3 - (SYM 124) Bridging the Therapy Gap in Major Depressive Disorder: A Feasibility Pilot of Cognitive Behavioral Immersion in the Metaverse

Major depressive disorder (MDD) represents a significant public health challenge and there are not enough therapists to meet the demand for treatment. This disparity is highlighted by the treatment-prevalence paradox, where despite advancements in depression interventions, prevalence rates continue to rise. One way to address the provider shortage is through training lay counselors to facilitate Internet-based cognitive behavioral support groups. Instead of using traditional video technology, it is possible to facilitate CBT-based depression groups through immersive 3-D environments where each person is represented as an avatar and communicates via voice (e.g., “the metaverse”). This technology can be used to transport group members from their separate real-world environments and place them into a shared virtual environment. Innerworld is a clinical research platform that utilizes the metaverse to deliver Cognitive Behavioral Immersion (CBI), a novel synchronous cognitive behavioral skills training program delivered by lay counselors in the metaverse. An eight-session feasibility pilot was conducted with over 500 participants to explore the feasibility of delivering CBI for individuals with symptoms of depression. Participants could attend the eight sessions in a closed group or choose sessions individually in an open 'à la carte' model for personalized relevance. The ‘à la carte’ model was developed based on participant feedback during the pilot. Lay counselors could also present pre-recorded avatars to teach psychoeducational concepts and standardize the delivery of content during groups. Data will be presented including qualitative feedback, change in PHQ-9 scores, retention and platform usage metadata. Lastly, strategies for implementing user-centered design principles through real-world testing and iteration will be shared. Innerworld’s unique combination of structured groups and casual social interaction enables a real-time community to provide feedback and suggest ideas to improve its depression intervention. Through involving the community in the development and dissemination of technology-based CBT interventions for MDD, it may be possible to develop new treatment models that help to overcome the treatment-prevalence paradox.