Can experience sampling self-monitoring tools promote the activation of clients in mental healthcare? A qualitative study

Actively engaging clients in managing their health and care is crucial for person-centered mental healthcare. Self-monitoring tools such as the Experience Sampling Method (ESM) can help individuals collect information about their mental health and daily activities on their smartphones and share this with their clinicians. This qualitative paper examines how ESM self-monitoring might enhance self-insight, self-management, self-efficacy, therapeutic alliance, and shared decision-making and this way facilitate the activation of clients in mental healthcare. Twelve clinicians and 24 clients participated in the IMPROVE study. After using the IMPROVE ESM self-monitoring tool, seven clinicians and 11 clients were interviewed, and a thematic analysis examined participants’ experiences of changes in processes related to client activation. Clients reported improvements in self-awareness, self-insight, and self-management. Only a few participants experienced enhanced self-efficacy, improved therapeutic alliances, and more client involvement. Self-awareness was mainly boosted via smartphone self-monitoring, while collaborative data interpretation between clients and clinicians was crucial for unlocking insights about clients’ mental health and creating actionable therapy goals. Our findings suggest that using ESM self-monitoring tools can help facilitate the activation of clients in mental healthcare. Future research should develop best practice guidelines for integrating these tools into clinical care.