Digital Therapeutics in Psychiatric Rehabilitation: A Scoping Review of Efficacy, Accessibility, and Implementation
DOI:
https://doi.org/10.69980/ajpr.v28i1.320Keywords:
Digital therapeutics, psychiatric rehabilitation, recovery-oriented care, serious mental illness, efficacy, digital equity.Abstract
This scoping review examines the emerging role of digital therapeutics (DTx) in psychiatric rehabilitation, emphasizing efficacy, accessibility, and implementation within recovery-oriented frameworks. Drawing on 31 empirical studies from 2015 to 2025, the review synthesizes evidence demonstrating that DTx interventions—ranging from smartphone applications and web-based therapies to virtual reality and AI-powered platforms—can enhance functional recovery, promote symptom self-management, and support social and occupational reintegration for individuals with serious mental illnesses (SMI). Key findings highlight that thoughtfully designed DTx can extend the reach of psychiatric rehabilitation, achieve high user engagement, and promote autonomy and empowerment when integrated with participatory design and peer-supported models. However, challenges persist, including digital literacy barriers, socioeconomic disparities, clinician workload concerns, data privacy issues, and limited long-term sustainability evaluations. The review underscores the importance of implementation science frameworks, co-production methodologies, and ethical governance in ensuring equitable access, clinical effectiveness, and alignment with recovery principles. Future research should prioritize longitudinal studies, diverse populations, ethical evaluations, and mixed-methods approaches to optimize the integration of DTx into psychiatric rehabilitation. This synthesis provides actionable insights for clinicians, policymakers, and researchers committed to leveraging technology to advance recovery-oriented mental health care.
References
1. Alvarez-Jimenez, M., Bendall, S., Lederman, R., Wadley, G., Chinnery, G., Vargas, S., ... & Gleeson, J. F. (2021). On the HORYZONS trial: moderated online social therapy for long-term recovery in first-episode psychosis. World Psychiatry, 20(2), 233–243. https://doi.org/10.1002/wps.20887
2. Anthony, W. A. (1993). Recovery from mental illness: The guiding vision of the mental health service system in the 1990s. Psychosocial Rehabilitation Journal, 16(4), 11–23. https://doi.org/10.1037/h0095655
3. Arksey, H., & O’Malley, L. (2005). Scoping studies: towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19–32. https://doi.org/10.1080/1364557032000119616
4. Ben-Zeev, D., Buck, B., Kopelovich, S. L., & Mueser, K. T. (2018). Mobile technologies among people with serious mental illness: Opportunities for future services. Administration and Policy in Mental Health and Mental Health Services Research, 45(3), 329–339. https://doi.org/10.1007/s10488-017-0810-5
5. Best, M. W., Milanovic, M., Iftene, F., & Bowie, C. R. (2020). A randomized controlled trial of a web-based cognitive remediation program for schizophrenia. Schizophrenia Research, 218, 287–295. https://doi.org/10.1016/j.schres.2020.02.012
6. Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009). Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implementation Science, 4(1), 50. https://doi.org/10.1186/1748-5908-4-50
7. Farkas, M., & Anthony, W. A. (2010). Psychiatric rehabilitation interventions: A review. International Review of Psychiatry, 22(2), 114–129. https://doi.org/10.3109/09540261003730372
8. Firth, J., Torous, J., Nicholas, J., Carney, R., Pratap, A., Rosenbaum, S., & Sarris, J. (2017). The efficacy of smartphone-based mental health interventions for depressive symptoms: a meta-analysis of randomized controlled trials. World Psychiatry, 16(3), 287–298. https://doi.org/10.1002/wps.20472
9. Firth, J., Torous, J., Nicholas, J., Carney, R., Pratap, A., Rosenbaum, S., & Sarris, J. (2019). Can smartphone mental health interventions reduce symptoms of anxiety? A meta-analysis of randomized controlled trials. Journal of Affective Disorders, 243, 171–180. https://doi.org/10.1016/j.jad.2018.09.098
10. Fortuna, K. L., Lohman, M. C., Cotton, B. P., Tyler, C. M., Boisseau, C. L., Muench, F., & Bartels, S. J. (2019). Peer support and digital technologies to promote physical and mental health among older adults with serious mental illness. Psychiatric Rehabilitation Journal, 42(4), 381–388. https://doi.org/10.1037/prj0000376
11. Fortuna, K. L., et al. (2020). The integration of peer support and digital technology for the self-management of serious mental illnesses: A randomized controlled trial. Psychiatric Services, 71(9), 910–917. https://doi.org/10.1176/appi.ps.201900676
12. Freeman, D., et al. (2018). Automated psychological therapy using immersive virtual reality for treatment of fear of heights: a single-blind, parallel-group, randomised controlled trial. The Lancet Psychiatry, 5(8), 625–632. https://doi.org/10.1016/S2215-0366(18)30226-8
13. Gooding, P., & Kariotis, T. (2022). Ethics and law in digital mental health: interdisciplinary perspectives. Journal of Medical Internet Research, 24(6), e32320. https://doi.org/10.2196/32320
14. Grist, R., Porter, J., & Stallard, P. (2017). Mental health mobile apps for preadolescents and adolescents: a systematic review. Journal of Medical Internet Research, 19(5), e176. https://doi.org/10.2196/jmir.7332
15. Hollis, C., et al. (2015). Technological innovations in mental healthcare: Harnessing the digital revolution. The British Journal of Psychiatry, 206(4), 263–265. https://doi.org/10.1192/bjp.bp.113.142612
16. Hong, Q. N., Pluye, P., Fàbregues, S., Bartlett, G., Boardman, F., Cargo, M., ... & Vedel, I. (2018). Mixed Methods Appraisal Tool (MMAT), version 2018. Education for Information, 34(4), 285–291. https://doi.org/10.3233/EFI-180221
17. Insel, T. R. (2017). Digital phenotyping: technology for a new science of behavior. JAMA, 318(13), 1215–1216. https://doi.org/10.1001/jama.2017.11295
18. Levac, D., Colquhoun, H., & O'Brien, K. K. (2010). Scoping studies: advancing the methodology. Implementation Science, 5, 69. https://doi.org/10.1186/1748-5908-5-69
19. Lewandowski, K. E., Sperry, S. H., Cohen, B. M., & Öngür, D. (2019). Cognitive remediation in schizophrenia: Current status and future directions. Schizophrenia Research: Cognition, 16, 1–7. https://doi.org/10.1016/j.scog.2019.03.001
20. Mohr, D. C., et al. (2017). Trials of intervention principles: evaluation methods for evolving behavioral intervention technologies. Journal of Medical Internet Research, 19(7), e242. https://doi.org/10.2196/jmir.7459
21. Naslund, J. A., Marsch, L. A., McHugo, G. J., & Bartels, S. J. (2020). Emerging mHealth and eHealth interventions for serious mental illness: A review of the literature. Journal of Mental Health, 29(3), 263–275. https://doi.org/10.1080/09638237.2018.1466041
22. Noel, V. A., Carpenter-Song, E., Smith, T. E., & Brunette, M. F. (2022). Digital literacy training for people with serious mental illness participating in digital health interventions: The Digital Opportunities for Outcomes in Recovery Services study. Psychiatric Services, 73(3), 269–275. https://doi.org/10.1176/appi.ps.202100222
23. Patel, V., Saxena, S., Lund, C., Thornicroft, G., Baingana, F., Bolton, P., ... & UnÜtzer, J. (2018). The Lancet Commission on global mental health and sustainable development. The Lancet, 392(10157), 1553–1598. https://doi.org/10.1016/S0140-6736(18)31612-X
24. Proctor, E., Silmere, H., Raghavan, R., Hovmand, P., Aarons, G., Bunger, A., ... & Hensley, M. (2011). Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Administration and Policy in Mental Health and Mental Health Services Research, 38(2), 65–76. https://doi.org/10.1007/s10488-010-0319-7
25. Slade, M., Amering, M., & Oades, L. (2014). Recovery: An international perspective. Epidemiology and Psychiatric Sciences, 23(3), 229–238. https://doi.org/10.1017/S2045796014000047
26. Topol, E. J. (2019). High-performance medicine: the convergence of human and artificial intelligence. Nature Medicine, 25(1), 44–56. https://doi.org/10.1038/s41591-018-0300-7
27. Torous, J., et al. (2018). Towards a consensus around standards for smartphone apps and digital mental health. World Psychiatry, 17(3), 317–318. https://doi.org/10.1002/wps.20554
28. Torous, J., Lipschitz, J., Ng, M., & Firth, J. (2020). Dropout rates in clinical trials of smartphone apps for depressive symptoms: A systematic review and meta-analysis. Journal of Affective Disorders, 263, 413–419. https://doi.org/10.1016/j.jad.2019.11.167
29. Torous, J., Wisniewski, H., Liu, G., & Keshavan, M. (2021). Mental health mobile phone app usage, concerns, and benefits among psychiatric outpatients: Comparative survey study. JMIR Mental Health, 8(4), e27362. https://doi.org/10.2196/27362
30. Tricco, A. C., et al. (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and explanation. Annals of Internal Medicine, 169(7), 467–473. https://doi.org/10.7326/M18-0850
Downloads
Published
Issue
Section
License
Copyright (c) 2025 American Journal of Psychiatric Rehabilitation
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License permitting all use, distribution, and reproduction in any medium, provided the work is properly cited.
