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ViewAttendees 4

Symposia

Technology/Digital Health

Technology-Led, Human-Centered Innovations In Treating Major Depressive Disorder

5 - (SYM 124) Use of “therapy in Your Pocket”: Patterns of Skills Review in Smartphone Cognitive Behavioral Therapy (CBT) for Depression

Sunday, November 17, 2024
8:30 AM – 10:00 AM EST
Location: Liberty B, Level 3, Marriott Downtown
Abstract Body

Smartphones could enhance CBT for depression. Users may frequently and flexibly access bite-size CBT content, review and practice skills, and thereby achieve better outcomes. Yet, little is known about how users spontaneously access content and the effects of such choices. Participants (N=26) were enrolled in an 8-week, therapist-guided smartphone CBT for depression. For each participant, we calculated overall use (i.e., total number of app interactions), within-module use (i.e., interactions with content from current module), and between-module use (i.e., interactions with content from a previous module). We examined the degree to which people repeated and revisited content and relationship between overall, within-, and between-module interactions and baseline and end-of-treatment symptoms. Eighteen people (69%) completed all content and 14 (53%) used content more than was required. Overall number of interactions varied widely (Mean=71.54, Median=63, SD=31.89) and was not associated with symptom severity. Within modules, most participants consistently used content more than was required to progress and tended to return to all types of content rather than focus on one skill. By contrast, only 15 people ever revisited prior content, revisit frequency was low (Mean=4.08, Median=1, Mode=0), and revisits were associated with more severe baseline and end-of-treatment depression. Neither total number nor within-module interactions was associated with symptom severity. We found that providing content at users’ fingertips can translate to flexible review or use of skills for many; this is encouraging as depression is characterized by low motivation and energy. However, that module revisits were uncommon and associated with greater depressive symptoms raises additional questions, including whether users naturally gravitate towards the type and frequency of skills practice most likely to benefit them. Overall, results support that frequency of use is an insufficient engagement metric. The nuance of what people are using and when is essential for personalizing recommendations, improving app design, and yielding better outcomes for depression.