REThinkEMOTIONS Project

REThinkEMOTIONS platform integrates the following tools that were separately tested in laboratory conditions and found effective: 

  • the online REThink therapeutic video game (David, Cardos, & Matu, 2018a,b)
  • the MoodWheel app for momentary ecological assessment of mood (David & David, 2019).
  • the PsyPills app for the enhancement of self-control and emotional regulation though „psychological pills” (David & David, 2019)

The platform is developed based on the experimental-demonstrative project PN-III-P4-ID-PCE-2020-2170, awarded to Dr. Oana David by UEFSCDI. The integrated platform will be accessed by youth, parents and clinicians or researchers. The main original feature is the integration of state of the art online, mobile and gaming technologies into a unique platform that allows easy access to personalized, accessible and validated prevention.

The platform aims to allow access to attractive, easily accessible and evidence-based prevention for youths. The system will be validated in the second step as an integrative, multi-componential and adaptive platform for the prevention of emotional disorders in youth. Based on the findings, the platform will be further refined and enriched with additional modules for specific populations and difficulties in future.

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Ecological mood assesment and intervention tools

Mood Wheel

Mood Wheel is a  web and mobile-based app that uses experience sampling procedures for the assessment of current/previous distress and positive emotions. The aim of the app is to inquire about the valence, control and functionality of users’ emotions.


PsyPills

PsyPills is a self-help psycho-educational instrument intended to build stress resilience and to target (only) mild and transient negative mood states, alone or in combination with other methods/instruments.

Psychological Pills (PsyPills) are inspired by Rational-Emotive & Cognitive-Behavioral Therapy (CBT/REBT), which has strong evidence for its efficacy/effectiveness in human development/health promotion and in the treatment of a variety of psychological conditions. 

The PsyPills app was tested in a pilot study and showed positive effects on reducing distress. We will test the efficacy of the app adjunct to other therapeutic tools within the platform in our projects.

Status

The REThinkEMOTIONS platform is fully implemented and can be accessed using the following link: https://app.rethinkplatform.ro/#/login and on Google Play and App Store.

The EMA (Mood Wheel) application was developed and is available on Google Play and will be integrated in the REThinkEMOTIONS Platform.

The study assessing the REThinkEMOTIONS Platform’s validity for the evaluation of children and adolescents’ levels of emotion regulation abilities has been implemented, and has successfully collected data from 196 parents and youths.

The following step consists in refining and personalizing the REThink online game based on emotion regulation difficulties and integrating it with the EMA tools in the REThinkEMOTIONS platform. We are also in preparation to start recruitment for the second study testing the usability of the platform and the efficacy of its main game-based emotion regulation strategies.


Update December 2022

On this phase of the project the REThink EMOTIONS platform was refined in order to be more accessible for users and researchers. Also, we implemented refinements in the REThink Game based on the feedback we collected from the participants in the studies. MoodWheel App was refined also and extended to collect data regarding physical activity and PsyPills app was re-implemented using latest technologies.

All the apps (REThink EMOTIONS, REThink Game, MoodWheel and PsyPills) are freely available on Google Play and App Store.

In the phase we implemented two research project where the REThink Game levels were tested as a standalone interventions and in combination with MoodWheel and PsyPills Apps for the stress reduction in children and adolescents.

Following steps in this project constist of a full scale trial to test the REThink Game intervention and EMA/EMI Apps for prevention of ER disorders in youths.



Publications

TitleYear JournalAuthorsStatus
David, O. A., Predatu, R., & Cardoș, R. A. I. (2021). Effectiveness of the REThink therapeutic online video game in promoting mental health in children and adolescents. Internet Interventions, 25, 100391. https://doi.org/10.1016/j.invent.2021.100391
2021Internet InterventionsDavid Oana
Predatu Răzvan
Cardoș Roxana
Published
David, O. A., Cîmpean, A., Costescu, C., DiGiuseppe, R., Doyle, K., Hickey, M., & David, D. (2021). Effectiveness of Outpatient Rational Emotive Behavior Therapy Over One Decade. American Journal of Psychotherapy, 74(4), 157–164. https://doi.org/10.1176/appi.psychotherapy.20200009
2021American Journal of PsychotherapyDavid Oana
Cîmpean Alina
Costescu Cristina
DiGiuseppe Raymond
Doyle Kristene
Hickey Michael
David Daniel
Published
Tomoiagă, C., & David, O. (2022). The Efficacy of Guided and Unguided Game-Based Cognitive-Behavioral Therapy in Reducing Distress in College Students. Games for Health Journal, 11(6), 403-413. Doi: https://doi.org/10.1089/g4h.2021.01952022Games for Health JournalTomoiagă Cristina
David Oana
Published
David, O. A., Magurean, S., & Tomoiagă, C. (2022). Do Improvements in Therapeutic Game-Based Skills Transfer to Real Life Improvements in Children’s Emotion-Regulation Abilities and Mental Health? A Pilot Study That Offers Preliminary Validity of the REThink In-game Performance Scoring. Frontiers in Psychiatry, 325. Doi: https://doi.org/10.3389/fpsyt.2022.8284812022Frontiers in PsychiatryDavid Oana
Magurean Silvia
Tomoiagă Cristina
Published

Although evidence-based interventions exist, estimates suggest that about 60% percent of children and adolescents with mental health disorders do not receive the treatment they need. In this context, one expanding strategy for increasing access to mental health care for children and adolescents is the use therapeutic, or serious, games. REThink is one such therapeutic game, developed to offer a CBT-based prevention that was documented in a controlled trial to develop psychological resilience in children and adolescents, aged between 10 and 16, helping them learn healthy strategies for coping with dysfunctional negative emotions such as anxiety, anger and depression. This study aims to test the effectiveness of the REThink therapeutic online video game in promoting emotional health in children and adolescents in a pilot study.

Participants (N = 31), aged between 10 and 16 years, were recruited on a volunteer basis from a school. Emotional problems, irrational beliefs, negative automatic thoughts, rational beliefs, and problem solving abilities were assessed pre- and post-using the therapeutic game. We also measured participants’ satisfaction with the game. Results obtained show improvements in terms of emotional problems of the youths, their irrational beliefs, negative automatic thoughts and high levels of intervention satisfaction. The results of this study are in support of the previous findings suggesting that the REThink online game can be a valuable tool for large-scale mental health efforts aimed at the prevention of emotional disorders in children and adolescents, in accordance with evidence-based prevention protocols.

The aim of this article was to explore the effectiveness of rational emotive and cognitive-behavioral therapy (REBT) in a clinical setting. METHODS: This study included 349 patients of the Albert Ellis Institute who sought psychotherapy from 2007 to 2016. Analyses were conducted by using the intent-to-treat principle, and outcomes were measured after three sessions of therapy (to measure early response) and at the end of 20 sessions. Outcome Questionnaire-45 was used to measure patient functioning. RESULTS: Patients reported significant improvements in their functioning after participating in REBT, with a medium effect size for early response after three sessions of psychotherapy and at the end of the 20 sessions. CONCLUSIONS: The authors’ findings documented that REBT can be effectively transported from a research setting to clinical practice.


College students` mental health is an international prioritized research subject. Dedicated interventions are constantly developed to be more suited, attractive, and effective and to reach as many students as possible. Our study aims to investigate the efficacy of an online game-based cognitive-behavioral therapy transdiagnostic intervention (REThink game) in reducing psychology students’ distress. Our sample consisted of 139 students (mean age 26.27; 17 male students and 122 female students) who voluntarily enrolled in our study, and they were randomly assigned to 1 of our 3 groups (REThink game without guidance n = 44; REThink game with guidance n = 46; or care-as-usual control group n = 49). They completed the pretest questionnaires (distress [negative functional and dysfunctional emotions], rational, and irrational cognitions), then they were offered to play the trial version of the REThink game, and after that, two specific levels focused on relaxation with mindfulness abilities, and on cognitive change emotion-regulation abilities. After completing the game, students in the REThink game with guidance received email support aimed to help them implement the skills learned in the game. Results showed medium effect size improvements for the REThink game without guidance group compared to the control group in terms of dysfunctional negative emotions and improvements in irrational cognitions for both experimental groups compared to the control group. So far, the REThink therapeutic game proved to be a promising innovative, efficient, and highly accessible intervention for helping students manage distress.


Therapeutic or serious games are considered innovative ways of delivering psychological interventions especially suited for children and adolescents, which can have a positive impact on mental health, while also being fun and easily accessible online. While most serious games for children and adolescents address specific issues, such as anxiety or depression, preventive measures received less attention. REThink is an online therapeutic game designed as a stand-alone prevention tool, aiming to increase resilience in healthy children and adolescents in a Rational Emotive Behavioral Therapy framework (David et al., 2019). The aim of this pilot study was to investigate the validity of in-game performance measurements or scores as indicators of the game effectiveness in building real life emotion-regulation abilities. We analyzed how scores of different game levels (addressing different skills) are associated with improvements in mental health and emotion regulation abilities. Our preliminary results suggest that in-game performance at some levels (scores) consistently reflect improvements in psychological functioning, while in-game performance at other levels are less associated with changes in real life self-reported psychological functioning. These results offer important information about which levels can be used as preliminary indicators of psychological improvements, and which levels need to be revised in terms of task or scoring. Overall, results of our study offer preliminary validation of REThink’s game scoring system, while also suggesting the elements to be refined.