Patients’ experience of an ecological momentary intervention involving self-monitoring and personalized feedback for depression

There are high expectations of Ecological Momentary Interventions (EMI) for depression treatment. Findings on their ability to reduce depressive symptoms have, however, been conflicting. A recent trial did not find statistical evidence that an EMI comprising self-monitoring and personalized feedback impacted clinical or functional outcomes beyond the effects of regular care, regardless of whether the module focused on positive affect and activities or on negative affect and thinking patterns. In apparent contrast, 86% of the participants who completed the intervention indicated they would recommend it to others. In the present study, we used in-depth interviews (n = 20) and an evaluation questionnaire (n = 89) to better understand the EMI’s personal and clinical benefits and downsides. A thematic analysis of the interviews generated six areas of impact with various subthemes. In line with the trial results, few participants reported behavioral changes or symptom improvement over time; the self-assessments mainly amplified momentary mood, in either direction. The most often mentioned benefits were an increase in self-awareness, insight, and self-management (e.g., a stronger sense of control over complaints). Consistently, these domains received the highest ratings in the evaluation questionnaire. Furthermore, the EMI instilled a routine into the days of individuals without regular jobs or other activities. Participants reported few downsides. The experiences were rather similar between the two modules. This study suggests that EMI might contribute to health by helping individuals deal with their symptoms, rather than reducing them. This implies EMI research is currently using a too narrow definition of efficacy.