Randomized Controlled Trial of SuperBetter, a Smartphone-Based/Internet-Based Self-Help Tool to Reduce Depressive Symptoms

Games Health J. 2015 Jun;4(3):235-46. doi: 10.1089/g4h.2014.0046. Epub 2015 Feb 19.


Objective: Technological advances have sparked the development of computer- and smartphone-based self-help programs for depressed people, but these programs' efficacy is uncertain. This randomized controlled trial evaluated an intervention called SuperBetter (SB), which is accessed via smartphone and/or the SB Web site.

Materials and methods: Online, we recruited 283 adult iPhone(®) (Apple, Cupertino, CA) users with significant depression symptoms according to the Center for Epidemiological Studies Depression questionnaire (CES-D). They were randomly assigned to one of three conditions: (a) a version of SB using cognitive-behavioral therapy and positive psychotherapy strategies to target depression (CBT-PPT SB); (b) a general SB version focused on self-esteem and acceptance (General SB); or (c) a waiting list control group (WL). The two SB groups were instructed to use SB for 10 minutes daily for 1 month. All participants completed psychological distress and well-being measures online every 2 weeks through follow-up. An intent-to-treat analysis was conducted using hierarchical linear modeling.

Results: As hypothesized, SB participants achieved greater reductions in CES-D scores than WL participants by posttest (Cohen's d=0.67) and by follow-up (d=1.05). Contrary to prediction, CBT-PPT SB did not perform better than General SB; both versions of SB were more effective than the WL control. Differences between SB versions favored General SB but were not statistically significant.

Conclusions: These large effect sizes should be interpreted cautiously in light of high attrition rates and the motivated, self-selected sample. Nonetheless, smartphone-based/Internet-based self-help may play an important role in treating depression.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Analysis of Variance
  • Anxiety / psychology
  • Chi-Square Distribution
  • Depression / therapy*
  • Female
  • Humans
  • Internet / instrumentation*
  • Linear Models
  • Male
  • Middle Aged
  • Patient Dropouts
  • Self Care / instrumentation
  • Self Care / methods
  • Self Concept
  • Self Efficacy
  • Smartphone / instrumentation*
  • Software*
  • Surveys and Questionnaires
  • Therapy, Computer-Assisted / instrumentation*
  • Therapy, Computer-Assisted / methods
  • Treatment Outcome