title: Behavioral activation-based guided self-help treatment administered through a smartphone application: study protocol for a randomized controlled trial.
abstract: BACKGROUND
  The need for cost-effective interventions for people suffering from major depressive disorders is essential. Behavioral activation is an intervention that can largely benefit from the use of new mobile technologies (for example smartphones). Therefore, developing smartphone-based behavioral activation interventions might be a way to develop cost-effective treatments for people suffering from major depressive disorders. The aim of this study will be to test the effects of a smartphone-delivered behavioral activation treatment.
  
  
  METHODS
  The study will be a randomized controlled trial with a sample size of 120 participants, with 60 patients in each group. The treatment group includes an 8-week smartphone-based behavioral activation intervention, with minimal therapist contact. The smartphone-based intervention consists of a web-based psychoeducation, and a smartphone application. There is also a back-end system where the therapist can see reports from the patients or activities being reported. In the attention control group, we will include brief online education and then recommend use of a smartphone application that is not directly aimed at depression (for example, 'Effective meditation'). The duration of the control condition will also be 8 weeks. For ethical reasons we will give the participants in the control group access to the behavioral activation treatment following the 8-week treatment period.
  
  
  CONCLUSIONS
  We believe that this trial has at least three important implications. First, we believe that smartphones can be integrated even further into society and therefore may serve an important role in health care. Second, while behavioral activation is a psychological treatment approach for which there is empirical support, the use of a smartphone application could serve as the therapist's prolonged arm into the daily life of the patient. Third, as we have been doing trials on guided Internet treatment for more than 10 years it is now time to move to the next generation of information technology - smartphones - which are not only relevant for Swedish conditions but also for developing countries in the world which are increasingly empowered by mobile phones with Internet connection.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01463020.
authors.affiliation: Department of Behavioral Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden. kien.hoa.ly@liu.se
authors.forename: Kien Hoa
authors.initials: KH
authors.lastname: Ly
authors.forename: Per
authors.initials: P
authors.lastname: Carlbring
authors.forename: Gerhard
authors.initials: G
authors.lastname: Andersson
mesh_terms: D001521:Behavior Therapy / Q000295:instrumentation* / Q000379:methods; D040421:Cell Phone; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D010353:Patient Education as Topic; D011569:Psychiatric Status Rating Scales; D012107:Research Design; D012648:Self Care / Q000295:instrumentation*; D013548:Sweden; D013997:Time Factors; D016896:Treatment Outcome