Table 3.

Mixed methods evaluation of program components (n=19).

Component	Most helpfula, n (%)	Least helpful, n (%)	Helpful aspects	Areas to improve
Practices	12 (63)	0 (0)	Having narrator-guided practices Specific practices, spanning CBTb and mindfulness deemed helpful Included 3-minute reset, breathing, mindfulness, self-compassion, establishing boundaries, and thought record	Usability issues such as loss of progress if interrupted (or exiting app) while practicing Desire for chimes or signals when practices end (too much silence) Need for more introductory practices for certain components (eg, self-compassion) Clearer option to skip reflection questions after practices
Therapist Support	7 (37)	2 (11)	Therapist was caring, thoughtful, genuine, and supportive Provided helpful feedback and comments on participant entries Helped personalize the program by providing additional information and resources when necessary	Unclear how frequently to interact with therapist Unclear how much information to share with therapist
Information Provided	4 (21)	2 (11)	Education and information about mood and thinking patterns Provides underlying rationale for CBT and mindfulness practices	One participant requested practices to help differentiate rumination from reflection concerning thought boundaries.
Group	0 (0)	15 (79)	Reading others’ responses helped people feel less alone and feel validated in their struggles.	Confusion about how to use the group and need for guidelines Low rates of participants using group Limited response options (preprogrammed drop-down) to other members’ comments

^aThree individuals ranked more than 1 component as most helpful; 1 person did not select the most helpful component.

^bCBT: cognitive behavioral therapy.