Smartphone app HabitWorks improves anxiety and depression symptoms

In an effort to increase access to evidence-based interventions to help manage anxiety and depression, Mass General Brigham investigators have developed and tested a novel digital intervention called HabitWorks. HabitWorks is a smartphone app that uses personalized exercises to target interpretation bias, or the mental habit of jumping to negative conclusions in uncertain situations. According to results of a randomized trial published in the Journal of Consulting and Clinical Psychology, HabitWorks was effective at improving participants' interpretation bias and global symptom severity and functioning, suggesting a feasible and scalable way to deliver tools that can benefit personal mental health. 

When we negatively interpret a situation, it impacts how we feel and respond-especially in people experiencing anxiety and depression. By providing a simple, game-like exercise through an app, we have shown that we can help individuals gain insight into their thinking patterns in a more accessible and engaging way, that leads to meaningful improvements."

Courtney Beard, PhD, senior author, director of the Cognition and Affect Research Education (CARE) Laboratory at McLean Hospital, member of the Mass General Brigham healthcare system

Access to evidence-based treatments for anxiety and depression remains a significant challenge for many individuals due to provider shortages, high costs, and stigma surrounding mental health care. Digital tools have the potential to bridge these gaps; however, most available apps are not rigorously studied, resulting in a wide variance in quality and effectiveness. In addition, users often drop off these apps shortly after download. The researchers designed HabitWorks with these limitations in mind, working with an advisory board of individuals with lived experience of anxiety and depression.

In their new study, the investigators enrolled 340 adults across 44 states, who were randomized to use the HabitWorks app for four weeks or to a control condition that involved self-assessment surveys tracking symptoms of depression and anxiety.

Participants using HabitWorks reported significantly greater improvements in interpretation bias, functioning, and overall mental health symptom severity after one month compared to the control group. HabitWorks also achieved excellent retention rates with 77.8% of participants still using the app in week 4 and 84.4% of participants completing the post-intervention assessment.

"One thing that makes our approach unique in digital mental health is its focus on short, five-minute exercises," said lead author Alexandra Silverman, PhD, a clinical investigator in the CARE Laboratory. "Unlike traditional interventions that mimic long therapy sessions, HabitWorks aligns with how people use their phones in short bursts, creating an approach that fits into daily life."

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