Table 4.2.
Examples of DHIs for Depression.*
| DHI | Description | Comments |
|---|---|---|
| Guided (facilitated) DHIs | ||
| Good days ahead* | Program designed for use by a CBT therapist to provide additional CBT instruction outside of the session. | Two large RCTs showed this program reduced the need for face-to-face CBT by half, with equivalent clinical outcomes. |
| BounceBack | Free online CBT program with various formats: self-directed version, or with telephone-delivered lay coaching. | No RCT but a large prospective study was positive in MDD; available free in several Canadian provinces, managed by the Canadian Mental Health Association. |
| Deprexis*# | Online CBT program with tailored guidance provided by an AI conversational agent; includes BA and mindfulness techniques. | Structured 12-week program designed for 90-day use; available in many countries in several languages; tested in multiple clinical trials, with a positive meta-analysis. Available in Europe and the USA. |
| MoodBeacon | Online guided CBT program; guidance provided by trained therapists. | Although there is no published study, this DHI was reviewed and approved for use by the Province of Ontario in 2021. |
| Pacifica/Sanvello*# | Mobile- and web-based apps intended to assist users in relieving stress, anxiety, and depression. Free; offers in-app purchases. | Uses blend of CBT, mindfulness, and relaxation tools; suitable for adults and adolescents; guidance is through peer discussion in chat groups; has positive results from an RCT. Available in the USA. |
| Unguided (self-directed) DHIs | ||
| Catch It | Free CBT-based mobile app, primarily uses automatic thought records and reflection exercises to address anxiety and depressive symptoms. | Developed jointly by the Universities of Liverpool and Manchester; includes a mood tracker and diary; and has an observational trial of users showing benefits. |
| Headspace | Popular mobile app with self-guided meditation and mindfulness techniques and some CBT approaches. | Designed for a wide variety of stress, depression and anxiety symptoms; extensively studied with good outcomes in many conditions (of mild severity), but not specifically in MDD. |
| MoodGYM* | Internet-based CBT self-help program, with very structured modules. | Most widely used platform; initially developed by Australian National University; extensively studied with good outcomes in mild depression. |
| MoodKit* # | CBT-based toolkit app with detailed instructions on how to use thought records and BA. | Teaches multiple aspects of CBT and is well-integrated with mood monitoring and optional journaling. Available in the USA. |
| Spark Direct* # | A mobile app providing core elements of CBT and BA in a 5-week program. | Designed for youth depression; uses interactive tasks and rewards; tested in an RCT with positive findings. Available in the USA. |
Note. AI = artificial intelligence; BA = behavioural activation; CBT = cognitive-behavioural therapy; DHI = digital health intervention; MDD = major depressive disorder; RCT = randomized controlled trial. These DHIs are illustrative examples only and are not officially endorsed by CANMAT. They were selected based on criteria including availability, popularity, and having a published evaluation study. Given the rapid changes in DHIs, they must be individually evaluated prior to clinical application, especially to ensure adequate privacy and security safeguards (see Q.4.b). DHIs available without cost are noted in the description.
*DHI has at least 1 positive RCT in patients with MDD. # Not available in Canada.