Psychiatr Clin North Am
· 2026 Jun · PMID 42069382
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Digital mental health tools-including telehealth, mobile applications, wearable devices, machine learning, and artificial intelligence-are changing the way patients and providers manage mental health care. This review su...Digital mental health tools-including telehealth, mobile applications, wearable devices, machine learning, and artificial intelligence-are changing the way patients and providers manage mental health care. This review summarizes the current research findings of digital interventions on patient access to care, the factors impacting personalized care, and overall patient engagement. Gaps of knowledge and future considerations are discussed, including careful observation of existing barriers to care. Clinical recommendations are discussed for clinicians who are considering implementing digital mental health tools into practice.
Psychiatr Clin North Am
· 2026 Jun · PMID 42069381
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This article presents a review of examples of digital mental health technology (DMHT) for assessing and treating posttraumatic stress disorder (PTSD), including research supporting these innovative solutions. Tools for a...This article presents a review of examples of digital mental health technology (DMHT) for assessing and treating posttraumatic stress disorder (PTSD), including research supporting these innovative solutions. Tools for assessing PTSD are reviewed, including digital administration of self-report measures, ecological momentary assessment methods, personal sensing, electronic medical record and other naturalistic data sources, and emerging digital assessment tools. Next, DMHTs for PTSD treatment are reviewed, including Internet-based interventions, mobile mental health apps, virtual reality therapy, and several emerging digital interventions. DMHT applications for PTSD have demonstrated promise in research and are beginning to be used in clinical practice.
Psychiatr Clin North Am
· 2026 Jun · PMID 42069380
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Obsessive-compulsive disorder (OCD) is a debilitating neuropsychiatric disorder that remains chronic unless intervened with evidence-based intervention. Cognitive behavioral therapy (CBT) with exposure and response preve...Obsessive-compulsive disorder (OCD) is a debilitating neuropsychiatric disorder that remains chronic unless intervened with evidence-based intervention. Cognitive behavioral therapy (CBT) with exposure and response prevention is the gold-standard psychological intervention for OCD, but many individuals do not receive this intervention due to barriers to accessing treatment. Mental health technology tools such as telehealth, computerized programs, internet-delivered CBT, and mobile applications have been adopted to expand the accessibility of CBT. An up-to-date summary of the evidence base of technology-mediated formats of CBT for OCD treatment is provided. Clinical benefits offered by such approaches, current limitations, and future research directions are discussed.
Ramos G, Karyotaki E, Mohr DC
… +1 more, Schueller SM
Psychiatr Clin North Am
· 2026 Jun · PMID 42069379
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Depression leads to a significant societal burden worldwide, yet most individuals affected lack adequate care. Digital mental health treatments (DMHTs) offer evidence-based, accessible interventions via websites, text me...Depression leads to a significant societal burden worldwide, yet most individuals affected lack adequate care. Digital mental health treatments (DMHTs) offer evidence-based, accessible interventions via websites, text messaging, virtual reality, and mobile apps, among other technologies. Studies demonstrate DMHT effectiveness, often comparable to traditional therapies, with high treatment acceptability and satisfaction. Key challenges include poor engagement, high attrition, and limited integration into routine care. Despite these barriers, innovations such as human support, improved reimbursement practices, patient-treatment matching strategies, and emerging AI-driven tools promise to broaden DMHTs' impact and position these programs as a frontline treatment option for depression globally.
Delgado N, McCalla K, Siegel A
… +1 more, McGuire JF
Psychiatr Clin North Am
· 2026 Jun · PMID 42069378
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Anxiety disorders can emerge across the lifespan, causing significant distress and impairment. Although evidence-based treatments like cognitive behavioral therapy exist for anxiety disorders, several challenges exist wh...Anxiety disorders can emerge across the lifespan, causing significant distress and impairment. Although evidence-based treatments like cognitive behavioral therapy exist for anxiety disorders, several challenges exist when implementing these treatments in clinical practice that can impede treatment accessibility and/or effectiveness. Fortunately, several technological advancements have resulted in considerable innovative solutions. Here, we examine the evidence for augmenting evidence-based treatments for anxiety disorders using: (1) telehealth/telemedicine; (2) digital mental health interventions and mobile health applications; and (3) virtual reality, extended reality, and/or augmented reality. Despite the considerable promise of technological augmentation of evidence-based treatment, further research and technological advancements are needed.
Psychiatr Clin North Am
· 2026 Jun · PMID 42069377
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Virtual reality (VR) has generated growing enthusiasm as a tool to deliver evidence-based mental health treatments. By immersing individuals in interactive, simulated environments, VR allows for repeated exposure to fear...Virtual reality (VR) has generated growing enthusiasm as a tool to deliver evidence-based mental health treatments. By immersing individuals in interactive, simulated environments, VR allows for repeated exposure to feared stimuli, real-time practice, and clinician involvement. While the strongest evidence supports using VR exposure therapy for anxiety-related disorders, promising applications are emerging across a range of conditions. Despite promising findings, most studies have small samples with limited follow-up. Broader integration in clinical practice will require continued innovation, testing, and adaptation to meet patient needs, enhance therapist training, and address health care system constraints.
Polizzotto NR, Badawi JC, Sanches M
… +2 more, Lane SD, Patriquin MA
Psychiatr Clin North Am
· 2026 Jun · PMID 42069376
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Wearable technology holds promise for improving mental health care by enabling continuous, objective monitoring of physiologic parameters. Building on decades of psychophysiology research, wearables can provide an additi...Wearable technology holds promise for improving mental health care by enabling continuous, objective monitoring of physiologic parameters. Building on decades of psychophysiology research, wearables can provide an additional source of measurement for implementing measurement-based care in learning mental health systems. This review describes wearable use across inpatient and outpatient settings, identifying gaps and opportunities in clinical care and research. While widely studied in outpatient, wearables hold immense potential for in inpatient settings. Advancements needed include user-centered design, better understanding of complex populations and settings, and use of modern analytical methods to generate clinically actionable mental health insights for all.
Psychiatr Clin North Am
· 2026 Jun · PMID 42069375
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Digital phenotyping-the moment-by-moment quantification of human behavior using data from smartphones and wearables-offers new pathways for mental health research and care. This review summarizes current trends, tools, a...Digital phenotyping-the moment-by-moment quantification of human behavior using data from smartphones and wearables-offers new pathways for mental health research and care. This review summarizes current trends, tools, and applications of digital phenotyping, highlighting its growing clinical relevance in early detection, symptom monitoring, and personalized interventions. Although studies increasingly demonstrate its feasibility and clinical utility across conditions such as depression, anxiety, and schizophrenia, challenges persist. These challenges include inconsistent data quality, small and nonrepresentative samples, lack of methodological standardization, and pressing ethical considerations about privacy and transparency.
Psychiatr Clin North Am
· 2026 Jun · PMID 42069374
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A number of articles have heralded the use of artificial intelligence (AI) agents to serve as a replacement for human psychotherapists. Despite the rapid advancements in the use of both rule-based and generative AI progr...A number of articles have heralded the use of artificial intelligence (AI) agents to serve as a replacement for human psychotherapists. Despite the rapid advancements in the use of both rule-based and generative AI programs in the recent past, an overall review shows only small impacts on certain mental health symptoms, particularly depression, and then only in the short-term. Significant strides forward, both in terms of technology and the development of answers to ethical questions regarding AI's use in psychotherapy, must be seen before the use of such systems becomes widespread or regularly recommended to replace human mental health clinicians.
Psychiatr Clin North Am
· 2026 Jun · PMID 42069373
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Over the past decade, telehealth-delivered psychotherapy has become an increasingly accessible and viable modality for providing evidence-based care. Current research on its efficacy is varied, with some protocols demons...Over the past decade, telehealth-delivered psychotherapy has become an increasingly accessible and viable modality for providing evidence-based care. Current research on its efficacy is varied, with some protocols demonstrating comparable outcomes between virtual and in-person modalities and others suggesting a differential impact of disorder and/or protocol-specific factors (eg, symptom severity). This review examines recent findings across treatment settings and protocol types as well as provides recommendations and considerations for providers. Future research is warranted to further compare virtual and in-person treatment delivery and determine long-term outcomes.
Kostick-Quenet KM, Hurley M, Herrington J
… +1 more, Storch EA
Psychiatr Clin North Am
· 2026 Jun · PMID 42069372
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Computer perception (CP) technologies are poised to deliver near real-time behavioral insights with high precision. As technical barriers recede, our field's ethical focus must shift from "Can we trust the data?" to "Sho...Computer perception (CP) technologies are poised to deliver near real-time behavioral insights with high precision. As technical barriers recede, our field's ethical focus must shift from "Can we trust the data?" to "Should we use it here, and how?" We propose a contextual ethics framework that: (1) defines the appropriate scope of CP integration; (2) advocates codesigned roadmaps to manage expectations and epistemic conflict; (3) expands evaluation beyond performance metrics to humanistic outcomes; and (4) anticipates future high performance systems to safeguard dignity, empathy, and shared decision-making in clinical care.
Psychiatr Clin North Am
· 2026 Mar · PMID 41708271
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Compulsive exercise, a common eating disorder (ED) symptom, may contribute to protracted illness and poor treatment outcomes. Currently, there is no consensus or robust evidence base for best practices in addressing exer...Compulsive exercise, a common eating disorder (ED) symptom, may contribute to protracted illness and poor treatment outcomes. Currently, there is no consensus or robust evidence base for best practices in addressing exercise within ED treatment, a challenge that becomes even more complex when treating athletes. This clinical review synthesizes current evidence regarding how exercise is managed in ED treatment and provides recommendations around best practices in screening, treatment, and return to play (as applicable). Additionally, we propose directions for future research to advance treatment approaches for compulsive exercise, both in general ED populations and in athlete-specific contexts.
Psychiatr Clin North Am
· 2026 Mar · PMID 41708270
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Given the potential for a reciprocal and functional relationship between eating disorder (ED) and post traumatic stress disorder (PTSD) symptoms, and the evidence that PTSD is associated with greater drop out from ED tre...Given the potential for a reciprocal and functional relationship between eating disorder (ED) and post traumatic stress disorder (PTSD) symptoms, and the evidence that PTSD is associated with greater drop out from ED treatment and poorer treatment outcomes, addressing PTSD as part of an ED treatment plan is recommended. Options include concurrent, integrated, and transdiagnostic/integrative psychotherapies, as well as pharmacotherapy. Although evidence is in the emerging stage, interventions that specifically address the potential interaction between ED and PTSD symptoms may be preferable to prevent drop out, improve outcomes, and meet the preferences of those with ED-PTSD.
Dodd DR, Forrest LN, Velkoff EA
… +1 more, Smith AR
Psychiatr Clin North Am
· 2026 Mar · PMID 41708269
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Individuals with eating disorders (EDs) have elevated risk for self-injurious thoughts and behaviors (SITBs) relative to people without EDs, yet no treatments of EDs specifically address SITBs. All patients with EDs shou...Individuals with eating disorders (EDs) have elevated risk for self-injurious thoughts and behaviors (SITBs) relative to people without EDs, yet no treatments of EDs specifically address SITBs. All patients with EDs should complete a safety plan early in treatment and should receive evidence-based ED interventions. For patients with EDs and SITBs, clinicians should additionally develop an integrative approach that incorporates evidence-based SITB interventions into the ED treatment plan. Effective clinical management of SITBs relies on (1) routine assessment, (2) evidence-based interventions commensurate with the level of risk, and (3) clear documentation.
Psychiatr Clin North Am
· 2026 Mar · PMID 41708268
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Long-standing anorexia nervosa is presently conceptualized as a persistent symptomatic state associated with global functional and interpersonal impairments. Understanding of effective treatments is incomplete; psycholog...Long-standing anorexia nervosa is presently conceptualized as a persistent symptomatic state associated with global functional and interpersonal impairments. Understanding of effective treatments is incomplete; psychological therapy is at the core, but also important are psychosocial and recovery support that includes significant others, tailored treatment targets such as improved quality of life, a collaborative and flexible approach to higher levels of care, and pharmacologic agents that augment therapy and address concurrent mental health problems. Research is needed to develop agreed-upon criteria (including specifiers for duration, severity, and treatment trajectory) and randomized controlled trials that can inform person-centered care.
Psychiatr Clin North Am
· 2026 Mar · PMID 41708267
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Atypical eating disorders (EDs) appear to be comparable to classical eating-disorder variants with regard to eating-symptom severity, illness burden, concurrent mental-health problems, medical complications, etiology, an...Atypical eating disorders (EDs) appear to be comparable to classical eating-disorder variants with regard to eating-symptom severity, illness burden, concurrent mental-health problems, medical complications, etiology, and treatment needs. It remains to be determined to what extent atypical EDs are truly distinct from classical variants, or simply represent early or residual phases of these disorders. Available evidence suggests that, except for variants for which symptom-specific treatment elements are indicated, conventional eating-disorder treatments are also well-suited for the treatment of atypical EDs.