Human-centered Perspectives on a Clinical Decision Support System for Intensive Outpatient Veteran PTSD Care

TL;DR

This paper explores designing a human-centered clinical decision support system for veteran PTSD therapy, emphasizing clinician and patient perspectives to address challenges and opportunities in mental health technology integration.

Contribution

It introduces a theory-informed design framework for a PTSD therapy CDSS based on interviews with clinicians and veterans, highlighting human-centered considerations.

Findings

Identified key opportunities for CDSS features like homework review and patient conceptualization.

Revealed challenges related to context, deployment, and VA system navigation.

Proposed design considerations grounded in human-centered theories.

Abstract

Psychotherapy delivery relies on a negotiation between patient self-reports and clinical intuition. Growing evidence for technological support of psychotherapy suggests opportunities to aid the mediation of this tension. To explore this prospect, we designed a prototype of a clinical decision support system (CDSS) for treating veterans with post-traumatic stress disorder in a Prolonged Exposure (PE) therapy intensive outpatient program. We conducted a two-phase interview study to collect perspectives from practicing PE clinicians and former PE patients who are United States veterans. Our analysis distills opportunities for a CDSS (e.g., offering homework review at a glance, aiding patient conceptualization) and larger challenges related to context and deployment (e.g., navigating Veterans Affairs). By reframing our findings through three human-centered perspectives (distributed cognition, situated learning, infrastructural inversion), we highlight the complexities of designing a CDSS for psychotherapists in this context and offer theory-aligned design considerations.