Opening the contextual black box: a case for idiographic experience sampling of context for clinical applications

The experience sampling method (ESM) is increasingly used as a clinical tool in mental health care. Currently, ESM studies pay relatively little attention to assessing contextual factors, such as a person's experience and perception of events, activities, and social interactions. This has been referred to as the 'contextual black box'. However, personalized context information is essential for applications in clinical settings to gain insight in triggering and maintaining factors of psychopathology. Typically, ESM context items are designed for nomothetic research questions, to capture broad factors that are shared across individuals, such as 'unpleasant events'. We provide an overview of such nomothetic items. We argue that these items have limited clinical utility and describe idiographic alternatives to ESM context assessment to obtain more specific and personalized information about individual clients. Specifically, we present three existing idiographic ESM techniques to context assessment with clinical potential. First, we illustrate open-ended ESM items that prompt clients to fill in text, such as a description of a specific unpleasant event they experienced. Second, we describe personalized response options and self-learning items that ask clients to define personally relevant response categories, such as types of events the client finds unpleasant. Third, we describe personalized ESM items that client and clinician select or formulate together for concepts of interest. We discuss the advantages and disadvantages of these idiographic techniques. Additionally, we suggest future directions for clinical research aiming to address the 'contextual black box' and enhance the potential of ESM in mental health care.