A new study has shown that a cognitive behavioral therapy (CBT) app can significantly reduce the chances of depression in young people who are at high risk.
This app could be an effective, low-cost public health tool to support mental health in a group that is increasingly facing anxiety and depression.
Globally, mental health issues among young people are on the rise, and experts are concerned about how to address this growing problem.
Finding ways to prevent anxiety and depression in young people has become a priority, and mobile apps have been suggested as part of the solution.
Although there is some evidence that mental health apps can help treat depression and anxiety, this study, led by the University of Exeter, is one of the first large-scale projects to rigorously test an app aimed at preventing depression in young people.
The four-year study involved two linked trials, ECoWeB-PREVENT and ECoWeB-PROMOTE, across four countries: the UK, Germany, Belgium, and Spain.
The results, published in Lancet Digital Health, reveal that a CBT-based self-help app can help protect young people who are at higher risk of depression.
Professor Ed Watkins, who led the project, said, “For young people who are at elevated risk, the CBT app shows a clear preventative effect against depression.
It also improved their quality of life, work performance, and social functioning. However, we found that for young people who are already doing well, the app didn’t make much of a difference.”
The study highlights that prevention works best when the focus is on those who are more at risk, rather than using the app universally.
This means that identifying young people who are vulnerable—through online screening or professional referrals—could be key to getting the best results.
The study tested the impact of three different apps on young people aged 16 to 22. A total of 3,700 participants took part in one of the largest trials of its kind.
The young people were split into two groups: 1,200 who had signs of emotional difficulties, like overthinking and worrying, and 2,500 who were mentally healthier.
The first group, who were at higher risk for depression, focused on the prevention of depression, while the second group focused on promoting general mental well-being.
Both groups were randomly assigned to use one of three apps. One was a self-monitoring app where participants tracked their emotions daily. The second was a self-help app aimed at improving emotional skills.
The third was a CBT-based app designed to teach cognitive behavioral strategies to manage thoughts and emotions. Participants were monitored at three months and 12 months to see how their mental health had changed.
The results were promising for those at higher risk of depression. The CBT app helped prevent an increase in depression symptoms in this group compared to the self-monitoring app.
However, for young people who were not at risk, there was no significant difference in the outcomes, no matter which app they used.
Professor Watkins explained, “Even if young people only used the CBT app a few times, we still saw small but meaningful benefits. Since the app can be used by large numbers of people at a low cost, it could be a valuable tool for public health, alongside other mental health services.”
The next steps for the research team include exploring what parts of the app were most helpful, improving engagement with the app, and finding ways to ensure young people continue using it over time.
This large project involved 13 partners, including companies specializing in voice analysis and app development. Universities from the UK, Germany, Belgium, and Spain led the trials, while the University of Oxford focused on analyzing the data.
Overall, this study offers hope that digital tools like CBT apps can help prevent depression in young people, especially those who are most vulnerable. By targeting at-risk individuals, these apps could become a valuable part of a wider mental health strategy.
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The research findings can be found in The Lancet Digital Health.
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