Investigating Cognitive Behavioral Therapy treatments for Anxiety Disorder with Psychologists

How Patients Respond to Cognitive Behavioral Therapy Treatment Homework

Stress is a common experience for all walks of life. Some people experience more stress than others, while everyone copes with stress in their own unique way. My thesis research will investigate how technology can serve as an intervention system to help people cope with stress more effectively. This research will investigate users who suffer from high levels of stress and are seeking treatment to alleviate their symptoms. This tool will serve as an automated system in which biosensors will collect real-time data of the user, calculate stress levels, and encourage the user to engage in various stress-reducing techniques. Thus, my research will begin with interviewing psychology graduate students (secondary stakeholders) who have experience with treating anxiety disorders and will provide qualitative data that will assist my design concepts.

Research of cognitive behavioral therapy has provided empirical support for its efficacy of changing behavior through in-session therapy and assigned homework for patients to complete outside of therapy. By better understanding the treatment experiences of these practitioners, I hope to develop a device that will create the best user experience to allow users to maintain a healthier level of stress.

There have been some research findings that have used technology as a mediator between cognitive behavioral therapy and patient. Research in emotional eating in cognitive behavioral therapy (CBT) suggests that in order to modify eating behaviors, one must identify what triggers emotional eating and what makes the person become aware of their maladaptive behavior (Carrol, 2013, p. 1). The way CBT approaches this is by having the person keep daily food and mood logs to encourage “real-time self-monitoring”. This model of changing behavior hopes to bring the automatic thoughtless actions into consciousness to motivate engagement (Carrol, 2013, p. 2). In Food and Mood: Just-in-Time Support for Emotional Eating, participants were asked to use a mobile application EmotiTree, to log their mood every hour as well as their eating patterns. In addition, they investigated on an intervention technique that asked users to do breathing exercises whenever they would input stress or anxiety. Results showed that 87.5% people became more aware of their eating habits but only 37.5% reported that their eating behaviors changed (Carrol, 2013, p. 3).

Designing for Positive Health Affect (Toscos, 2013, p154) is a project that uses three different theoretical frameworks that help shape design recommendations to help counter the negative emotions associated to glucometer devices for adolescents. Current glucose measuring devices generate negative emotions associated with the device. In order to understand why, this paper conducted two interviews to reveal different needs of children dealing with Type I Diabetes and how it affects the parent-child relationship. These interviews were designed to gain a better understanding of concerns that span across different developmental stages regarding the use of glucometers and to seek ways of lowering emotional barriers of using the device. In the interviews between parent and child, the researchers realized that these devices lacked a communication platform to help facilitate conversation between the two about the child’s glucose levels.

My research will investigate patients’ behavior involving their use of stress-reducing techniques (e.g., methods of reminding themselves). Thus, my inquiry will begin with interviewing 6 psychologists to ask about the behaviors of their patients and what types of disorders involve high stress, and what kinds of interventions are used. My questions will sought to answer specifically why the specific interventions are used, when they are implemented, how effective they found them to be, and how often they are used, and what kinds of customized changes are needed to be made.

I chose to inquire within this community because they are more accessible to recruit than patients who suffer from anxiety disorders. The process to recruit these users for interviews would require me as a researcher to approach counseling centers, and ask for permission to recruit their patients. In addition, it would also require participants to expose their mental illness, which I may be perceived as an invasive interviewer even if I were to offer compensation for their time and information.

Through meeting these psychologists who have experience with cognitive behavioral therapy, I would like to conduct in-depth interviews on the phone and in-person at The New School Counseling Center and Rutgers faculty and Graduate students at the Graduate School of Applied and Professional Psychology.


Carroll, E., Czerwinski, M., Roseway, A., Kapoor, A., Johns, P., Rowan, K., Schraefel, M.C (2013). Food and Mood: An Exploration in Emotional Eating Intervention.

Toscos, T., Connelly, K., Rogers, Y. (2013). Designing for Positive Health Affect. International Conference on Pervasive Computing Technologies for Healthcare and Workshops.

Interview One FitBit user

Download Word Document here: MadisonsInterview

Crystal Tong

Thesis I


Scott Pobiner

Louisa Campbell

Interview I

This interview was conducted to explore current health tracking device users and their needs, wants, and behavior.

Biography of subject

Madison is a 28 year old female who lives and works in Los Angeles. Her career is in the apothecary and commercial business. Her day job often entails her managing the editorial, logistical process, and clients in an apothecary company. At night she is usually casted as an extra in commercials at least once a week. Her body image and health is extremely important to her, so she is pretty avid at exercising and eating a balance diet. She just recently purchased a Fitbit three months ago.

Scripted questions and Transcript

When do you put on your Fitbit?

I wear it every minute of the day

Do you use the silent alarm feature? Do you look at your Fitbit in the morning? If so when? What data are you looking at?

I use it to track my sleep if I remember. It’s interesting to see how often you are restless and whether you woke up. I like using it in the shower.

Do you share your data or achievements with your social circles?

Sharing weirds me out

Do you use the water and calorie intake?


What do you do for physical activity? How has it changed your physical activity been?

Going to the gym is about the same. I sometimes work out longer because of the fitbit. I also opt for stairs and walking more everywhere I go because of it

2:20 secs: I take more steps, I sometimes walk in circles and take the stairs while watching my steps change.


When I have to charge, it doesn’t calculate your pulse. Which it would give more accurate view of your heart rate and calories you’re really burning. It’s basically now using an educated estimate.

Style is also a problem. If they came out with more options that are not as expensive. I don’t like to take it off if I am going to a meeting.

Do you set goals for yourself? If so what are they?

I have goals for steps, distance, minutes of being active throughout the day. Calorie intake and balance. How many you burn how many you consumed. Water, making sure I’m drinking the water throughout the day. It’s very satisfying to fulfill it by seeing the colors change from orange to green. It also sends you messages through phone alerts or emails. It’s one of those things if you are goal-oriented person, it’s really satisfying.

Which goals are you more obsessed about?

I am bummed about certain goals , others are whatever.

How often do you go to the gym?

I started running more. I use to not run at all.

How often do you check your Fitbit?

4-5 times an hour if I am active. If I am sedentary, I wouldn’t check it as frequently.

If you were to prioritize reasons why you track your health could you tell me what they are?

  1. reach fitness goals short term- gain weight
  2. long term health to quantified self. quantified selfers.
  3. deeper level to control.


Madison was the perfect candidate to talk to as an avid health tracker user. She is addicted to using this device because she is goal-oriented. She is so much so goal-oriented that she described one of her frequent behaviors which was to check whether her goals have all turned green (signified reaching goal). The Fitbit also supports this behavior and gives her contingent feedback when she would accomplish a goal, and it also delivers micro feedback when she would take each step.

Her short term goals behind using the Fitbit really says that she is concerned about the immediacy of improvements of herself, and that she is self-conscious about her body image. She is also fascinated by the data the device collects and the feedback she receives that she wouldn’t otherwise receive if she didn’t wear the Fitbit, which leads me to believe that if there was another feature added to the device she would use it. For example heart rate, perspiration, and stress.

The secondary reason why she uses the Fitbit is to benefit her long term health. I think that she would be interested in monitoring her mental health because the mental and physical performance of one’s health attributes to each other.

I think users like Madison who enjoys quantifying herself would consider quantifying her own emotions if she had the opportunity to. Thus, the next step in research would be to have her log her emotions and location throughout the day and compare and contrast her Fitbit data to see if there are any relationships between her environment and her emotions and her physical activiy.


Week 1&2 Notes: Domains, Venn diagram, stakeholders

Closer to design. More problem to address. Investigate the history of those who try to solve the problems. In design of question of aesthetics. Doesn’t solve elegantly. Are you tryin to address an issue or a problem?

Some articles i’m interested in:

Slow design. Emotional design mike kineoski

  • Hernandez J., Li Y., Rehg J., and Picard R. W., “BioGlass: Physiological Parameter Estimation Using a Head-mounted Wearable Device,” To appear in International Conference on Wireless Mobile Communication and Healthcare, Athens, November 2014.
  • Hernandez J., Picard R. W., “SenseGlass: Using Google Glass to Sense Daily Emotions,” To appear in ACM User Interface Software and Technology Symposium, Honolulu, October 2014.
  • McDuff, D., Gontarek, S., Picard, R. W., “Remote Measurement of Cognitive Stress Via Heart Rate Variability,” In the 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Chicago, August, 2014. PDF

scream bodies, presentation of emotion through our interation, theres therepeutic tools.

who do people really care about what you’re creating within these domains?

find the relevance of what you want to create

irvin goffman- presentation of self, hey way you feel inside is portayred differently from what you want portrayed outside. may not be what you want to do but see how one exercises the use of emotions and helping those express it. what can i do with emotions? help express? how does the output of emotions help others.

without the service part of your design, you’re not designing.

 perhaps there is a social aspect of outputting your emotions on display

find online that you are interested in with a group that deals with the issue relevant to you

this would be a venn diagram of your domains, within this would be a subgroup that you can reach out to.

venn diagram, once you have the groups and the expertise, and they aren’t quite connected, you can identify what’s missing. locating an expert in each of these domains in the core of your project. hunt for an expert that knows their domain, and knows other domains, and you can talk about them next weekend. and this is part of your community.

how are collecting data of emotions helpful? how does it address in all your communities?

More notes during class:

Domain Methodology and What is thesis?

A thesis is you compiling a domain. You are specifically interested in improv, or virtual reality, or something you define it. but it’s up to you to decide how all those dominions fit together.

What is your question? Is it figment fear, a narrative fear,

Helping others understand the fear as oppose to interested in studying the subject itself. DT facilitating those who study fear. Like Kelly Nichols. Moved from prosthetics to memory and dysfunction. As expert as he could become about cognitive dysfunction. he is not an expert. but speaking to an expert, he has not idea to design interfaces. so when he went to the conference. why is a designer here? his prototypes were used at the university of toronto. when we start to identify a domain, we don’t recognize it to be there but we authorize your work by the people in your domain.

Data visuals with a biologic approach. you have to separate the methodologies between the two and see how you can engage it. and that’s domain methodology.

example: user experience- and user interface design. could be through retail space or through a city. to help them accomplish that goal. all the needs to understand what fails.

interface design, what each step and each process they need to accomplish. such as color, what they see.

Educational games

methodologies of education-

how deep should she go on narrowing down the domain. is education the domain?

how deep do you go? what are your aims?

Uzman haque- open burble

usually a few people really find her niche

your production should keep producing because you’re trying to figure out your domain.

citing experts doesn’t mean they can be your giants. how sound develops in your mind, a text book is a great place to look at that. when you look at personality and biology, look at the text book. it works. or use amazon.

killer app- changes the way people get things accomplished

school of innovation in the spring

democratization and adoption-

we all should eventually want to use and want to use. so we all want to adopt. what is an overt behavioral change? a behavioral change is changes the way you use things. overt is fundamental how we interact in the world

study the history of what you are interested post it on the blog, and post your presentation on your blog and buy 5 notebooks!

A Chris Henrick (Peer) Interview

The specific domains Chris is interested in:

  • digital cartography
  • ethnographic information science
  • data visualize
  • critical theory
  • social justice

Christopher Henrick is interested in tying in critical theory around academic cartography with technology, and social justice. Specifically, he is interested in ways people are using non normative maps to convey information. For example, in Ho Chi Minh City, the way in which you navigate through the city is by temporal maps on sidewalks. Such examples incorporate cultural values to mapping cities, and answer questions that traditional academic mapping wouldn’t be able to answer with empirical data.

The motivation behind his concept and domain is due to the legacy academics and professionals have paved out for cartography . At the time, it was held as the absolute, the objective way of learning about the world. When actuality, maps always served a specific purposes, such as political motivation.  And since it is a generalized depiction of the real world, some things are being left out and purposefully included. For example, when you’re looking at a map of the gulf coast, where there is an open body of water on it, and the map leaves out the mass oil infrastructures used for the extraction. Henrick is interested in teaching academics and professionals to learn about the implications of their work and unintentional consequences when they leave out such information and to learn to take precautionary measures when designing maps. 

Lastly, to further establish his concept, he would like to answer the following questions:

How can the field to be made more humanistic? Do we need to move beyond cartography, and do we need to move more democratic? Do we need something different from map. Is participatory mapping a viable solution for democratizing viable fields.