shows a different scenario from the one described above, in which the self-care app / self-care function module starts with the core process of value, steps related to the self's core process as context are added, and the execution order of the other core processes is changed from Figure 3(a). The processing is performed in the same way as in Figure 3(a), and exercises for each step are provided to the user. In the above example, a system using System 2 was exemplified, but when System 1 is used, processing is no longer performed in cooperation between the server and the information processing terminal, and the necessary data, etc. are stored in the storage device 102 within the terminal, and processing is modified to be performed by the terminal's control device 101, and processing is performed in the same way.
[0022] (Emergency response) In preparation for the possibility that the user's pain may intensify while using the app, an emergency button is provided on the app screen (display device 103). When the user touches the emergency button (input device 104), the app pauses the program (storing in storage device 133 the point in the schedule where the program was paused in the calendar function) and stops execution of the program until an instruction to resume the app is received (typically, when the app is relaunched from an icon or the like, a button on the screen is touched to resume the program from that point based on the information at the time of the pause). In this case, a separate routine may be executed, for example, to connect to an online medical consultation system affiliated with the system to allow the user to receive medical support, or information on tips for when pain occurs may be stored in storage device 133 in advance and displayed on the screen when the system is paused. In parallel with the operation of the system, the user may be required to periodically (e.g., daily) input the intensity of pain as an ecological momentary assessment (EMA) using the information processing terminal 110 in an input format such as a VAS, and the above-mentioned pause processing may be performed if the pain exceeds a predetermined value. In addition, these EMA data can also be linked to the system's calendar function and recorded as symptom memory.In this case, depending on the disease in question, for example, in the case of chronic pain as in this example, it is preferable to administer pain assessment questionnaires such as the Japanese Short McGill Questionnaire, the Japanese Pain Detect, the Pain Disability Assessment Scale (PDAS), or the Japanese EuroQol; the Hospital Anxiety and Depression Scale (HADS, assessing anxiety and depression), the Pain Catastrophizing Scale (PCS, assessing catastrophic thinking); psychological assessment questionnaires such as the Self-Rating Depression Scale (SDS, assessing depression), the State Trait Anxiety Inventory (STAI, assessing anxiety level), the Yatabe-Guilford Personality Inventory, or the Minnesota Multiphasic Personality Test; or a combination of these. The responses to these questions are evaluated, and the evaluation results, EMA, and assessment results of the exercises and core processes and their mastery are recorded in a symptom diary linked with a calendar function. Needless to say, these questions can be tailored to the disease and symptoms in question. Furthermore, external factors that further affect these symptom memories, such as weather and atmospheric pressure in the case of pain, can be recorded, and these recorded items, such as the correlation between pain intensity and atmospheric pressure, can be periodically analyzed and displayed graphically on the screen by the user, which can be useful for self-health management. In particular, when a committed behavioral exercise is performed, the correlation between the set goal and the recorded EMA, evaluation results of evaluation indicators, external factors, and the implementation status of core process exercises can be analyzed, and it becomes possible to extract, for example, the causes of correlations that are hindering the behavior.
[0023] While the above examples show three scenarios for chronic pain treatment and self-care, scenario designers can freely design scenarios based on themes and associated core processes they deem necessary for treatment and self-care, depending on the target disease or symptom. Scenarios can be designed simply with the necessary core processes, or they can be composed of a combination of themes consisting of one or more core processes corresponding to themes of treatment and self-care, or they can incorporate themes and exercises unrelated to the core processes. Furthermore, instead of performing the steps of each core process, mindfulness exercises can be implemented. Furthermore, after performing each core process, assessments can be conducted using well-known scales such as the Multidimensional Psychological Flexibility Inventory (MPFI), CompACT (Comprehensive assessment of Acceptance and Commitment Therapy Processes), AAQ-II (Acceptance and Action Questionnaire), FFMQ (Five Facet Mindfulness Questionnaire), and CFQ (Cognitive Fusion Questionnaire) to assess the user's mastery of each core process. If the user does not reach a predetermined level, the exercises for the same core process can be repeated.
[0024] (Example) Next, an embodiment of the present invention will be described according to the flow chart in FIG. 4. In the embodiment of the present invention, an example using system 2 is shown. However, even when applied to system 1, the necessary data and the like can be stored in storage device 102, and processing control can be performed by modifying and executing the system. The smartphone app of the present invention is a software program consisting of a part that controls the front end on the information processing terminal 110 side and a part that controls the back end on the server 130 side. The program to control each part is stored in storage device 102 and storage device 133, and the control devices 101 and 132 cooperate with each other to process and execute the program on the devices included in each information processing terminal 110 and server 130 based on information stored in their respective storage devices. It is also possible to design the system so that either the information processing terminal 110 or the server 130 mainly controls and stores information, while the other device is used for specific processing. (For example, it is conceivable that the server 130 mainly controls the program, and the information processing terminal is used as an input / output device.)
[0025] Assume that the software program for this smartphone app is already installed on the user's information processing terminal 110, such as a smartphone, and on the server 130. First (401), the user touches an icon representing this app displayed on the display device 103, which is the smartphone's LCD screen. Upon detecting input from the input device 104, the control device 101 calls up the software program from the storage device 102 and starts the app according to that program. (402) Next, only at the first start, the program displays a screen on the display device 104 prompting the user to enter personal data and symptoms. The user enters the specified data, etc., from the input device 104 using a predetermined input method, and this information is stored in the storage device 133 along with the user's identification information.
[0026] (403) Next, the system reads the question information for the MPFI (a subscale for assessing psychological flexibility) evaluation index for assessing the user's mastery of core processes, stored in the storage device 133, and the control device 101 presents it to the user via the display device 103. Specifically, the user reads the questions displayed on the LCD screen and inputs their answers using the response input method (e.g., a six-point scale) displayed for each question. The input answers are sent to the server 130, and the control device 132 aggregates the answers, calculates the mastery of each core process, and evaluates whether the mastery meets the standard by comparing it with the reference score for each core process (the reference score is stored as data in the storage device 133 along with the evaluation index data). Note that the mastery questions or evaluations may only evaluate the core processes used to select the prepared scenario. For example, if acceptance and defusion, which are considered to have the greatest impact, are the first two in the scenario, the evaluation may be limited to these two, or if a "now moment" scenario is added, the evaluation may be limited to three, including "now moment." Of course, it is possible to evaluate all core processes, and because values and committed actions are related, it goes without saying that it is also sufficient to evaluate only the five processes excluding committed actions. Note that if proficiency in the core processes of acceptance, defusion, here and now, and self as context is low, this low level can have a significant impact on the level of mastery of the exercise, but high levels of mastery of values and committed actions can be desirable as it motivates people to continue with the scenario, so it is possible to set low levels of proficiency in the core processes of acceptance, defusion, here and now, and self as context as the criterion for judgment, and high levels of mastery of values and committed actions as the criterion for judgment.
[0027] In this embodiment, three scenarios are prepared: Scenario A (starting with acceptance) in Figure 3(a), Scenario B (starting with defusion) in Figure 3(b), and Scenario C (starting with valuing) in Figure 3(c). Each core process of the MPFI is then evaluated. The user is prompted to respond to five questions about the core processes of acceptance, defusion, and valuing, which are subscales of the MPFI's psychological flexibility, using a six-point scale. The control device 101 controls the information input via the input device 104 of the information processing terminal 110 to be sent to the server 130, and the control device 132 aggregates the data for each core process. Examples of core process reference value information stored in the storage device 133 include 10 points for acceptance, 10 points for defusion, and 22 points for valuing. While the reference values may be set to values that represent proficiency in each core process, it is convenient to set the reference values lower than the reference values, since the core processes will be studied from now on. Regarding value, since a higher level of learning is more motivating, it is convenient to set a value higher than the reference value. Then, if the user's score for acceptance is 10 points or less, scenario A is selected; if the score for defusion is 10 points or less, scenario B is selected; and if the score for value is 22 points or more, scenario C is selected. These are the scenarios to be provided to the user. The reference point information conveniently includes a conditional expression for determining which scenario is selected based on the user's score. The conditional expression includes the selection conditions based on the reference point described above, and selection conditions when there are multiple scenarios below the reference point (e.g., a description that the program can recognize as a condition, such as selecting the scenario with the largest difference from the reference point, selecting the scenario with the largest magnification of the difference from the reference point, determining a priority order in advance and selecting according to that priority, or selecting scenario A if none of the above conditions apply). These conditions are stored in the storage device 133 together with the reference value information. In this embodiment, the user's evaluation scores are 12 points for acceptance, 8 points for defusion, and 11 points for value, and scenario B is selected in accordance with the selection conditions.In this way, in the user evaluation, the user is prompted to answer questions on a scale for assessing their proficiency in the core processes, the answers are tallied, and the proficiency level of each core process is evaluated using a total score. Based on this evaluation score for each core process and the scenario selection criteria, a scenario to be provided to the user is determined from the group of scenarios stored in the storage device. While three scenarios are shown in this embodiment for simplicity, other scenarios may be prepared, such as four scenarios starting from acceptance, defusion, the present moment, and self as context, which are related to mindfulness, or six scenarios using all core processes. Multiple scenarios may also be prepared for one core process. Furthermore, scenarios may be designed as needed, such as by simply changing the order of the core processes included in the scenario, or by changing the core processes or exercises included.
[0028] In the above example, the evaluation score was determined using an evaluation scale for core process proficiency, but in combination with or instead of this, behavioral trait assessments such as BIG5, Enneagram, MBTI, or scales for gamification motivation and behavioral traits such as HEXAD SCALE or the BAUM test may be implemented and the evaluation score may be used (BIG5 is particularly convenient because it can obtain similar behavioral traits from an analysis of the user's smartphone usage history or tweets on social media without asking questions). For example, when using BIG5, if the person has a tendency toward neuroticism, scenario B is selected because it is expected to be related to fusion, and if the person has a tendency toward openness, scenario A is selected because it is expected to be compatible with acceptance, a relatively new concept.
[0029] Next, the program proceeds to step (404). Note that step 404 may be executed prior to step 403. This step executes the process described above in (Step of providing motivation through creative despair). The program calls the above function, executes the function according to the procedure, and provides the user with a motivation step.
[0030] Next, proceed to step (405). This step is a step of providing the user with the scenario selected in step 403, and executes the selected scenario according to the procedure exemplified in (Self-care application example (scenario example)), thereby providing treatment and self-care to the user.
[0031] In this example, chronic pain has been described as the target disease, but the present invention is not limited to this and can be applied to stress-related diseases and their symptoms, mental disorders, etc. In particular, the present invention is effective for chronic pain, migraine, menstrual symptoms, sleep disorders, eating disorders, dental psychosomatic disorders, dieting, erectile dysfunction (ED), depression, anxiety disorders, ADHD, postpartum depression, female menopause, male menopause, diabetes, atopic dermatitis, irritable bowel syndrome, muscle tension pain, autonomic imbalance, psychogenic dizziness, bronchial asthma, premenstrual syndrome, body dysmorphic disorder, tinnitus, psychogenic hearing loss, psychogenic aphonia, infertility, panic disorder, dementia, developmental disorders, schizophrenia, psychogenic vomiting, and self-mental care for caregivers, young carers, and workers.
[0032] It goes without saying that the above-described embodiments are not independent of each other, and that the elements of each embodiment can be combined. [Explanation of symbols]
[0033] 100 systems 101 Control device 102 Storage device 103 Display device 104 Input Device 105 Communication equipment 106 Measuring Equipment 110 Information processing terminal 116 Measuring Equipment 120 Network 130 servers 131 Communication equipment 132 Control device 133 Storage device
Claims
1. A system including an information processing device for performing mental health self-care, a motivation function in which the information processing terminal provides an intervention process for motivating the implementation of a self-care scenario based on psychotherapy; a self-care function that provides a user with an intervention process of a self-care scenario based on the psychotherapy, The motivation function is Asking the user questions regarding how to deal with their current symptoms; and providing the user with metaphoric content to guide the user in a paradoxical intervention with the coping method.
2. The system of claim 1 , wherein the psychotherapy is ACT (Acceptance and Commitment Therapy) or mindfulness.
3. The system of claim 1 or claim 2 further includes a step of acquiring a user's answer to the question acquired in the step of evaluating the question, and then determining the content of a metaphor to be provided based on the result of the answer or the result of an analysis of the answer, and providing the content to the user in an actionable manner.
Citation Information
Patent Citations
Treatment assistance system and treatment assistance program
WO2023204239A1