Source: JMIR Human Factors, by Kathryn M Taylor; Thomas Ward; Matteo Cella; Philippa Garety; Amy Grant; Katie Philps; Anna Wojdecka; Melanie Flory; Amy Hardy (October 2, 2026). AI-generated summary by biochip.com, published . Not independently reviewed.
Key takeaways
- King's College London collaborators integrated the Spire Stone respiratory-rate biosensor with the SloMo digital therapy app.
- Eight of 10 users said wearable prompts increased use of SloMo features and other coping strategies.
- The 10-person feasibility study did not establish clinical effectiveness across broader user needs.
Researchers at King's College London, South London and Maudsley NHS Foundation Trust, and partner organizations co-designed a wearable-enabled version of the SloMo digital therapy for people with psychosis. The prototype links the SloMo smartphone app with the Spire Stone, a clothing-adhered biosensor that tracks respiratory rate and stress-related physiology. In an eight-week feasibility study involving 10 people with lived experience of psychosis, 80% said the wearable encouraged them to use SloMo features and other coping strategies more often. The work matters because a passive sensor could prompt support at moments when distress makes it hardest to remember therapeutic tools.
Pairing a biosensor with digital therapy
SloMo is a digitally supported form of cognitive behavioral therapy for psychosis, or CBTp. It combines one-to-one sessions with a therapist and a mobile app designed to help people practice strategies in daily life, particularly strategies for slowing down fast thinking associated with paranoia.
That between-session practice can be difficult when someone feels stressed, anxious, or overwhelmed. The proposed wearable acts somewhat like a discreet check-engine light: rather than requiring a user to constantly assess their own state, it detects physiological signals that may accompany stress and can cue a response through the app.
The team selected the Spire Stone, a sensor worn on clothing that monitors breathing rate and stress physiology. The integrated interface was intended to notify users of elevated physiological signs of stress, helping them recognize the moment and consider relaxation, slower-thinking, or other SloMo coping strategies.
Designing with people who had used SloMo
The project used an inclusive, human-centered co-design process known as the Double Diamond framework. Its co-design group included 10 experts by experience, four designers, five software developers, six clinicians, and five researchers.
The 10 experts by experience had already completed SloMo during a randomized controlled trial. They were recruited across three United Kingdom National Health Service sites in London, Sussex, and Oxford, with the team seeking variation in age, ethnicity, and confidence using technology.
User feedback guided iterative changes during a five-month data collection period in 2018. Participants emphasized that the technology needed to be easy to use, secure, and tailored to each person through meaningful user control. Those priorities are particularly important in mental health settings, where concerns about privacy and misuse of personal data can affect whether people trust a device enough to wear it.
Engagement differed sharply among users
Participants tested the system for eight consecutive weeks and provided ratings and interview feedback on usability, acceptability, and engagement. Eight of the 10 participants reported that the wearable increased their use of SloMo app functions and other coping approaches.
Results varied substantially with use of the technology. The three participants who used it more reported higher usefulness, an average 25% reduction in paranoia with a standard deviation of 6%, and average satisfaction of 84%, with a standard deviation of 13%.
Among seven participants who engaged less, paranoia increased by an average of 11%, with a standard deviation of 17%. Their average satisfaction was 63%, with a standard deviation of 20%, suggesting that a wearable prompt is not equally useful or acceptable for every person.
Why This Matters
Digital therapy often depends on a person remembering to open an app and use a learned technique at exactly the point when stress can disrupt planning, attention, and recall. A physiological sensor may help bridge that gap by providing a prompt based on continuously collected bodily signals rather than relying entirely on self-monitoring.
The feasibility findings do not establish that the wearable reduces paranoia or improves clinical outcomes. They do show that people with psychosis can help shape a biosensor-linked therapy interface and that many participants perceived prompts as useful. Further development will need to make the system work across a broader range of preferences, comfort levels, and patterns of technology use.
Topics: Biosensors
Start here: Biosensors explained
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