Information to explain the use of elona therapy as part of therapy

Practitioners should suggest the following aspects to their patients when explaining how to use elona therapy:

Requirements and preparation:

• The content of elona therapy is based on the cognitive behavioral therapy process (about medical content and sources). This therapeutic procedure comprises a wide range of disorder-specific and cross-disorder interventions that are scientifically proven and evidence-based. The treatment of depression includes established psychotherapeutic approaches such as behavioral activation (development and planning of activities), cognitive restructuring (recognition, handling and change of automatic thoughts, cognitive distortions and basic assumptions), emotion regulation (transfer of knowledge, handling and regulation of emotions), social skills and competencies (psychoeducation and behavioral training), mindfulness & acceptance (reflection of personal values, building acceptance of unwanted feelings and thoughts) and the prevention of relapse (identification of early warning symptoms, preparation of crisis plans). For the treatment of anxiety/panic disorder, elona therapy uses established approaches such as psychoeducation (transfer of knowledge about the nature of anxiety, disorders, comorbidities, models for development and maintenance, behavioral analyses and self-observation), exposure methods (knowledge transfer, preparation, implementation and debriefing), cognitive interventions, emotion regulation (transfer of knowledge, handling and regulation of emotions), aspects of acceptance and commitment therapy (ACT) for anxiety and relapse prevention (Identification of early warning symptoms, preparation of crisis plans, dealing with relapses). Relaxation content (progressive muscle relaxation, imagination, mindfulness and meditation) is also suitable for both disorders. In elona therapy, appropriate exercises — divided into courses, chapters and lessons — are available for patients. The overall goal is to reduce symptoms (e.g. anxiety, panic and depression) and to increase the quality of life, including by permanently changing dysfunctional thought and behavior patterns.
• elona therapy is based on the scientific concept of integrated psychotherapy. Digital-based interventions are integrated into regular psychotherapy so that patients have easy access to individually tailored psychotherapeutic resources even between therapy sessions. A variety of studies on interlinked psychotherapy have already shown positive effects of interlinked psychotherapy compared to conventional (face-to-face) psychotherapy (e.g. Psychotherapy and Psychosomatics: Klein et al., 2016; Journal of Affective Disorders: Schuster et al., 2020).
• For patients, elona therapy is available as a native smartphone app, i.e. the patient should have an Internet-enabled smartphone (with the latest versions of the Android or Apple operating systems) and be interested in using the smartphone. Practitioners can also access elona therapy via a web application and, by selecting appropriate content, further tailor elona therapy's offerings for their patients.
• As a digital health application, elona therapy can in future be prescribed by health care providers (medical and psychological psychotherapists) and reimbursed by all statutory health insurance companies. This works in the same way as prescribing medications: the psychotherapist prescribes the app using the well-known drug regulation form (sample 16). The patient can submit this regulation to his/her statutory health insurance company. He/she then receives a code for activation, can download the app independently (from the Apple App Store or Google Play) and register a user account with the code.
• elona therapy is a CE-marked medical device (class I, MDD). Medical devices are regulated and must meet high requirements. This includes technical documentation, clinical evaluation, an acceptable benefit-risk ratio, usability, and compliance with software life cycle processes.
• As a digital health application, elona therapy also meets high requirements for information security and data protection, which go beyond the minimum legal standards of the GDPR. The data is stored pseudonymously and encrypted on servers specially designed for health applications, so that the security of the data is guaranteed. As a manufacturer, Elona Health is also certified by TÜV Süd in accordance with ISO/IEC 27001. We have compiled further information on our “Security & Trust” page. For more information on data protection, please see our Privacy statements.
• As soon as the patient has downloaded the application and created an account, the psychotherapist and the patient can connect via a QR code or numeric code.

During therapy:

• Patients have access to psychoeducational content and behavioral therapeutic interventions (exercises, methods and techniques) to treat depression and/or anxiety disorder.
• Patients can easily access the content and exercises of their therapy via their smartphone, which are structured into individual courses (e.g. anxiety disorder, depression, relaxation) on a topic-specific and clear basis. In addition, exercises in elona therapy - in contrast to worksheets - cannot be lost.
• In addition, in elona therapy, patients can regularly record their mood, plan activities and jot down/log questions and findings for the next session. This enables the best possible preparation and follow-up of therapy sessions.
• The content and exercises in elona therapy are presented in multimedia — i.e. in text, audio or video form. The duration of each exercise is given at the beginning and is usually three to ten minutes.
• The continuous integration of exercises into therapy can help to promote patients' self-management skills so that therapeutic content is transferred faster and better into everyday life.
• The patient retains control over his/her data, i.e. the content of the exercises is not shared with the therapist in elona therapy. However, the patient has the option to activate the development of symptoms (e.g. mood progression) recorded in elona therapy for their therapist. This enables the therapist to improve monitoring, i.e. he/she continuously monitors the patient's development and receives timely insight into possible changes made by their patients.
• The therapist can send an appointment reminder via elona therapy and thus help the patient to meet agreed appointments reliably. This increases treatment adherence.

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After treatment:

• After treatment has ended, the patient can continue to have access to their treatment content if prescribed by the practitioner. In addition to therapy, the patient can regularly repeat helpful exercises and refresh psychoeducational knowledge, which should contribute to improved prevention of relapse.

references:

Klein, J.P., Berger, T., Schröder, J., Späth, C., Meyer, B., Caspar, F., Lutz, W., Arndt, A., Greiner, W., Graefe, V., Hautzinger, M., Fuhr, K., Rose, M., Nolte, S., Loewe, B., Anderssoni, G., Vettorazzi, E., Moritz, S., & Hohagen, F. (2016). Effects of a Psychological Internet Intervention in the Treatment of Mild to Moderate Depressive Symptoms: Results of the EVIDENT Study, a Randomized Controlled Trial. Psychotherapy and Psychosomatics, 85(4) 218—228

Schuster, R., Laireiter, A.R., Berger, T., Moritz, S., Meyer, B., Hohagen, F., & Klein, J.P. (2020). Immediate and long-term effectiveness of adding an Internet intervention for depression to routine outpatient psychotherapy: Subgroup analysis of the EVIDENT trial. Journal of Affective Disorders, 274, 643—651.