title: Randomized Controlled Trial of SuperBetter, a Smartphone-Based/Internet-Based Self-Help Tool to Reduce Depressive Symptoms.
abstract: OBJECTIVE
  Technological advances have sparked the development of computer- and smartphone-based self-help programs for depressed people, but these programs' efficacy is uncertain. This randomized controlled trial evaluated an intervention called SuperBetter (SB), which is accessed via smartphone and/or the SB Web site.
  
  
  METHODS
  Online, we recruited 283 adult iPhone(®) (Apple, Cupertino, CA) users with significant depression symptoms according to the Center for Epidemiological Studies Depression questionnaire (CES-D). They were randomly assigned to one of three conditions: (a) a version of SB using cognitive-behavioral therapy and positive psychotherapy strategies to target depression (CBT-PPT SB); (b) a general SB version focused on self-esteem and acceptance (General SB); or (c) a waiting list control group (WL). The two SB groups were instructed to use SB for 10 minutes daily for 1 month. All participants completed psychological distress and well-being measures online every 2 weeks through follow-up. An intent-to-treat analysis was conducted using hierarchical linear modeling.
  
  
  RESULTS
  As hypothesized, SB participants achieved greater reductions in CES-D scores than WL participants by posttest (Cohen's d=0.67) and by follow-up (d=1.05). Contrary to prediction, CBT-PPT SB did not perform better than General SB; both versions of SB were more effective than the WL control. Differences between SB versions favored General SB but were not statistically significant.
  
  
  CONCLUSIONS
  These large effect sizes should be interpreted cautiously in light of high attrition rates and the motivated, self-selected sample. Nonetheless, smartphone-based/Internet-based self-help may play an important role in treating depression.
authors.affiliation: 1 Department of Psychology, University of Pennsylvania , Philadelphia, Pennsylvania.
authors.forename: Ann Marie
authors.initials: AM
authors.lastname: Roepke
authors.affiliation: 1 Department of Psychology, University of Pennsylvania , Philadelphia, Pennsylvania.
authors.forename: Sara R
authors.initials: SR
authors.lastname: Jaffee
authors.affiliation: 1 Department of Psychology, University of Pennsylvania , Philadelphia, Pennsylvania.
authors.forename: Olivia M
authors.initials: OM
authors.lastname: Riffle
authors.affiliation: 2 SuperBetter Labs, LLC , San Francisco, California.
authors.forename: Jane
authors.initials: J
authors.lastname: McGonigal
authors.affiliation: 2 SuperBetter Labs, LLC , San Francisco, California.
authors.forename: Rose
authors.initials: R
authors.lastname: Broome
authors.affiliation: 2 SuperBetter Labs, LLC , San Francisco, California.
authors.forename: Bez
authors.initials: B
authors.lastname: Maxwell
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001007:Anxiety / Q000523:psychology; D016009:Chi-Square Distribution; D003863:Depression / Q000628:therapy*; D005260:Female; D006801:Humans; D020407:Internet / Q000295:instrumentation*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010352:Patient Dropouts; D012648:Self Care / Q000295:instrumentation / Q000379:methods; D012649:Self Concept; D020377:Self Efficacy; D000068997:Smartphone / Q000295:instrumentation*; D012984:Software; D011795:Surveys and Questionnaires; D013813:Therapy, Computer-Assisted / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome