Mobile Health Technology for Personalized Behavioral Activation Therapy

In-active behavior, lack of interest in activities, constant feeling of hopelessness, and guilt characterize depressive symptoms. Twenty percent experience depressive symptoms during their life and only 1 out of 4 receive proper treatment. Behavioral Activation (BA) is a simple therapy method for depressive symptoms.

It focuses solely on behavior, in order to support planning and enacting in pleasant activities – moving your body moves your mind. Smartphones are ubiquitous sensing devices capable of capturing the behavior of their owner. Therefore, they can be a prime tool for BA therapy. We investigated how smartphones can be used in BA therapy.

First, we showed that sensing of vigorous activity, time at home, and screen-on duration are reliable features to detect depressive symptoms. Then, we teamed up with the Psychiatric Center Copenhagen, Rigshospitalet and patients to develop a smartphone app called Moribus to assist the clinic's current BA therapy program.

Instead of registering activities and mood symptoms on paper, they were able to register on Moribus and receive visual analytic feedback. We ran a clinical feasibility study on eight of their BA patients. Overall, they stated that they preferred Moribus and gained valuable insights from the visual analytic tool.

Moribus was able to accelerate therapy sessions, but only for the “lucky few” patients that received treatment. To provide a tool independent of the clinic, we used data from Moribus in order to build a recommender model that can suggest specific activities personalized from past behavior. We ran a new design process with patients to incorporate the model in an app: MUBS.

We ran an 8-week long study of MUBS on 17 patients. The patients that used MUBS had a significant reduction in depressive symptoms. The app helped them become aware of the smaller positive things in life and enabled them to plan more pleasant activities. The PhD thesis showed that computational tools can be a perfect medium to assist patients with depressive symptoms to achieve better well-being.