Our platform is based on cognitive behavioral therapy (CBT) models. CBT is a research-driven therapy that is considered the Gold Standard for many mental challenges including anxiety, depression, self-esteem, obsessions and sexuality. CBT models suggest that the way we interpret reality (our self-talk) affects how we function in the world. If our self-talk is mainly negative and rigid, we will be distressed, have functioning difficulties and will find less joy in our lives.
Several recently-published studies have shown that using our GGtude apps helps people change their self-talk, reduce distress and increase well-being. For instance, a recent study comparing people using the app with people who did not use it, showed that using our platform for two weeks (3 minutes a day) reduced doubts, obsessions and increased self-esteem. Another recent study showed that using our platform can help people cope better with the negative influence of social media.
Summary of publications:
1. Can brief, daily training using a mobile applications help change maladaptive beliefs? A cross-over randomized-control study evaluating the efficacy of a mobile-app based intervention in reducing maladaptive beliefs and obsessive-compulsive symptoms.
- A cross-over RCT study showed the efficacy of a mobile-app based intervention in reducing maladaptive beliefs
- App use (GGRO) was also associated with a reduction in obsessive-compulsive symptoms
- Brief, daily training using GGRO can reduce maladaptive beliefs
Background: Obsessive compulsive disorder (OCD) is a disabling condition with a wide variety of clinical presentations including contamination fears, fear of harm and relationship-related obsessions. Cognitive behavioral models of OCD propose obsessive-compulsive (OC) symptoms result from catastrophic misinterpretations of commonly occurring intrusive experiences and associated dysfunctional strategies used to manage them. OCD-related maladaptive beliefs including inflated responsibility, importance and control of thoughts, perfectionism and intolerance for uncertainty increase the likelihood of such misinterpretations.
Objective: Consistent with accumulating evidence suggesting mobile health (mHealth) apps based on cognitive-behavioral principles may lead to significant reductions in psychopathological symptom, we assessed the effectiveness of a novel cognitive training app (GGRO) designed to challenge OCD-related beliefs.
Methods: Ninety-seven students were randomized to immediate use (iApp) or delayed use (dApp) groups of GGRO. All participants were requested to complete web-based assessment, with questionnaires relating to maladaptive beliefs, mood and OC symptoms at baseline (T1), 15 days following baseline (T2) and 30 days following baseline (T3). Participants in iApp group started using the app at baseline and continued using the app for 15 consecutive days. They were then requested to stop using the app until T3. Participants in the dApp group were requested to wait for 15 days and only then start using the app (cross-over) for 15 consecutive days.
Results: All participants used the app for a mean 14.07 (SD=1.41) days with a 2.94 levels per day. Replicating previous findings, app use was associated with medium-large effect size reductions in both groups iApp (n=51) and dApp (n=46). In the iApp group, all effects remained significant during 15 days follow-up. Analyses focusing on the first two assessment occasions revealed significant Treatment × Repeated Measures interactions on maladaptive beliefs, several OC symptom measures and self-esteem.
Conclusions: This study provides further evidence for the efficacy of GGRO as a mobile delivered training exercises useful for the reduction of OCD-related beliefs and symptoms.
Trial registration: ClinicalTrial.gov ID NCT03571464.
Cite: Roncero, M., Belloch, A., & Doron, G. (2019). Can brief, daily training using a mobile applications help change maladaptive beliefs? A cross-over randomized-control study evaluating the efficacy of a mobile-app based intervention in reducing maladaptive beliefs and obsessive-compulsive symptoms. JMIR mHealth and uHealth, 7, e11443, DOI: 10.2196/11443.
To see a pre-printed version of the paper see this link
2. Assisting relapse prevention in OCD using a novel mobile app-based intervention: A case report.
Mobile health-apps increase the accessibility of Cognitive Behavioral-based interventions before, during, or following treatment. GGOC is a mobile app designed to challenge maladaptive beliefs in Obsessive-Compulsive Disorder (OCD). This single-case study assesses the usefulness of GGOC as a relapse prevention tool for individuals with OCD.
Method: The patient was a 26-year-old female with severe contamination and washing/cleaning OCD symptoms (Y-BOCS=33) and co-morbid Major Depression. GGOC was used for relapse prevention (daily/2weeks) following 32 weekly/sessions of individual CBT (Y-BOCS at the end of CBT and before GGOC=7). Patient completed 47 levels dedicated to OCD-relevant maladaptive beliefs. Before and after GGOC, the Y-BOCS, Obsessive-Compulsive Inventory (OCI-R), Obsessive Beliefs Questionnaire (OBQ-20), and DASS-20 Depression were completed.
Results: The OBQ-20 and OCI-R scores decreased from pre- to post-GGOC. The Y-BOCS score decreased from 7 pre-GGOC to 2 post-GGOC.
Conclusions: Findings support the efficacy of GGOC as a relapse prevention tool for individuals with OCD, and it contributes to maintaining the gains after CBT.
Cite: Pascual-Vera, B., Roncero, M., Doron, G., & Belloch, A. (2018). Assisting relapse prevention in OCD using a novel mobile app-based intervention: A case report. The Bulletin of the Menninger Clinic, 82, 390-406.
To see a pre-printed version of the paper see this link
3. A novel approach to challenging OCD related beliefs using a mobile-app: An exploratory study
- A novel, mobile delivered, cognitive training exercise is evaluated.
- This training exercise is designed to challenge OCD-related beliefs.
- Training included 2-minutes daily training for a period of 15 days.
- Training lead to large-effect size reductions in levels of OCD-related beliefs.
- Pre-post changes in levels of OCD-beliefs was associated with reductions in OCD symptoms.
Background and objectives: According to cognitive models, obsessive compulsive symptoms result from catastrophic misinterpretations of commonly occurring intrusive experiences and the use of counterproductive strategies to manage them. Obsessive Compulsive Disorder (OCD) related beliefs such as inflated responsibility, importance of thoughts and perfectionism increases the likelihood of such misinterpretations. Consistent with a growing body of literature supporting the usefulness of mobile delivered technologies in fostering cognitive behavior change, the present study assessed the effectiveness of a novel cognitive training exercise designed to challenge OCD-related beliefs. This mobile app training exercise consists of users having to pull statements challenging OCD beliefs towards themselves (downwards) and to throw away (push upwards) contra-productive self-statements.
Methods: 36 third-year BA students started the trial. Twenty completed pre and post measures of OCD-beliefs, mood and OCD symptoms including relationship-obsessions. Participants were instructed to complete 3 min of daily training for a period of 15 days.
Results: No significant differences were found between completers and non-completers on demographic and most symptom related measures at Time 1. Repeated-measures MANOVA of the 20 completers showed a significant reduction on all OCD symptoms measures and on OCD-beliefs. No significant reduction was found in depression symptoms. Regression analysis showed change in levels of OCD-beliefs was associated with reduction in OCD symptoms at Time 2 over and above OCD symptoms at Time 1.
Limitations: The study is an open trial with non-clinical participants. Conclusions: This mobile delivered training exercise may be useful for the reduction and relapse prevention of OCD-related beliefs and symptoms.
Cite: Roncero, M., Belloch, A., & Doron, G. (2018). A novel approach of challenging OCD related beliefs using a mobile-app: An exploratory study. Journal of Behavior Therapy and Experimental Psychiatry, 59, 157-160.
To see a pre-printed version of the paper see this link
4. Can self-esteem be improved using short daily training on mobile applications? Examining real world data of GG self-esteem users
- App use was associated with increased self-esteem and mood
- The higher the level participants used the app the more their self-esteem increased
- Real world data is consistent with findings from previous controlled studies
Objective. Using real world data, we examined the associations between self-esteem ratings and short, daily use of a Cognitive Behavioural Therapy (CBT)-based mobile application targeting self-esteem related beliefs. The effects of using this application on mood ratings were also assessed.
Method. Real world data of GG Self-esteem users was collected from January 2019 until August 2019. Participants’ self-esteem and mood scores were evaluated at three time points corresponding to levels 1, 20 and 46 of the mobile application.
Results. Significant increases in self-esteem ratings were found across all three time points. Increased mood ratings were only found at level 20, compared to baseline. Dropout rates across assessment points were associated with younger age, and males showed significantly higher self-esteem scores than women at baseline and the second assessment point.
Conclusions. Our findings are consistent with previous controlled trials indicating that using CBT-based mHealth applications targeting maladaptive beliefs may be useful for increasing user’s wellness and reducing distress.
cite: Omeara, M., Doron. G. (in press). Can self-esteem be improved using short daily training on mobile applications? Examining real world data of GG self-esteem users. Clinical Psychologist.
5. Reaching reliable clinical change using short, daily, cognitive training exercises delivered on a mobile application: The case of Relationship Obsessive Compulsive Disorder (ROCD) symptoms and cognitions in a subclinical cohort
- ROCD is characterized by symptoms pertaining to interpersonal relationships
- ROCD is associated with dyadic distress, depression, and anxiety
- Daily training with a mobile app may reduce ROCD symptoms in subclinical samples
- Mobile app may be effective in university students with ROCD concerns
(Cerea, Ghisi, Bottesi, Carraro, Broggio, & Doron, 2020)
Background: Relationship Obsessive-Compulsive Disorder (ROCD) is a disabling presentation of obsessive compulsive disorder (OCD) centering on interpersonal relationships. The aim of the current randomized control trial (RCT) was to assess the efficacy of short, game like, daily cognitive interventions delivered using a mobile application in reducing subclinical ROCD symptoms and associated phenomena.
Methods: Fifty university students identified as having subclinical levels of ROCD symptoms (using the Structured Clinical Interview for DSM-5 Clinical Version) were randomized in two groups: immediate-use group (iApp group; n = 25); delayed-use group (dApp group; n = 25). Participants in the iApp group started using a cognitive-behavioral training application at baseline for 15 days (T0 to T1). Participants in the dApp group commenced using the application at T1 for a period of 15 days (T1 to T2). All participants completed questionnaires at baseline (T0), 15 days from baseline (T1), and 31 days from baseline (T2).
Results: Repeated measure ANOVAs showed significant Group (iApp vs. dApp) × Time (T0 vs. T1) interactions indicating greater decrease on ROCD symptoms, OCD beliefs and social anxiety symptoms, as well as greater self-esteem increase in the iApp group compared to dApp group at T1. Moreover, analyses using the reliable change index (RCI) indicated reliable change for a significant portion of participant (42 to 50 percent) on ROCD symptoms.
Limitations: The size of the sample and use of self-report measures limit the generalizability of the results.
Conclusions: Short, daily cognitive training interventions delivered using mobile applications may be useful in reducing subclinical OCD symptoms and associated features.
6. Cognitive Behavioural Training Using a Mobile Application Reduces Body Image Related Symptoms in High Risk Female University Students: A Randomized Controlled Study
- Body dissatisfaction represents a prevalent condition in young women
- Daily training with a mobile app may reduce some forms of body dissatisfaction
- Medium-large effect size reductions emerged for BDD symptoms
- Effects of the intervention on eating disorder symptoms seem more limited
Body dissatisfaction is prevalent in young women, and is associated with symptoms of Body Dysmorphic Disorder (BDD) and Eating Disorders (EDs). The aim of the study was to assess the efficacy of a mobile application, based on cognitive behavioral principles, in reducing body dissatisfaction and BDD/ED symptoms in female university students considered at high-risk of developing Body Image Disorders (BIDs).
Fifty university students at high-risk of developing BIDs (using self-report questionnaires assessing BIDs and the Structured Clinical Interview for DSM-5 Clinical Version) were randomized in two groups: immediate-use App group (iApp group; n = 25) and delayed-use App group (dApp group; n = 25). The iApp group started using the app at baseline for 16 days (T0 to T1). The dApp group waited for 16 days before starting to use the app (T1 to T2). Participants completed questionnaires at baseline (T0), 16 days from baseline (T1), and 32 days from baseline (T2).
Repeated measure Analyses of Variance (ANOVAs) showed a Group (iApp vs. dApp) × Time (T0 vs. T1) interaction on BDD symptoms indicating medium effect size (partial eta squared) reductions in the iApp group compared to dApp group at T1; post-intervention means for BDD symptoms were under the cut-off for extreme body dissatisfaction/BDD symptoms in both groups. Pertaining to ED symptoms, no significant Group × Time interaction was detected.
Training 3 minutes a day for 16 days with a CBT-based mobile application may lead to reductions in some forms of body dissatisfaction, including BDD symptoms in female university students at high-risk of developing BIDs. On the other hand, effects of the intervention on ED symptoms seem more limited.
cite: Cerea S., Ghisi, M., Bottesi, G., Manoli, E., Carraro., T., & Doron (in press). Short, Daily Cognitive behavioural Training Using a Mobile Application Reduces Body Image Related Symptoms in High Risk Female University Students: A Randomized Controlled Study. Behavior Therapy.
7. Building resilience to body image triggers using short, daily cognitive training on a mobile application: Evidence from a randomized control trial
- Body image disturbance (BID) is an increasingly common condition among women
- We investigated an accessible mobile application for BID
- Application use was linked with decreased BID and increased body appreciation
- Users of the app showed increased resilience on an Instagram exposure task
(Aboodi, Sieve, & Doron, 2020)
OBJECTIVE: Body image disturbance (BID) is increasingly common among women, characterized by persistent and distressing appearance dissatisfaction and linked with eating disorders. Although effective, cognitive behavioral therapy (CBT) delivered by trained professionals is not easily accessible. This randomized trial evaluated the effects of a CBT-based mobile application designed to increase resilience to body image triggers and reduce BID symptoms.
METHOD: A non-clinical sample of women (N = 90; Mage = 23.52) were randomized to use the mobile application for approximately four minutes of daily exercises for two weeks or to a control condition. Body image was measured at baseline, immediately after two weeks of mobile application use, and 1-month follow-up. To examine whether using the application was associated with increased resilience to common BID triggers, participants completed an Instagram exposure resilience task upon completion and at 1-month follow-up.
RESULTS: Relative to those in the control condition, participants who used the application demonstrated increased resiliency and reduced BID symptoms. Theses effects were medium-to-large and were maintained at 1-month follow-up.
CONCLUSION: These results underscore the potential usefulness of brief, low-intensity, portable interventions in reducing BID symptoms and in increasing resilience to thin-ideal body messages often portrayed on social media.