The Move Mood app by stem4 provides ways for young people to manage the behaviours associated with low mood or depression. Developed by Dr Nihara Krause, a Consultant Clinical Psychologist, together with ideas and input from young people, the Move Mood app uses a Behavioural Activation Framework (references below) to help increase motivation to change.
It is not a substitute for the assessment and individualised treatment of a health/mental health professional.
The Move Mood app has been developed for young people aged 13 and over and is suitable for mild/moderate depression. Young people under 13 may use the Move Mood app but should ask a trusted adult to help them. For young people who are severely depressed, the Move Mood app should only be used alongside treatment.
“Low mood and depression weigh you down. Instead, engage, initiate and activate. Build your power to lift this weight”.
The Move Mood app aims to help young people manage the behaviours associated with low mood or depression. It follows a type of treatment called Behavioural Activation Therapy (BAT) which encourages people with depression to approach activities they may be avoiding. This is done by defining goals and setting activity schedules since when a person is depressed they tend to avoid particular situations or activities. Unfortunately, avoidance leads to more depression trapping people in further depression. The app encourages the user, with the help of a ‘companion’ to carry out tasks they make a commitment to complete and to work towards ‘awards’ for completing them.
There is opportunity for monitoring progress and a section for resources.
For those individuals with severe symptoms of depression, the Move Mood app needs to be used together with individual support from a mental health professional.
The Move Mood app is password-protected and confidential.
Mood disorders have been impacted significantly as a result of the pandemic. This is partly because of the stressful nature of the pandemic itself and limited access to treatments and also because mood enhancement strategies such as exercise and meeting friends are restricted. In order to support children and young people affected, stem4 has created an animated video and user booklet on how to use the Move Mood app over this time. This includes specific mood issues that may have increased during the pandemic, also outlining pandemic safe tasks which abide by safety guidelines such as social distancing.
Downloads of the stem4 digital portfolio of apps has increased by 40% subsequent to the pandemic and we will endeavour to use the feedback we receive from our users and our focus groups to update the Move Mood app. Given the disruption to goals and daily structure, stem4 believes the Move Mood app has an important place in helping build resilience in recovery.
– To develop an evidence-based, widely accessible digital tool to help young people (age 13-25) manage the behaviours associated with low mood or depression symptoms.
– To devise an anonymised analytical model to evidence effectiveness and inform future development.
– To comply with NHS digital technology standards.
– To raise the profile of stem4 and its work to support teenage mental health.
A small pilot study is currently underway but interim measures are as follows. Six young people and two parents all experiencing low mood/depression, seeing a psychologist were given the Move Mood app to use alongside Cognitive Treatment for depression.
All participants were assessed at baseline using the Moods and Feelings Questionnaire Angold and Costello, 1987. This measure has been noted to be a reliable measure of depression in children and young people in both clinical and non-clinical samples (Burleson et al, 2006).
The child report version was given to the six young people (aged 14-17) and the adult version to the two parents. Due to the pandemic, all consultations, including questionnaire feedback was carried out remotely with the participant feeding back verbally. None of the young people had self-harm behaviours or reported high risk.
The app was used to reinforce homework assignments of behavioural goals. In addition, there was an attitude to the app questionnaire. The app was used alongside treatment for four weeks and will continue for a further four weeks.
At mid-point in treatment, the following are noted. Acceptability (wanting to use the app) is 98% (one adult slightly unsure of their technology skills in setting up). Reported engagement with reminders of the app 95%. Number completing their targets 90%. Weekly measures on the Moods and Feelings Questionnaire show reduction in symptoms although the sample size is too small for statistical analysis. Reminders were 100% appreciated, engagement with companions 80%. Liked categories were ‘view my tracker’ (77%) and ‘view my awards’ (75%).
stem4 will be seeking funding to carry out a large scale, quantitative and qualitative study on the Move Mood app effectiveness later this year.
In order to evidence the effectiveness of the Move Mood app, the following anonymised data is collected:
– Number of downloads and number of users (on both iOS and Android)
– Data submitted on installation of the Move Mood app (optional) including:
– Gender, Age Range, Location, whether they have sought professional treatment
– Aggregated data on user activity and its effectiveness
– Analytics on user journeys
All analytics collected are non-identifiable with users since we do not collect any identifiable data.
In the few months of release the Move Mood app has had over 5,000 downloads. Feedback comments include:
“This has helped me a lot. It’s just nice being organized about tasks and then getting an award, I really like it.”
The Move Mood app was developed co-collaboratively with young people. Co-collaborative workshops with young people explored desired outputs, user journeys, visual concepts, security/privacy, user experience, and tone of voice.
Clinical and professional groups provided input on safety, user characteristics, strengths, potential barriers, referrer experience and tone of voice.
stem4 consistently monitors user feedback via emails, social media and reviews on the App Store/Google Play. In addition, we will use annual, small user groups to feedback to update the Move Mood app.
Over the pandemic, an animated video and booklet were created providing Move Mood app users with guidance on how to use the app safely. The content for this was created by a Clinical Psychologist together with feedback from a small group of users.
We aim for all our user groups to be diverse and inclusive and represent a cross-section of our youth user community.
Clinical Input and Safety
The clinical content of the Move Mood app was created by a Clinical Psychologist and the app underwent a clinical safety assessment with a range of clinicians including a GP, Adolescent Psychiatrist, family therapist and Clinical Psychologists.
Our clinical evaluation groups also include a diverse range of different professionals.
We welcome user feedback which can be emailed to firstname.lastname@example.org.
A number of standards were used. These included:
NHS Digital DCB0129 standards. Developed by the NHS, this standard is designed to help manufacturers of health IT software evidence the clinical safety of their products.
User Needs design based on workshop feedback with young people.
Design with data using existing app data.
Iteration – New updates depending on things that have (or haven’t) worked or new functionality.
stem4 strives to be as broadly accessible as possible through the use of industry best practices. For example, contrast colours for those with sight issues, using a font that’s clear to read etc.
stem4 has put a number of measures in place to ensure that the Move Mood app is clinically safe to use.
The Move Mood app has been developed by a Consultant Clinical Psychologist and validated by the group it is for. The Move Mood app complies with the clinical safety standard DCB0129. Developed by the NHS, this standard is designed to help manufacturers of health IT software evidence the clinical safety of their products.
stem4 has a Clinical Risk Management Plan. A Clinical Safety Review with clinical professionals was undertaken for the Move Mood app and a Clinical Safety Case Report and Hazard Log created. The clinical risk is monitored and laid out in the Hazard Log. A flow chart of hazard mitigation and response is available which outlines how issues will be addressed together with target response times.
The target response time for urgent issues is 24 hours, for high priority issues 72 hours, medium priority 7 working days and low priority 14 working days.
The Clinical Safety Officer (CSO) is Dr Nihara Krause.
stem4 consistently monitors user feedback via emails, social media and reviews on the App Store/Google Play.
The Move Mood app is reviewed on a quarterly basis during which app efficacy, including the efficacy of the activities, is reviewed, and the app updated as necessary to ensure it is clinically valid.
The Move Mood app is reviewed every three months and updated as required.
The Move Mood app is an app that can be used on iOS and Android devices. The content is downloaded the first time the user opens the Move Mood app and then cached. It can still be viewed and used offline.
The Move Mood app has been designed with young people to ensure data and device memory/data use in their preferred device (smartphone) is not compromised.
The Move Mood app does not collect personally identifiable data and an account does not need to be created to use the Move Mood app. No cookies are used. IP addresses are not captured. The Move Mood app is standalone and does not connect to any other apps or devices or interact with existing enterprise systems.
Some optional questions are asked in the Move Mood app. This information is only used for research purposes and is completely anonymous. Anonymised data on whether tasks helped is collected to ensure that we can monitor the effectiveness of the Move Mood app and individual tasks.
Move Mood app users can be reassured that all information that is noted information is completely private. stem4 has no access to any of this information.
In order to evidence the effectiveness of the Move Mood app, the following data will be made available:
Activity is logged to present the user with the following information:
● Tasks chosen
● How hard it is to carry out the tasks
● Pre-task mood rating and post completion mood measure
● Task log
● Most used tasks
All optional question and feedback data collected via the Move Mood app is aggregated and cannot be tracked to each user/device. However, the security of this data is still important to us and we will take all steps reasonably necessary to ensure that the data is treated securely. The transfer of data is encrypted over a secure connection (SSL).
Move Mood app data is stored using Amazon Web Services (AWS) which has certification for compliance with ISO 27001:2013 – https://d1.awsstatic.com/certifications/iso_27001_global_certification.pdf.
This data is retained for no longer than is necessary and destroyed by 5 years after expiration.
The developers of the Move Mood app, stem4, are not required to register with the ICO (Information Commissioner’s Office) as no personal information is being processed. stem4 is compliant with the Data Protection Act 2018 and the GDPR. stem4’s nominated Data Protection Officer (DPO) is Yvette Nieslony and can be contacted at email@example.com.
The Move Mood app does not create user accounts. This was based on user research, with young people telling us they valued privacy. This means that if the Move Mood app is deleted or the device is changed, any app data is lost. stem4 therefore recommends that screenshots of any data that is to be saved are taken.
To report an issue with the Move Mood app please email firstname.lastname@example.org providing as many details about the issue as you can. The developers of the Move Mood app, stem4, endeavour to respond within target response times. The target response time for urgent issues is 24 hours, for high priority issues 72 hours, medium priority 7 working days and low priority 14 working days.
stem4 assesses and records any clinical risk. The Move Mood app is reviewed quarterly and updates made where necessary.
stem4 will resolve major bugs that prevent the intended Move Mood app functionality from working for devices and operating systems supported.
The Move Mood app uses an evidence-based approach but it does not substitute for the assessment and treatment of a suitably qualified mental health professional. Please contact your GP or physician before use or if you are uncertain of whether the Move Mood app is for you. As the saying goes ‘no one size fits all’ and digital approaches help some and not others.
If your mood remains low after each use of the Move Mood app, please try another approach or use the Move Mood app alongside another approach.
If you are under the age of 13, please use it with a responsible adult.
stem4 does not offer a counselling service. For any concerns please contact a GP and also the signposts in the Move Mood app. In an emergency please contact 111 or 999.
“Move Mood offers a fantastic evidence-based approach to supporting young people create and work towards motivational goals. The app is smart, user friendly and engaging. Move Mood is a useful tool that is helpful for pre clinical groups as well as being something that would work well alongside additional therapeutic input. I would thoroughly recommend it.”
Joe Stone, Family and Systemic Psychotherapist
FAQ v2 25/03/21