Presentation by Sabrina Darrow, PhD; Serina Deen, MD, MPH; and Yan Leykin, PhD, at the UCSF Depression Center's "Depression: Pathways to Resilience and Recovery" event on September 13, 2014.

1. ONLINE TOOLS FOR
ASSESSMENT &
TREATMENT
Sabrina Darrow, PhD
Serina Deen, MD, MPH
Yan Leykin, PhD
UCSF Department of Psychiatry

2. What’s out there
Plenty, actually
Government
Research
Patient communities
Business
Weird
people

3. Non-intervention resources
Information only
What is depression or
bipolar disorder?
Now what do I do?

4. Non-intervention resources
Information only
Screening
http://tiny.ucsf.edu/mood_screener
What is depression or
bipolar disorder?
How to do you feel?
Now what do I do?
How are you compared
to before?

5. Non-intervention resources
Information only
Screening
http://tiny.ucsf.edu/mood_screener
Community support sites
How to do you feel?
You are not alone
How are you compared
to before?
Talk with other people
who share your
experience

6. Interventions
Level of support
Supported
• Provider, as part of care
• By lay coach
Unsupported
• No human contact
• Fully-automated, user-driven

7. Interventions
Breadth
Comprehensive
• Many lessons, tools
• Includes kitchen sink
Micro-intervention
• Tool-based
• Symptom-based
http://tiny.ucsf.edu/mint

8. Interventions features
• Lessons / Tools
• Interactive elements
• Videos
• Forum
• Trackers
• Feedback
• Downloads
• Tailoring/personalization
• Connection to provider, if available
• Private and Confidential

9. Intervention delivered
Treatment approach
• Most use cognitive behavioral therapy (CBT)
• Others are less common
• Problem solving therapy, acceptance and commitment therapy,
cognitive remediation, interpersonal therapy, etc.
Availability

10. Mobile – types of apps
• Flexible – user defined
• Mindfulness
Tracking/assessment
• Specific
Sleep?
Coping strategies
• Positive statements
Interventions
________?

11. Why use apps?
Tracking can help
• Increase awareness
• Notice patterns
• Part of interventions
Always by your side
Quick booster / reminder

12. Quackery
• “Cure!” “100% effective!” “Everyone!”
• Treatment process is unclear
• Not based on traceable science
• Authors are unknown or not MHP
– Or celebrities
• Blames you for not improving

13. Quackery – 100% effective cure!!!
• Be careful with frivolous googling
• www.quackwatch.com
• Whenever in doubt – ask for info
• Even free resources can be quackery
– People with agendas

14. What to expect when you are expecting
to become a research participant
Consent!!!
• Full disclosure of everything
• Very important to read

15. What to expect when you are expecting
to become a research participant
Consent!!!
• Full disclosure of everything
• Very important to read
Purpose – benefit society, not participants
• Protocol is everything
• Will not be broken

16. What to expect when you are expecting
to become a research participant
Consent!!!
• Full disclosure of everything
• Very important to read
Purpose – benefit society, not participants
• Protocol is everything
• Will not be broken
You are extremely valuable
• Hounded for data, information
• May be paid for use or follow-up

17. What to expect when you are expecting
to become a research participant
Consent!!!
• Full disclosure of everything
• Very important to read
Purpose – benefit society, not participants
• Protocol is everything
• Will not be broken
You are extremely valuable
• Hounded for data, information
• May be paid for use or follow-up
Can find the new, best, and most exciting
• May not work

18. EXAMPLES:
INFORMATION ONLY
WEBSITES

19. National Institute of Mental Health
• Website:
https://www.nimh.nih.gov/health/topics/depression/index.s
html
• About: One of the institutes in the National Institutes of
Health, an agency of the US Department of Health and
Human Services
• Features:
• Summary of symptoms of depression, causes, risk factors, and
treatment options
• Links to ongoing clinical trials
• Links to latest research discoveries about depression

22. WebMD
• Website: http://www.webmd.com/depression/default.htm
• About: American corporation that provides health
information
• Features: Depression Health Center
• Lists symptoms of depression
• Describes how antidepressants work
• Lists ways to treat depression naturally
• Has videos about depression

25. EXAMPLES:
COMMUNITY SUPPORT
WEBSITES

26. National Alliance for Mental Illness (NAMI)
• Website: http://www.nami.org/
• About: Grassroots mental health organization that
advocates for access to services, treatment, supports and
research for mental illness
• Features:
• Online information about Depression
• Information HelpLine: information and referral service
• Free education and support programs for individuals, family
members, providers and the general public
• Volunteer opportunities such as NAMIWalks

31. Depression and Bipolar Support Alliance
(DBSA)
• Website: http://www.dbsalliance.org
• About: Peer-directed national organization focusing on
depression and bipolar disorder
• Offers:
• Information about depression (website, podcasts, brochures,
videos)
• In-person and online support groups
• Family member resources

34. EXAMPLES:
INTERVENTION
WEBSITES

35. MoodGYM
• About: Web program designed to prevent depression
• Developed by: National Institute for Mental Health Research at the
Australian National University
• Time Commitment: Five modules each taking 20 to 40 minutes to
complete
• Type: Unsupported
• Treatment Approach: CBT
• Cost: Free
• Evidence Base: Very Good

41. This Way Up
• About: Guided programs and self-help programs for depression and
anxiety
• Designed by: St Vincent’s Hospital and the University of New South
Wales in Australia
• Time commitment: The full course lasts 8 weeks
• Type: Supported and Unsupported
• Treatment Approach: CBT
• Cost: $55 AUD (~$50 USD) for supported, free for unsupported
• Evidence Base: Good

48. Deprexis
• About: 10 content modules representing different psychotherapeutic
approaches to depression
• Developed by: German public health company named Gaia
• Time commitment: 10 to 60 minutes for each of the 10 modules
• Type: Unsupported
• Treatment Approach: Mainly CBT but also Mindfulness, Problem
Solving, Positive Psychology and Emotion-Focused Interventions,
among others
• Cost: Fee, but free for students and unemployed
• Evidence Base: Fair

52. EXAMPLES:
MOBILE APPS

53. Example of tracking app:
T2 Mood Tracker
• Anxiety, depression, general well-being, head injury,
PTSD, stress
• Customizable scales, automatically graphs input
• Can share info with provider

54. Example of a Mindfulness App:
Calm

55. Example of a coping strategies app:
Positive Thinking & My Thoughts+

56. Example of an Intervention App:
MoodKit
• Based on CBT
• Suggests activities
• Analyze thoughts
• Track Mood
• Journal

57. Intervention Apps
Currently under study and not available to
the general public
• Mobilyze!
• Get Happy Program

58. Where to find interventions
• clinicaltrials.gov
•centerwatch.com
•patientslikeme.org
•beacon.anu.edu.au