Creating an app outline and co-design guidelines for artificially intelligent driven software to support CBTp practitioners working with clients experiencing first episode psychosis

Psychosis presents a somewhat unique challenge to individual sufferers, the clinicians and services that support them, and the NHS broadly. This is due to the complex presentation of psychosis, which often co-occurs with or precipitates a myriad of co-morbidities, which often result in decreased quality and length of life. One of the NICE-recommended treatments for first episode psychosis is the delivery of Cognitive Behavioural Therapy for psychosis (CBTp). The delivery of CBTp is challenging and complicated, requiring fidelity to the model, treatment coordination with multiple stakeholders, and a significant administrative burden. Artificial Intelligence (AI) was considered as a potentially valuable contribution to supporting practitioners in their work. Initial explorations identified two gaps in the research: first, there was no evidence of applications leveraging AI specifically in support of CBTp practitioners; second, there was a lack of methodological coherence in the research regarding the development of software applications in mental health contexts. To address these gaps, this research set out to develop a design outline for an AI-driven software application and in doing so, create a methodological guideline to inform future research. An initial systematic literature review identified action research as the methodological foundation for this research project. With this in hand, a working group of CBTp practitioners was formed, and the CBTp Companion app was created. Positive stakeholder feedback on the app focused on its potential to enhance coordination and collaboration, help maintain fidelity to the CBTp model, and lift some of the administrative burden from practitioners. A key caution was that the app should aid but not replace practitioners. The Working Group’s experience enacting a research culture that allowed them to wrestle with complex and sensitive issues related to professionalism, ethics, and the therapeutic relationship allowed them to develop and articulate a co-design guideline rooted in the very process it seeks to influence.