Self-help Tools for Depression

Overseen By Isabel Berwian, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Trustees of Princeton University

Disqualifiers: Attention issues, Identity check failure

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

Compensation: Varies

Number of Visits: 1

Duration: 5 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests self-help tools to determine if they can improve symptoms of depression. It compares two methods: one encourages engaging in enjoyable activities (behavioral activation), and the other focuses on changing negative thinking patterns (cognitive restructuring). Researchers aim to predict which method might work better for each person based on their responses to specific tasks and questions. This trial suits those who wish to lift their mood, reduce negative thoughts, and enjoy activities again. Participants must be fluent in English and have a working webcam for identity verification. As an unphased trial, this study provides a unique opportunity to explore innovative approaches to managing depression.

Do I need to stop my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that self-help tools using behavioral activation and cognitive restructuring are generally easy for people to use. Behavioral activation is a practical and acceptable way to treat depression, even in rural areas. Reviews of digital tools using this method suggest they can effectively reduce depression symptoms. Studies have not reported any significant negative effects regarding safety.

Cognitive restructuring helps people change negative thought patterns and has effectively reduced depression symptoms. Research indicates this method is safe, with no major side effects reported. It is often a key part of cognitive-behavioral therapy, a well-known approach for managing mental health issues.

Both methods have a strong safety record, making them promising options for those considering self-help tools to manage depression. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these self-help treatments for depression because they empower individuals to actively participate in their own mental health care. The behavioral activation approach encourages engaging in enjoyable activities, which can uplift mood and increase overall well-being. Meanwhile, the cognitive restructuring method helps people challenge and change negative thought patterns, offering a proactive way to manage depressive symptoms. Unlike traditional options like medication or in-person therapy, these self-help tools offer flexible, accessible support that individuals can use at their own pace and comfort.

What evidence suggests that this trial's treatments could be effective for depression?

This trial will compare two self-help tools for managing depression: one based on behavioral activation and the other on cognitive restructuring. Research has shown that both approaches can help reduce depression symptoms. Participants in the behavioral activation group will engage in exercises to stimulate engagement in pleasant activities, which studies have found can lead to improvements similar to those achieved with medication. Meanwhile, participants in the cognitive restructuring group will focus on changing negative thought patterns, an approach proven effective in reducing depression. Both methods have shown promising results and could be helpful for managing depression. ^{6 7 8 9 10}

Are You a Good Fit for This Trial?

This trial is for English-speaking individuals who want to improve their mood, reduce negative thoughts or symptoms of depression, and are willing to verify their identity on a video call. It's not suitable for those who can't pay attention during the study, aren't honest, or fail an identity check.

Inclusion Criteria

Fluent in English

Having a picture ID and be willing to meet with us on a video zoom call for identity verification if invited to do so

I want to improve my mood and reduce depression symptoms.

Exclusion Criteria

Identity check failure

Lack of attention when completing parts of the study, lack of honesty or not completing parts of the study in a timely way

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Online screening and consent

Treatment

Participants engage with the self-help tool e-couch for 5 weeks, completing either cognitive restructuring or behavioral activation modules

5 weeks

Online engagement with self-help tool

Mid-treatment Assessment

Participants complete behavioral tasks and symptom self-report questionnaires to assess progress

1 week

Online assessment

Follow-up

Participants are monitored for changes in symptoms at various intervals after the treatment period

48 weeks

Online assessments at 1, 3, 5, 12, 24, and 48 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Self-help information based on principles of behavioral activation
• Self-help information based on principles of cognitive restructuring

Trial Overview The study tests two self-help tools for depression: one based on cognitive restructuring and another on behavioral activation. It aims to predict which tool better reduces symptoms by analyzing participants' self-reports and behavior in tasks.

How Is the Trial Designed?

Group I: Cognitive restructuring group Experimental Treatment 1 Intervention

Participants will read information and engage in exercises through the self-help tool e-couch that aim at tackling negative thinking.

Group II: Behavioral activation group Experimental Treatment 1 Intervention

Participants will read information and engage in exercises through the self-help tool e-couch that aim at stimulating their engagement in pleasant activities.

Who Is Running the Clinical Trial?

Trustees of Princeton University

Lead Sponsor

Trials

2

Recruited

1,700+

Published Research Related to This Trial

Behavioral Activation (BA) is a well-supported psychotherapy for depression that has evolved over the years, incorporating various techniques such as activity monitoring, scheduling, and skills training, which have empirical support as effective components.

While some techniques like activity scheduling and relaxation training have been validated as effective on their own, others are more effective when used as part of a comprehensive treatment package, highlighting the importance of a tailored approach in BA interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

What is behavioral activation? A review of the empirical literature. Kanter, JW., Manos, RC., Bowe, WM., et al.[2022]

Cognitive Behavioral Therapy (CBT) employs active and collaborative strategies, such as cognitive restructuring, to help patients identify and change unhelpful thoughts that contribute to emotional distress.

CBT also includes techniques like behavioral activation to encourage engagement in pleasurable activities, exposure therapy to reduce fear responses, and problem-solving to systematically tackle life challenges, making it a comprehensive approach for treating various mental health issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Basic Strategies of Cognitive Behavioral Therapy. Wenzel, A.[2018]

Behavioral activation (BA) is an effective standalone psychotherapy for depression, showing comparable efficacy to traditional cognitive-behavioral therapy (CBT) and is recognized as an evidence-based guided self-help intervention.

Further research is needed to understand the neurobiological mechanisms behind BA and to assess the potential for integrating e-mental health applications of BA into China's public healthcare system.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Narrative Review of Empirical Literature of Behavioral Activation Treatment for Depression. Wang, X., Feng, Z.[2022]

A study involving 128 participants with major depressive episodes found that a Health Action Process Approach (HAPA)-based internet-delivered behavioral activation intervention significantly reduced clinician-rated depressive symptoms compared to a control group, with a strong effect size at 8 weeks (d = 0.79).

The intervention group also showed improvements in self-rated depressive symptoms, behavioral activation, and various motivational and volitional outcomes, indicating that the HAPA framework effectively enhances treatment for depression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of a Web-Based Behavioral Activation Intervention on Depressive Symptoms, Activation, Motivation, and Volition: Results of a Randomized Controlled Trial. Mueller-Weinitschke, C., Bengel, J., Baumeister, H., et al.[2023]

In a study of 313 patients with major depressive disorder, internet-based behavioral activation significantly reduced depressive symptoms by increasing engagement in enjoyable activities, with a measurable effect observed after 4 weeks.

The findings suggest that clinicians and patients should expect a 4-week period for activation levels to improve before seeing a notable reduction in depression symptoms, which typically occurs around 6 weeks into the treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Explaining the Efficacy of an Internet-Based Behavioral Activation Intervention for Major Depression: A Mechanistic Study of a Randomized-Controlled Trial. Fu, Z., Burger, H., Arjadi, R., et al.[2022]

Behavioral activation is an effective treatment for depression that focuses on increasing engagement in pleasurable and meaningful activities, and it can be used alone or alongside antidepressant medications.

The method involves activity monitoring to help patients track their behaviors and moods, which aids in identifying patterns that contribute to their depression, making it a versatile approach even for those with other mental health issues like psychosis.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Behavioral activation: a strategy to enhance treatment response. Sudak, DM., Majeed, MH., Youngman, B.[2014]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11264713/

Comparing the effectiveness of behavioral activation in ... The results of a Mixed ANOVA analysis revealed that participants who underwent BAGT showed significant improvement in depression, rumination, ...

2. tandfonline.com tandfonline.com/doi/full/10.1080/10503307.2023.2197630

Individual behavioral activation in the treatment of depression Although the quality of most of the trials was modest, this meta-analysis suggested that BA is an effective treatment for depression as well as other outcomes.

3. jmir.org jmir.org/2025/1/e68054

Effectiveness of Digital Behavioral Activation Interventions ... Digital BA interventions are effective in reducing depressive symptoms and improving QoL in the short- to midterm. However, these effects tend to diminish over ...

4. sciencedirect.com sciencedirect.com/science/article/abs/pii/S016503272200427X

Are self-managed online interventions for depression ... This study aims to examine short- and long-term effects of online interventions on behavioral activation in routine care.

5. thejcn.com thejcn.com/DOIx.php?id=10.3988/jcn.2024.0148

Behavioral Activation and Brain Network Changes in ... The results showed that the efficacy of BA was comparable to that in pharmacotherapy in the acute treatment of MDD, and better than CT in ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12021889/

Efficacy and safety of behavioural activation on depression ... Meta-analysis showed behavioural activation had little effect on depression symptom improvement in people with NCDs.

7. medicine.umich.edu medicine.umich.edu/sites/default/files/content/downloads/Behavioral-Activation-for-Depression.pdf

Behavioral Activation for Depression Note: Behavioral Activation has been shown in research studies to be effective on its own for some people to overcome depression. However, it is often used ...

8. sciencedirect.com sciencedirect.com/science/article/pii/S2949732925000730

A Behavioral Activation Digital Intervention Incorporating ... The Kuamsha app is a feasible and acceptable treatment for depression among adolescents in rural South Africa.

9. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC2882847/

Behavioral activation interventions for well-being: A meta- ... These results provide evidence that BA interventions can increase the well-being of recipients and that they are equally effective regardless of depression ...

10. mental.jmir.org mental.jmir.org/2023/1/e46877

Efficacy, Safety, and Evaluation Criteria of mHealth ... This review suggests that mHealth interventions can be effective in reducing depressive symptoms, with hybrid interventions achieving the best results.