"Beat-It: A pilot study on the practicality and effectiveness of a m-health application in improving emotion regulation in adolescents with externalizing disorder. "

Difficulties in emotion regulation in adolescents with the externalizing
disorders ADHD , ODD and / or CD forms a basic problem. In these adolescents is
often a chronic vulnerability: they react quickly and violently on emotional
stimuli and their arousal will slowly return to the basic level. As a result,
adolescents experience the feeling of being overwhelmed by emotions and do not
know how to deal with its intensity. For many adolescents are this disruptive
experiences, accompanied by mood swings, problems in self-control, impulsivity,
and in some cases self-injury ( Appelo - Wichers , Appelo , & Bos , 2008). To
cope with this intense and overwhelming emotions Beat -It is developed. Beat
-it is a smartphone application that can help adolescents with aggression
problems to reduce their stress and agression ( Bruil , 2011). With Beat -It
adolescents positively influence their own performance without the presence of
a therapist, independently and on their own strength. When they feel that
their tension increaes and potentially can lead to an aggressive outburst, they
may benefit from playing Beat It.

The aim of present pilot study is to evaluate the effects of the use of the
Beat-it app for adolescents with an externalizing disorder and emotion
regulation problems.

The two central research questions of this study are the following:
1. Will self-reported behavioural problems of adolescents take off in the
period that they use beat it?
2. Will the use of self-reported maladaptive emotion regulation strategies take
off in the period that adolescents use Beat-it?

The design of this pilot study consists of an open random pre-post treatment
design with a waiting list condition. All children who are enrolled received
the intervention, or immediately, or at the end of the waiting period of 8
weeks.

The intervention consists of the use of the application for a period of 8
weeks. The frequency of use will depend on the degree of need from the
participant. During the intervention there will be monitoring adolescents. A
telephone questionnaire regarding use of the application and state of mind of
the participant will be taken weekly. In total there will be eight times of
(short) telephone contact during the intervention period.

No risks are expected for the participating adolescents .

Use of Beat-It:
The average time investment will depend on the frequency of use by the
adolescent. For 8 weeks, the application will be used as often as required by
the participants. For each use the time investment will be between 5 minutes
and 10 minutes .

Intervention:
At the start of the study the clients who have indicated that they are
interested in participating will be contacted by telephone. During this
telephone call they receive additional information and any questions will be
answered. If the client is interested and has agreed to participate an
appointment for the T0-measurement will be made directly. This telephone call
will take about 30 minutes. During the T0-measurement a number of
questionnaires will be filled in by both the adolescent and the parents with a
duration of about 60 minutes. For the intervention group, the 8 -week
intervention can be started. For the waiting list condition there wille be 8
weeks in which they receive their treatment as usual. Furthermore, a telephone
questionnaire regarding use of the application and state of mind of the
participant will be taken weekly with a duration of 15 minutes. After 8 weeks
of intervention there will be a post-test (T1) in which all measurements of T0
are repeated with an added satisfaction questionnaire for adolescents. The
duration of the post-test wil beabout 75 minutes for the adolscent and about 60
minutes for the parents.

Expected profit to reduce aggression problems independently, reduction of
tension and aggression and achieve better emotion regulation.