{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T02:49:44Z","timestamp":1779245384411,"version":"3.51.4"},"reference-count":59,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>To address the unique challenges faced by refugees diagnosed with complex post-traumatic stress disorder (CPTSD), psychotherapy needs to be personalized. The integration of self-tracking instruments into therapy offers a promising approach to personalizing treatment. This feasibility pilot study develops and explores a preliminary self-tracking assisted treatment concept using a wearable self-tracking instrument called the One Button Tracker (OBT). The OBT is a single-purpose self-tracking instrument, designed to track subjectively experienced phenomena.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The feasibility pilot study adopted a participatory action research design, involving close collaboration between two therapists, two refugees diagnosed with CPTSD, and a research team. Quantitative data was collected from the OBT and qualitative data consisted of semi-structured post-treatment interviews and session logbooks. Reflexive thematic analysis was used for the interpretation of interview data. Quantitative data was used descriptively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The integration of OBT into psychotherapy with refugees was found to be feasible, marked by consistent high engagement as seen in the self-tracking data. Five themes were generated from the interview analyses, across two contexts: therapy sessions (navigating between precision and alliance with the OBT, and data usefulness in therapy) and daily life (paradox of awareness, OBT as a sign of treatment, and following the Doctor\u2019s orders).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This feasibility pilot study illustrates the feasibility and therapeutic potential for integrating the OBT into psychotherapy for refugees with CPTSD to enhance engagement and personalization. The findings emphasize the necessity of an adaptive, personalized approach, vigilance regarding potential risks, and consideration of cultural factors. Further research is needed to refine this novel therapeutic approach.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2025.1250552","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T09:21:36Z","timestamp":1740561696000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Fostering engagement using a wearable for self-tracking assisted psychotherapy with refugees diagnosed with complex PTSD: a feasibility pilot study"],"prefix":"10.3389","volume":"16","author":[{"given":"Lisa G.","family":"Riisager","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lotte","family":"Huniche","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jakob Eg","family":"Larsen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas Blomseth","family":"Christiansen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lotte","family":"Kring","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabina","family":"Palic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stine Bjerrum","family":"Moeller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,2,26]]},"reference":[{"key":"B1","unstructured":"Refugee data finder\n          \n          \n          \n          2022"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)61027-6","article-title":"Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review","volume":"365","author":"Fazel","year":"2005","journal-title":"Lancet"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1080\/09638237.2017.1322182","article-title":"A systematic review of psychosocial interventions for adult refugees and asylum seekers","volume":"28","author":"Tribe","year":"2019","journal-title":"J Ment Health"},{"key":"B4","doi-asserted-by":"crossref","DOI":"10.1017\/S1352465812000550","article-title":"Asylum-seekers\u2019 Experiences of trauma-focused cognitive behaviour therapy for post-traumatic stress disorder: A qualitative study","volume":"41","author":"Vincent","year":"2013","journal-title":"Behav Cognit Psychother"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1177\/1078390316641489","article-title":"Modeling psychological functioning in refugees","volume":"22","author":"Robertson","year":"2016","journal-title":"J Am Psychiatr Nurses Assoc"},{"key":"B6","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.socscimed.2009.09.029","article-title":"War exposure, daily stressors, and mental health in conflict and post-conflict settings: Bridging the divide between trauma-focused and psychosocial frameworks","volume":"70","author":"Miller","year":"2010","journal-title":"Soc Sci Med"},{"key":"B7","doi-asserted-by":"crossref","DOI":"10.1192\/bjp.2020.43","article-title":"ICD-11 complex post-traumatic stress disorder: simplifying diagnosis in trauma populations","volume":"216","author":"Cloitre","year":"2020","journal-title":"Br J Psychiatry"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3402\/ejpt.v7.33253","article-title":"The factor structure of complex posttraumatic stress disorder in traumatized refugees","volume":"7","author":"Nickerson","year":"2016","journal-title":"Eur J Psychotraumatol"},{"key":"B9","unstructured":"International classification of diseases, eleventh revision (ICD-11)\n          \n          \n          \n          2019"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1080\/20008198.2020.1863579","article-title":"Prevalence, predictors and associations of complex post-traumatic stress disorder with common mental disorders in refugees and forcibly displaced populations: a systematic review","volume":"12","author":"Mellor","year":"2021","journal-title":"Eur J Psychotraumatol"},{"key":"B11","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/S0140-6736(22)00821-2","article-title":"Complex post-traumatic stress disorder","volume":"400","author":"Maercker","year":"2022","journal-title":"Lancet"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3389\/fnbeh.2018.00258\/full","article-title":"Treating PTSD: A review of evidence-based psychotherapy interventions","volume":"12","author":"Watkins","year":"2018","journal-title":"Front Behav Neurosci"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0171030","article-title":"Psychosocial interventions for post-traumatic stress disorder in refugees and asylum seekers resettled in high-income countries: Systematic review and meta-analysis","volume":"12","author":"Nos\u00e8","year":"2017","journal-title":"PLoS One"},{"key":"B14","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.cpr.2018.06.006","article-title":"Psychological interventions for post-traumatic stress disorder in refugees and asylum seekers: A systematic review and meta-analysis","volume":"63","author":"Thompson","year":"2018","journal-title":"Clin Psychol Rev"},{"key":"B15","doi-asserted-by":"crossref","DOI":"10.4321\/S0213-61632014000300001","article-title":"Complex posttraumatic stress disorder in traumatised asylum seekers: a pilot study","volume":"28","author":"Kissane","year":"2014","journal-title":"Eur J Psychiatry"},{"key":"B16","doi-asserted-by":"crossref","DOI":"10.1016\/j.jad.2021.07.007","article-title":"Stress management versus cognitive restructuring in trauma-affected refugees \u2014 A follow-up study on a pragmatic randomised trial","volume":"294","author":"Barhoma","year":"2021","journal-title":"J Affect Disord"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1176\/appi.psychotherapy.2001.55.4.475","article-title":"Psychotherapy for massively traumatized refugees: the therapist variable","volume":"55","author":"Kinzie","year":"2001","journal-title":"Am J Psychother"},{"key":"B18","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.cpr.2010.10.004","article-title":"A critical review of psychological treatments of posttraumatic stress disorder in refugees","volume":"31","author":"Nickerson","year":"2011","journal-title":"Clin Psychol Rev"},{"key":"B19","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-030-24082-0_9","article-title":"Cultural competence in psychotherapy","volume-title":"Intercultural Psychotherapy: For Immigrants, Refugees, Asylum Seekers and Ethnic Minority Patients","author":"Qureshi","year":"2020"},{"key":"B20","doi-asserted-by":"crossref","DOI":"10.1016\/j.psychres.2018.12.058","article-title":"Interpreter-mediated psychotherapy with trauma-affected refugees \u2013 A retrospective cohort study","volume":"271","author":"Sander","year":"2019","journal-title":"Psychiatry Res"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3389\/fcomp.2020.00021\/full","article-title":"A conceptual framework for personal science","volume":"2","author":"Wolf","year":"2020","journal-title":"Front Comput Sci"},{"key":"B22","volume-title":"Self-Tracking Modes: Reflexive Self-Monitoring and Data Practices","author":"Lupton","year":"2014"},{"key":"B23","doi-asserted-by":"crossref","DOI":"10.1145\/2556288.2557372","article-title":"Understanding quantified-selfers\u2019 practices in collecting and exploring personal data","volume-title":"Proceedings of the SIGCHI Conference on Human Factors in Computing Systems","author":"Choe","year":"2014"},{"key":"B24","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.brat.2018.11.017","article-title":"Real-time monitoring technology in single-case experimental design research: Opportunities and challenges","volume":"117","author":"Bentley","year":"2019","journal-title":"Behav Res Ther"},{"key":"B25","doi-asserted-by":"crossref","DOI":"10.2196\/24387","article-title":"Barriers to and facilitators of user engagement with digital mental health interventions: systematic review","volume":"23","author":"Borghouts","year":"2021","journal-title":"J Med Internet Res"},{"key":"B26","doi-asserted-by":"crossref","DOI":"10.1016\/j.bodyim.2013.06.003","article-title":"Does the burden of the experience sampling method undermine data quality in state body image research","volume":"10","author":"Fuller-Tyszkiewicz","year":"2013","journal-title":"Body Image"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD011849.pub2","article-title":"Psychological therapies for the treatment of mental disorders in low- and middle-income countries affected by humanitarian crises","volume":"2018","author":"Purgato","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22924","article-title":"Just-in-time adaptive interventions: A novel approach for enhancing skill utilization and acquisition in cognitive behavioral therapy for eating disorders","volume":"51","author":"Juarascio","year":"2018","journal-title":"Int J Eat Disord"},{"key":"B29","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/s40900-018-0136-9","article-title":"Framework, principles and recommendations for utilising participatory methodologies in the co-creation and evaluation of public health interventions","volume":"5","author":"Leask","year":"2019","journal-title":"Res Involv Engagem"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1037\/0022-0167.52.2.187","article-title":"Practicing participatory action research","volume":"52","author":"Kidd","year":"2005","journal-title":"J Couns Psychol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1111\/acps.13592","article-title":"The structure of ICD-11 post traumatic stress disorder in a clinical sample of refugees based on the International Trauma Interview","volume":"148","author":"Vindbjerg","year":"2023","journal-title":"Acta Psychiatr Scand"},{"key":"B32","article-title":"Active self-tracking of subjective experience with a one-button wearable: A case study in military PTSD","author":"Larsen","year":"2017","journal-title":"arXiv"},{"key":"B33","article-title":"Distinguishing between rumination and intrusive memories in PTSD using a wearable self-tracking instrument: a proof-of-concept case study","volume":"14","author":"Arendt","year":"2021","journal-title":"Cognit Behav Ther"},{"key":"B34","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1145\/3613905.3637112","article-title":"Snapping out of it: how a wearable for self-tracking assisted psychotherapy bridges the gap between thoughts and the world","volume-title":"Extended Abstracts of the CHI Conference on Human Factors in Computing Systems","author":"Riisager","year":"2024"},{"key":"B35","doi-asserted-by":"crossref","DOI":"10.2196\/32704","article-title":"Barriers to and facilitators of using a one button tracker and web-based data analytics tool for personal science: exploratory study","volume":"6","author":"Van De Belt","year":"2022","journal-title":"JMIR Form Res"},{"key":"B36","first-page":"262 p","volume-title":"Interpreting experience","author":"Josselson","year":"1995"},{"key":"B37","first-page":"338 p","volume-title":"Thematic analysis: a practical guide","author":"Braun","year":"2022"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1080\/17439760.2016.1262613","article-title":"Thematic analysis","volume":"12","author":"Clarke","year":"2017","journal-title":"J Posit Psychol"},{"key":"B39","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1080\/09581596.2013.794931","article-title":"Quantifying the body: monitoring and measuring health in the age of mHealth technologies","volume":"23","author":"Lupton","year":"2013","journal-title":"Crit Public Health"},{"key":"B40","doi-asserted-by":"crossref","DOI":"10.1192\/bjp.bp.110.083733","article-title":"Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis","volume":"199","author":"Leamy","year":"2011","journal-title":"Br J Psychiatry"},{"key":"B41","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41746-023-00749-3","article-title":"Long-term participant retention and engagement patterns in an app and wearable-based multinational remote digital depression study","volume":"6","author":"Zhang","year":"2023","journal-title":"NPJ Digit Med"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1136\/eb-2018-102891","article-title":"Clinical review of user engagement with mental health smartphone apps: evidence, theory and improvements","volume":"21","author":"Torous","year":"2018","journal-title":"Evid Based Ment Health"},{"key":"B43","doi-asserted-by":"crossref","DOI":"10.1016\/j.comppsych.2017.01.018","article-title":"Feasibility and acceptability of post-hospitalization ecological momentary assessment in patients with psychotic-spectrum disorders","volume":"74","author":"Moitra","year":"2017","journal-title":"Compr Psychiatry"},{"key":"B44","doi-asserted-by":"crossref","DOI":"10.2196\/13609","article-title":"Comparison of the effects of coaching and receipt of app recommendations on depression, anxiety, and engagement in the intelliCare platform: factorial randomized controlled trial","volume":"21","author":"Mohr","year":"2019","journal-title":"J Med Internet Res"},{"key":"B45","doi-asserted-by":"crossref","DOI":"10.1037\/a0025499","article-title":"Text messaging as an adjunct to CBT in low-income populations: A usability and feasibility pilot study","volume":"42","author":"Aguilera","year":"2011","journal-title":"Prof Psychol Res Pract"},{"key":"B46","article-title":"Cognitive behavioral psychotherapeutic treatment at a psychiatric trauma clinic for refugees: description and evaluation","volume":"25","author":"Buhmann","year":"2015","journal-title":"Torture J"},{"key":"B47","doi-asserted-by":"crossref","DOI":"10.1145\/2470654.2466232","article-title":"Technology preferences and routines for sharing health information during the treatment of a chronic illness","volume-title":"Proceedings of the SIGCHI Conference on Human Factors in Computing Systems","author":"Pang","year":"2013"},{"key":"B48","doi-asserted-by":"crossref","DOI":"10.1145\/2858036.2858128","article-title":"Health technologies \u201cIn the wild\u201d: experiences of engagement with computerised CBT","volume-title":"Proceedings of the 2016 CHI Conference on Human Factors in Computing Systems","author":"Rennick-Egglestone","year":"2016"},{"key":"B49","doi-asserted-by":"crossref","DOI":"10.2196\/58390","article-title":"Enhancing agency in posttraumatic stress disorder therapies through sensorimotor technologies","volume":"26","author":"Adrien","year":"2024","journal-title":"J Med Internet Res"},{"key":"B50","doi-asserted-by":"crossref","DOI":"10.2196\/jmir.4209","article-title":"You get reminded you\u2019re a sick person\u201d: personal data tracking and patients with multiple chronic conditions","volume":"17","author":"Ancker","year":"2015","journal-title":"J Med Internet Res"},{"key":"B51","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-030-24082-0_15","article-title":"Psychotherapy using electronic media","volume-title":"Intercultural Psychotherapy: For Immigrants, Refugees, Asylum Seekers and Ethnic Minority Patients","author":"Mucic","year":"2020"},{"key":"B52","first-page":"249 p","volume-title":"What Things Do: Philosophical Reflections on Technology, Agency, and Design. 2. Printing","author":"Verbeek","year":"2005"},{"key":"B53","doi-asserted-by":"crossref","DOI":"10.2196\/44502","article-title":"Digital phenotyping: data-driven psychiatry to redefine mental health","volume":"25","author":"Oudin","year":"2023","journal-title":"J Med Internet Res"},{"key":"B54","doi-asserted-by":"crossref","first-page":"191","DOI":"10.5840\/techne20159935","article-title":"Datafied life: techno-anthropology as a site for exploration and experimentation","volume":"19","author":"Ruckenstein","year":"2015","journal-title":"Techn\u00e9 Res Philos Technol"},{"key":"B55","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1007\/BF01205256","article-title":"Technology and prognostic predicaments","volume":"13","author":"Ihde","year":"1999","journal-title":"AI Soc"},{"key":"B56","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/978-3-030-24082-0_3","article-title":"Standards in intercultural psychotherapy","volume-title":"Intercultural Psychotherapy: For Immigrants, Refugees, Asylum Seekers and Ethnic Minority Patients","author":"Montgomery","year":"2020"},{"key":"B57","doi-asserted-by":"crossref","DOI":"10.1016\/j.mhpa.2016.02.001","article-title":"Wearable devices and smartphones for activity tracking among people with serious mental illness","volume":"10","author":"Naslund","year":"2016","journal-title":"Ment Health Phys Act"},{"key":"B58","doi-asserted-by":"crossref","first-page":"100403","DOI":"10.1016\/j.invent.2021.100403","article-title":"Targeting subjective engagement in experimental therapeutics for digital mental health interventions","volume":"25","author":"Graham","year":"2021","journal-title":"Internet Interv"},{"key":"B59","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1016\/S2215-0366(17)30096-2","article-title":"Digital technology for treating and preventing mental disorders in low-income and middle-income countries: a narrative review of the literature","volume":"4","author":"Naslund","year":"2017","journal-title":"Lancet Psychiatry"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2025.1250552\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T09:21:54Z","timestamp":1740561714000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2025.1250552\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,26]]},"references-count":59,"alternative-id":["10.3389\/fpsyt.2025.1250552"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2025.1250552","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,26]]},"article-number":"1250552"}}