“that Which Is Measured Improves”: A Theoretical and Empirical Review of Self-monitoring in Self-management and Adaptive Behavior Change - “that Which Is Measured Improves”: A Theoretical and Empirical Review of Self-monitoring in Self-management and Adaptive Behavior Change - Open Access Pub

Current psychological treatment approaches that rely on time-intensive, face-to-face psychotherapy are not capable of meeting the demand for mental health services. Mental health interventions that promote self-regulation and self-management of symptoms will play an increasingly important role in the well-being of millions of individuals. Self-monitoring is a core assessment and intervention component of many mental health interventions and an obligatory first step in the self-regulation process. The present paper reviews prominent theories of self-regulation and describes classic studies spanning clinical, social, cognitive, and personality psychology, which identify potential mechanisms underlying self-monitoring. At the empirical level, we describe the use of self-monitoring across a range of behavioral interventions directed at mental health and physical outcomes, identify factors that influence the effects of self-monitoring, and suggest ways in which technology can be incorporated into these interventions to improve the reach of psychological interventions. DOI10.14302/issn.2474-9273.jbtm-16-1180 The vast majority of individuals with mental health needs who would benefit from efficacious psychological treatments do not receive them.1 The failure of current one-on-one treatment modalities to meet existing mental health needs requires economically feasible, short-term and, in some cases, self-administered or web-based prescriptive treatments that exist outside specialized health care settings.2 Health care is becoming increasingly patient-centered, moving away from provider-centric models of care to ones in which patients take increasing responsibility for lifestyle modifications, behavioral change, and self-regulation.3, 4 This may be particularly true for psychological health.5 The focus of this theoretical and empirical review is the potential utility of self-monitoring for behavior change within the context of mental health interventions. An apocryphal quote often attributed to the mathematician and statistician Karl Pearson, “That which is measured improves,” captures the seemingly self-evident and logical conclusion that systematic self-monitoring (the process of measurement) facilitates behavior change. The evidence for this conclusion will be discussed, first, in light of theoretical models of self-regulation, and then in the context of empirical findings, including recent literature on self-management techniques for mental health utilizing technology. The review to follow will begin with a brief historical narrative of self-regulation