Social and non-social cognitive behavioural therapy strategies for depression: findings from the MoodMission smartphone application

Abstract

Objective: Cognitive behavioural therapy (CBT) is an evidence-based treatment of depression that can include strategies with a social component. Mental health apps (MHapps) are widely used amongst individuals with depression to access CBT strategies. Despite the research on CBT, it is not clear whether there is a difference in the correlation of CBT strategies for depression with a social component or not. Using MoodMission, an empirically validated MHapp that recommends CBT strategies (termed “Missions”), this study investigated whether social or non-social CBT strategies would correlate with participants’ ratings of helpfulness and distress reduction. Method: A total of 4,107 participants who completed at least one social or non-social Mission and baseline 9-item Patient Health Questionnaire (PHQ-9) were included. Multilevel modelling with 2-levels was used, with level 1 entered as the fixed effect between Mission type in predicting subjective helpfulness and distress reduction, and level 2 entered as the random effects of participant covariates of age, gender, and PHQ-9 scores. Results: Findings indicated that Missions without a social component was a significant positive predictor in distress reduction, but there was no significant difference in predicting subjective helpfulness. Conclusion: These findings suggest that individuals with depression using MHapps could benefit from engaging in non-social CBT strategies for the reduction of subjective distress, more so than social CBT strategies. Study limitations included the self-report study design, subjective outcome measures, and a higher representation of female (80.6%) participants. Further research is required to investigate the clinical significance of these findings with a more representative sample.