Online Tool with Dialectical Behavior Therapy for Depression

Overseen By Alexander Daros, PhD

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: University of Windsor

Disqualifiers: Psychosis, Mania, Intoxication, others

Stay on Your Current Meds You can continue your current medications while participating

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 5

Duration: 12 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests an online tool designed to assist people with depression who are already participating in dialectical behavior therapy (DBT). The tool, called Pocket Skills, provides video lessons and interactive exercises to teach DBT skills. Researchers aim to determine if using this tool alongside regular DBT sessions is beneficial and user-friendly. Individuals who have recently started DBT and have used alcohol or drugs in the past month might be suitable candidates for this study. As an unphased trial, this study presents a unique opportunity to contribute to innovative research that could enhance DBT therapy for others.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the study team or your doctor.

What prior data suggests that this online tool is safe for use in depression treatment?

Research has shown that the Pocket Skills Adjunct, an online tool based on dialectical behavior therapy (DBT), has been tested in several studies. These studies found that users generally had a positive experience. Most participants found it easy to use, and no major negative effects were reported. Specifically, after four weeks of use, users experienced fewer symptoms of depression and anxiety and used DBT skills more frequently. This suggests that the Pocket Skills Adjunct is a safe addition to standard DBT services. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about Pocket Skills 2.0 because it brings a new dimension to treating depression using dialectical behavior therapy (DBT). Unlike traditional therapy sessions, this tool is web-based and allows users to interact with a chatbot for a personalized experience. It stands apart by featuring lessons with Dr. Linehan through engaging videos and gamified elements like points and unlockable content, which can increase user engagement and adherence. This approach makes DBT skills training more accessible and potentially more effective for users who prefer digital interfaces over in-person sessions.

What evidence suggests that the Pocket Skills Adjunct is effective for depression?

Research shows that the Pocket Skills tool, an online program for teaching Dialectical Behavior Therapy (DBT) skills, can help reduce depression and anxiety. In this trial, participants will use the Pocket Skills tool for 4 weeks. Previous studies have shown that participants improved by using more DBT skills, indicating that Pocket Skills enhances learning and application of these skills. The tool includes interactive lessons and videos, which studies have proven to boost user engagement and effectiveness. ^{1 4 6 7 8}

Are You a Good Fit for This Trial?

This trial is for individuals struggling with alcoholism, substance use disorders, depression, or anxiety. Participants should already be receiving standard group Dialectical Behavior Therapy (DBT) services and are interested in an additional online tool to support their treatment.

Inclusion Criteria

I am between 16 and 70 years old.

Past year alcohol or substance use disorder

Reports at least 'contemplation' levels (score of 4+) of change with respect to substance use problems

Exclusion Criteria

Any known practical factors that would preclude participation (e.g., extended absences) in the study

Participation in another treatment/intervention study

Acute psychiatric (e.g., psychosis, mania) or medical condition (including acute intoxication or withdrawal requiring medical attention) that precludes participation in this study

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1 week

1 visit (telephone)

Baseline Assessment

Participants complete a baseline session via video conferencing, including a brief interview and questionnaires

1 week

1 visit (virtual)

Treatment

Participants use the Pocket Skills 2.0 app alongside standard DBT group treatment

12 weeks

Self-guided, with app usage at least twice a week

Follow-up

Participants complete follow-up assessments at weeks 4, 8, and 12

12 weeks

3 visits (remote assessments)

What Are the Treatments Tested in This Trial?

Interventions

• Pocket Skills Adjunct

Trial Overview The study tests an online adjunct intervention based on DBT skills training. It's designed to see if adding this tool to regular group therapy sessions helps people more than the therapy alone over a period of 12 weeks with assessments every 4 weeks.

How Is the Trial Designed?

Group I: Adjunct Intervention Experimental Treatment 1 Intervention

The intervention is called Pocket Skills 2.0, which is a web-based dialectical behavior therapy skills training (DBT-ST) intervention. The content and material is based on the most recent Linehan (2014) DBT-ST manual. Pocket Skills 2.0 incorporates brief lessons using videos featuring Dr. Linehan herself, exercises involving interaction with the chatbot which allow for text input and selection of responses, and the ability to gain points and unlock additional content which increases user engagement. Pocket Skills is currently the only comprehensive and not-for-profit DBT-ST app available where the effectiveness has been evaluated in at least three research trials.

Who Is Running the Clinical Trial?

University of Windsor

Lead Sponsor

Trials

14

Recruited

7,400+

Centre for Addiction and Mental Health

Collaborator

Trials

388

Recruited

84,200+

Citations

1. clinicaltrial.be clinicaltrial.be/en/details/435630?per_page=20&only_recruiting=0&only_eligible=0

The Pocket Skills Adjunct Project Higher scores indicate worse outcome (E.g., more alcoholic drinks consumed). 10. Dialectical Behavioral Therapy Ways of Coping Checklist.

2. dl.acm.org dl.acm.org/doi/10.1145/3173574.3173972

Pocket Skills | Proceedings of the 2018 CHI Conference on ... We developed Pocket Skills, a mobile web app based on Dialectical Behavior Therapy (DBT). Pocket Skills teaches DBT via a conversational agent.

3. microsoft.com microsoft.com/en-us/research/wp-content/uploads/2018/03/pn3413-paper.pdf

Pocket Skills: A Conversational Mobile Web App To ... We developed Pocket Skills, a mobile web app based on Dialectical Behavior Therapy (DBT). Pocket Skills teaches DBT via a conversational agent modeled on Marsha.

4. medrxiv.org medrxiv.org/content/10.1101/2025.10.07.25337533v1.full-text

Multilevel associations between skills use, engagement ... After 4 weeks in the study, the authors reported decreased depression and anxiety symptoms, while also increasing DBT skills use. Results ...

5. centerwatch.com centerwatch.com/clinical-trials/listings/NCT06402240/the-pocket-skills-adjunct-project

The Pocket Skills Adjunct Project | Clinical Research Trial ... This study aims to provide access to an adjunct intervention alongside standard group DBT services to examine feasibility, acceptability, ...

6. microsoft.com microsoft.com/en-us/research/publication/pocketskills-conversational-mobile-web-app-support-dialectical-behavioral-therapy/

PocketSkills: A Conversational Mobile Web App to Support ... We developed Pocket Skills, a mobile web app based on Dialectical Behavior Therapy (DBT). Pocket Skills teaches DBT via a conversational agent.

7. mental.jmir.org mental.jmir.org/2024/1/e50399

Feasibility, Acceptability, and Potential Efficacy of a Self ... List of skills covered within the Pocket Skills 2.0 internet-delivered dialectical behavior therapy (DBT) intervention. Module, DBT skills ...

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8639404/

A systematic review of dialectical behavior therapy mobile ... This review examines DBT based apps, with a specific focus on content quality and usability. Methods All apps referring to DBT were identified in Google Play ...