Multiple meta-analyses have shown that Computer-based Cognitive Behavioral Therapy (cCBT) programs can effectively alleviate depression. On the other hand, research suggests that many users do not complete these programs, and the programs are limited in their reach as they are often not available on smartphones. In response to these challenges, UpLift is an innovative cCBT program designed for smartphones that implements a wide array of techniques to increase user engagement. It consists of eleven 40-minute sessions and a toolkit with short, repeatable modules.
This pilot study examines the beta version of UpLift to measure effectiveness and retention. Participants consisted of 120 people who thought that the program would be of benefit, recruited via Mechanical Turk. They were given 6 weeks to complete UpLift. Participants were assessed via the Patient Health Questionnaire- 9 (PHQ-9) for depression at the beginning of the study, the end of each session, a 6-week follow-up, and a 6-month follow-up. A total of 82 participants (68.3%) completed all sessions of UpLift. There was a significant difference in PHQ-9 scores for the completers from the first session (M = 9.45, SD = 4.11) and final session (M = 4.51, SD = 3.67), t(79) = 10.42, p<.0001. Results were also significant with an "intent to treat" analysis with the last observation carried forward, t(116)=10.21, p<.0001. Both follow-up assessments (at 6 weeks and 6 months) demonstrated a significant difference in PHQ-9 scores between the initial and follow-up assessment period, t(65) = 7.64, p<.0001, and t(69) = 10.00, p<.0001, respectively.
These results suggest that UpLift’s smartphone-based cCBT program has high acceptability to participants, strong completion rates, and a significant benefit in terms of depression reductions. Further evaluation of the program is warranted, including studies of the moderators of outcome (e.g. initial depression severity). Comparisons with other modes of cCBT would also help to provide direction to the field about optimal strategies for dissemination of computer-based CBT programs.