TreadWill, an Automated Intervention for Depressive Symptoms

TreadWill is a fully automated digital intervention that provides a multi-modal treatment for depressive symptoms. It includes: Slides and interactive text-based conversations based on Cognitive Behavioral Therapy (CBT); Mindfulness videos; Game-based Cognitive Bias Modification paradigms; An empathetic chatbot. This study's primary aim is to test the differential effectiveness of this full-featured version of TreadWill compared to a text-based CBT program.

TreadWill is an online tool to deliver automated intervention for depressive symptoms. TreadWill helps the participants learn the concepts of Cognitive Behavioral Therapy (CBT), and practice mindfulness in an interactive manner. It also has games based on Cognitive Bias Modification (CBM) and an empathetic chatbot. We hypothesize that participants using TreadWill will show a significant reduction in depressive symptoms and will show engagement with the program. To test this hypothesis, we are conducting a randomized controlled trial. We will randomize participants into three groups: experimental, active control, and waitlist. Participants randomized to the experimental group will get access to the full-featured version of TreadWill as described above. Participants randomized to the active control group will have access to a limited version of TreadWill designed to deliver basic CBT in plain text format. The waitlisted participants will be put on a waitlist for 6 weeks.

The participant is masked to the intervention assigned to them. All outcome measures are self-reported by the participants through a computer program without any involvement of the experimenters.

This group receives the full-featured intervention, including CCBT, CBM, Mindfulness, chatbot with many interactive elements.

Participants will go through an automated program. Participants will learn and practice the techniques of CBT through multimedia elements. They will play games based on Cognitive Bias Modification (CBM) paradigms, practice mindfulness, and chat with an automated empathic chatbot.

Participants will be going through an automated program. Participants will learn and practice the techniques of CBT in a plain-text format with reduced features

Standard questionnaire for depressive symptoms. Total score is used; lower score indicates better outcome.

Standard questionnaire for generalized anxiety symptoms. Total score is used; lower score indicates better outcome.

Standard questionnaire for depressive symptoms. Total score is used; lower score indicates better outcome.

Standard questionnaire for depressive symptoms. Total score is used; lower score indicates better outcome.

after modules 1 (average 1 week), 2 (average 2 weeks), 3 (average 3 weeks), 4 (average 4 weeks) and 5 (average 5 weeks)

Standard questionnaire for generalized anxiety symptoms. Total score is used; lower score indicates better outcome.

after modules 1 (average 1 week), 2 (average 2 weeks), 3 (average 3 weeks), 4 (average 4 weeks) and 5 (average 5 weeks)

Users in the experimental group, using the chatbot, will indicate their mood in one of the three categories: positive, neutral, and negative.

Inclusion Criteria: Fluent in English PHQ-9 Score from 5 to 19 Access to an internet-enabled Android smartphone Plan to use TreadWill in Google Chrome browser Agree to allow notifications from TreadWill Agree to add TreadWill to Home screen Have email on one of the HTML-enabled platforms including Gmail, Outlook, Yahoo, Rediffmail, AOL, Hotmail. Exclusion Criteria: Suicide ideation (score greater than 0 on the 9th question of PHQ-9 and score greater than 4 on SIQ) Unemployed Current or previous diagnosis of bipolar disorder/manic-depressive disorder or psychosis Prospective participants who say they only want to check out the program and do not plan to complete it are excluded. Used an earlier version of TreadWill

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