Towards thriving: extending computerised cognitive behavioural therapy

Positive Psychology suggests that every one of us has the potential to increase our psychological wellbeing, while Positive Computing endeavours to develop technologies to support wellbeing and human potential. One such technology, Computerised Cognitive Behavioural Therapy (CCBT), has been found to be effective in increasing wellbeing for individuals with diagnosed mental health conditions. However, its ability to improve wellbeing in people without pre-existing mental health conditions is less well understood. To explore use in this population, an 8-week long user trial of a CCBT programme was conducted. Results provided insight into CCBT's ability to; increase subjective wellbeing; increase empathy for individuals who do experience mental health conditions; enhance self-reflection; increase positive behaviour change; and increase motivation to action. In lieu of perpetually creating new health technologies, we suggest a design approach which explores the extension and repurposing of existing evidence-based technologies to support and enhance the wellbeing of previously unintended populations. We found CCBT to be a tool which could contribute to the wellbeing of wider society from a preventative, proactive and positive perspective.

[1]  D. Vogel,et al.  Measuring Perceptions of Stigmatization by Others for Seeking Psychological Help: Reliability and Validity of a New Stigma Scale With College Students , 2009 .

[2]  V. Braun,et al.  Using thematic analysis in psychology , 2006 .

[3]  M. Csíkszentmihályi,et al.  Positive psychology. An introduction. , 2000, The American psychologist.

[4]  P. Corrigan.  How stigma interferes with mental health care. , 2004, The American psychologist.

[5]  B. Everitt,et al.  Clinical efficacy of computerised cognitive-behavioural therapy for anxiety and depression in primary care: Randomised controlled trial , 2004, British Journal of Psychiatry.

[6]  Gregory D. Abowd,et al.  Investigating the use of circles in social networks to support independence of individuals with autism , 2013, CHI.

[7]  David Coyle,et al.  Qualitative Meta-Synthesis of User Experience of Computerised Therapy for Depression and Anxiety , 2014, PloS one.

[8]  Irina Shklovski,et al.  Design for Existential Crisis , 2017, CHI Extended Abstracts.

[9]  Daniel Stein,et al.  Disentangling the Relationships Among Self-Reflection, Insight, and Subjective Well-Being: The Role of Dysfunctional Attitudes and Core Self-Evaluations , 2014, The Journal of psychology.

[10]  David Coyle,et al.  Computers in talk-based mental health interventions , 2007, Interact. Comput..

[11]  Stefan Rennick Egglestone,et al.  Health Technologies 'In the Wild': Experiences of Engagement with Computerised CBT , 2016, CHI.

[12]  Tayyab Rashid.  Positive psychotherapy: A strength-based approach , 2015 .

[13]  P. Cuijpers,et al.  Cost-Utility and Cost-Effectiveness of Internet-Based Treatment for Adults With Depressive Symptoms: Randomized Trial , 2010, Journal of medical Internet research.

[14]  G. Andersson,et al.  Pros and cons of online cognitive–behavioural therapy , 2008, British Journal of Psychiatry.

[15]  C. Ringwalt,et al.  Evaluation of an Internet-based alcohol misuse prevention course for college freshmen: findings of a randomized multi-campus trial. , 2011, American journal of preventive medicine.

[16]  Patrick W. Corrigan,et al.  Strategies for assessing and diminishing self-stigma , 2005 .

[17]  Sonja Lyubomirsky,et al.  Enhancing well-being and alleviating depressive symptoms with positive psychology interventions: a practice-friendly meta-analysis. , 2009, Journal of clinical psychology.

[18]  R. Lederman,et al.  On the HORYZON: Moderated online social therapy for long-term recovery in first episode psychosis , 2013, Schizophrenia Research.

[19]  M. Seligman,et al.  Group prevention of depression and anxiety symptoms. , 2007, Behaviour research and therapy.

[20]  Nigel Lester,et al.  Madness Explained: Psychosis and Human Nature , 2003, BMJ : British Medical Journal.

[21]  Katie Derthick,et al.  Understanding meditation and technology use , 2014, CHI Extended Abstracts.

[22]  Jeffery D. Higginbotham,et al.  Design Meets Disability , 2009 .

[23]  B. J. Fogg,et al.  A behavior model for persuasive design , 2009, Persuasive '09.

[24]  C. D. Erickson.  On the Stigma of Mental Illness: Practical Strategies for Research and Social Change , 2006 .

[25]  Z. Segal,et al.  How does cognitive therapy prevent depressive relapse and why should attentional control (mindfulness) training help? , 1995, Behaviour research and therapy.

[26]  E. Vesterinen,et al.  Affective Computing , 2009, Encyclopedia of Biometrics.

[27]  Jonathan Haidt,et al.  Flourishing: Positive psychology and the life well-lived. , 2003 .

[28]  B. Fredrickson.  The role of positive emotions in positive psychology. The broaden-and-build theory of positive emotions. , 2001, The American psychologist.

[29]  M. Seligman.  Flourish: A Visionary New Understanding of Happiness and Well-being , 2011 .

[30]  Young Lee,et al.  Designing wellness interventions and applications , 2012, CHI EA '12.

[31]  Kristján Kristjánsson,et al.  Positive Psychology, Happiness, and Virtue: The Troublesome Conceptual Issues , 2010 .

[32]  C. Williams,et al.  The use and feasibility of a CBT intervention. , 2011, Child and adolescent mental health.

[33]  J. Clarkson,et al.  Inclusive design , 2010 .

[34]  E. Caine,et al.  Risk of suicide and related adverse outcomes after exposure to a suicide prevention programme in the US Air Force: cohort study , 2003, BMJ : British Medical Journal.

[35]  H. Christensen,et al.  Delivering interventions for depression by using the internet: randomised controlled trial , 2004, BMJ : British Medical Journal.

[36]  Alan F. Newell,et al.  Inclusive design or assistive technology , 2003 .

[37]  David Coyle,et al.  Exploratory evaluations of a computer game supporting cognitive behavioural therapy for adolescents , 2011, CHI.

[38]  BJ Fogg,et al.  Creating persuasive technologies: an eight-step design process , 2009, Persuasive '09.

[39]  S. Lyubomirsky,et al.  The Benefits of Frequent Positive Affect: Does Happiness Lead to Success? , 2005, Psychological bulletin.

[40]  Leanne M. Casey,et al.  Dropout from Internet-based treatment for psychological disorders. , 2010, The British journal of clinical psychology.

[41]  E. Stice,et al.  Efficacy trial of a selective prevention program targeting both eating disorder symptoms and unhealthy weight gain among female college students. , 2012, Journal of consulting and clinical psychology.

[42]  S. Lyubomirsky,et al.  How Do Simple Positive Activities Increase Well-Being? , 2013 .

[43]  J. Kenardy,et al.  Internet-delivered indicated prevention for anxiety disorders: Six-month follow-up , 2006 .

[44]  A. Parks,et al.  Disseminating Self-Help: Positive Psychology Exercises in an Online Trial , 2012, Journal of medical Internet research.

[45]  Christopher Peterson,et al.  A Primer in Positive Psychology , 2006 .

[46]  H. Christensen,et al.  Internet-based mental health programs: a powerful tool in the rural medical kit. , 2007, The Australian journal of rural health.

[47]  G. Andersson.  Using the Internet to provide cognitive behaviour therapy. , 2009, Behaviour research and therapy.

[48]  Ann Light,et al.  Towards Mindfulness: Between a Detour and a Portal , 2015, CHI Extended Abstracts.

[49]  A. Christensen,et al.  A comparison of computer-based versus traditional individual psychotherapy. , 2001 .

[50]  Per Carlbring,et al.  Guided Internet‐based vs. face‐to‐face cognitive behavior therapy for psychiatric and somatic disorders: a systematic review and meta‐analysis , 2014, World psychiatry : official journal of the World Psychiatric Association.

[51]  Jennie Carroll,et al.  Completing design in use: closing the appropriation cycle , 2004, ECIS.

[52]  Edward L. Deci,et al.  A Self-Determination Theory Perspective on Social, Institutional, Cultural, and Economic Supports for Autonomy and Their Importance for Well-Being , 2011 .

[53]  David W. McDonald,et al.  Theory-driven design strategies for technologies that support behavior change in everyday life , 2009, CHI.

[54]  M. Rapaport,et al.  Classification and treatment of sub-threshold depression , 2006, Current opinion in psychiatry.

[55]  Kathleen M Griffiths,et al.  Effectiveness of a Web-Based Cognitive-Behavioral Tool to Improve Mental Well-Being in the General Population: Randomized Controlled Trial , 2012, Journal of medical Internet research.

[56]  Yvonne Rogers,et al.  Moving on from Weiser's Vision of Calm Computing: Engaging UbiComp Experiences , 2006, UbiComp.

[57]  Rafael A. Calvo,et al.  Positive computing: technology for a wiser world , 2012, INTR.

[58]  Reeva Lederman,et al.  Moderated online social therapy: Designing and evaluating technology for mental health , 2014, TCHI.

[59]  Rosa María Baños,et al.  Positive Technology: Using Interactive Technologies to Promote Positive Functioning , 2012, Cyberpsychology Behav. Soc. Netw..

[60]  Karl Rihaczek,et al.  Positive computing , 2016, Datenschutz und Datensicherheit - DuD.

[61]  David Coyle,et al.  Design and evaluation guidelines for mental health technologies , 2010, Interact. Comput..