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Using Mood Triggers with Therapy Clients

If you’re a therapist, you may be interested in using Mood Triggers with clients. Mood Triggers is a completely FREE Android application developed by Nick Jacobson at Penn State.

Why use Mood Triggers in Therapy?

Assessment is an important aspect of any  therapy, in order to provide and synthesize a case with a client. Mood Triggers can aid in case conceptualization, while requiring minimal work on the therapist’s part.

Many cognitive-behavioral therapies (particularly for anxiety and mood disorders) ask clients to engage in symptom monitoring using daily homeworks. These diaries can offer useful insights into how a client experiences anxiety and depression in their daily life, but these assessments do not offer a rich case conceptualization without discussing the diaries in depth with the client.

Record Monitoring

  1. Electronic diaries of anxiety and depression. Mood Triggers offers all of the normal features of paper monitoring tools, but provides many new monitoring features that have great clinical utility and are easy to implement in practice. Client’s will be prompted once per hour on their phones. Therapists can then view peaks and trends’ to clients anxiety and depression.
  2. Automatic Sleep Monitoring. Persons with anxiety and depression often report difficutly with sleep hygiene (sometimes sleeping too little and sometimes oversleeping). Indeed, empirical research has shown that anxiety and depression are both linked to poorer sleep quality, and this contributes to greater symptoms severity. Mood Triggers will automatically monitor client’s sleep duration (and soon sleep quality). As a therapist, early in therapy you get a full record of a client’s sleep behaviors, allowing you to build sleep hygeine into the early stages of therapy.
  3. Automatic Step Monitoring. A hallmark symptom of depression is low behavioral activation, which can contribute to low physical activity. Mood Triggers automatically logs and keeps a record of clients steps to give clinicians a snapshot of their client’s activity levels throughout the day. Walking has been shown to decrease anxiety and depression in experimental studies, and Mood Triggers allows a therapist to know when to intervene.

Personalized and empirically based case conceptualizations

  1. Mood Triggers monitors a number of constructs that have been empirically related to anxiety and depression (like avoidance, helplessness, hopelessness, attentional biases any many others). By clicking a single button in the app, Mood Triggers will list the aspects that are most impactful in determining a clients anxiety and depression symptoms. These are presented in an easy to read list, and this can be used to inform treatment plans.
    • Example 1: When a therapists clicks the results button, they see that the top symptom related to a given client’s anxiety is negative life events. This tells the therapist that the client’s anxiety is primarily driven by being overly reactive to stressors in their daily life. The therapist can then target stress reactivity first within treatment.
    • Example 2: When a therapists clicks the results button, they see that the top symptom related to a given client’s anxiety is avoidance. The therapist can target avoidance behaviors immediately within the therapy, and work on a construction of a fear hierarchy to work on fear exposures.
    • Example 3: When a therapist clicks the result button, they see that the top symptom related to a given client’s anxiety is heart rate. The therapist can see that the client is strongly reacting to their physiological arousal. The therapist immediately begin introceptive exposure to break the link between anxiety and physiological arousal.
    • Example 4: When a therapist clicks the results button, they see that the top symptom related to a given client’s depression is fatigue. The therapist can work on intervention strategies to increase energy levels throughout the day with the client.
    • Example 5: When a therapists clicks the results button, they see that the top symptom related to a given client’s depression is hopelessness. The therapist can work on a cognitive intervention targetting the client’s maladaptive thoughts about the future.

Sounds great, but isn’t this a lot of work?

No! We designed Mood Triggers to be easy to use, for both clients and therapists. Mood Triggers is designed to be a self-contained self-help tool.

Since Mood Triggers contains all the instructions needed to use the app within the app itself, all that would be required is to tell client’s the name of the Mood Triggers app, have them install it, and bring their phone in with them during the next therapy session.

A therapist can view a record of the client’s anxiety symptoms, depression symptoms, and health behaviors from one click on the home screen.

Accessing the personalized and empirically based triggers of that client’s anxiety and depression just requires that a therapist and look at the top of the list of triggers. If a trigger is green it means that as a client’s trigger goes up, their symptoms rises, if a trigger is red it means that as a client’s trigger goes up, their symptoms decreases.

Summary

Mood Triggers is a no-cost, useful assessment tool that can offer a therapist valuable insights into their client’s anxiety and depression symptoms, and requires only minutes of the therapists time.

Link to Mood Triggers on the Google Play Store

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Self Reflection

Sometimes self reflection can be difficult, and if you don’t have to, it is easy to never do it.  However, with the Mood Triggers app, you will have guided self reflection (potentially every hour) through the surveys.  This will help you to notice patterns of thinking you may not have noticed otherwise. This self reflection that Mood Triggers will help you with is part of reaching the first step in getting better: recognition.  Once you have been self reflecting and recognized a problem in your thinking, you may be able to catch yourself with a thought process that is contributing to your anxiety or depression. It may not be easy to stop the thoughts immediately, but being able to recognize this thought and perhaps even say to yourself, “no, this is not rational,” or something along those lines, will help improve your mood drastically.  Furthermore, the self reflection you will be engaging in will help you have better ideas of what to say about yourself in therapy. Self reflection will allow you, as well as your therapist, to better improve your mood and overall well-being!

Control in Anxiety

Control can have a significant impact on mental wellbeing.  It is easy to feel as though you are hopeless, with minimal control in regards to the events that happen to or around you.  This external locus of control can lead to feelings of anxiety, as it is easy to feel like other people have control over your life.  This takes away feelings of independence and self efficacy, and can cause learned helplessness – the way things are is the way things will always be.  For example, if you believe you are just simply bad at science, it is possible that you will accept no control and have no improvement in your abilities.

However, this helplessness can be changed – once you are aware of the issue.  The Mood Triggers app will help you take the first, very necessary, step to improving the idea of control you have over your life: noticing that it is a problem.  Among many survey questions, some ask about the amount of control you have had in recent events. The app will be able to tell you if hopelessness (and lack of control) is something that really impacts your mood.  If it is, you will have gained some insight to your feelings and will have something to focus on in therapy or in simple self help/self improvement!

Feeling Tense in Correlation to Anxiety

Among many features of anxiety comes tense muscles.  Tenseness may not be something that is regularly thought of in correlation to anxiety, but it is definitely something to be aware of.  The Mood Triggers Application asks a variety of questions about anxiety, one of them being “How tense do you feel right now?”  Being asked to think of your physical body features is one way to be more aware of the symptoms that come with your anxiety, which will in turn help you to better control your mood.  Furthermore, you will be able to track what types of situations lead to the variety of symptoms you encounter.  For example, writing an essay may make you very tense while preparing for a presentation may make you shaky (which is a focus of another anxiety question).  This knowledge will help you to focus on all anxiety triggering events in their own way, as not every circumstance will lead to the same feelings and physical manifestations.

Negative Events

The Mood Triggers application gives you the ability to track anything you consider to be a negative event that has occurred since you last took the survey.  Outside of asking if a negative event has occurred, the survey prompts you to answer questions about the negative event in relation to yourself: your contribution to the event as well as your ability to change the possible outcome.  These questions will allow you to reflect on the general reaction you have when a negative event occurs.  While it is quite easy (and often expected) to react pessimistically to a negative event, allowing these incidents to take over your mood can easily lead to depression.

Tracking your reactions to and the regularity of negative events in your life may also lead to a new discovery in the cause of your depression, which could be an ideal topic to discuss in therapy.  You will be able to talk with your therapist about different methods of coping with any given negative event, as well as discuss why some events make you react so poorly.  With recognition and discussion, you will be able to have more positive responses!

Weather and Mood

Among the large variety of aspects tracked by Mood Triggers is the weather.  It is very easy to have your mood affected by the weather, such as being in a worse, sadder, mood when the day is rainy and being in a more upbeat mood when the day is sunny.  Your mood is also liable to change with the season; in the winter, when it is colder and dark earlier, you may be sadder than you are in the summer.  This is called Seasonal Affective Disorder (SAD), which is an extremely common disorder.  There are specific therapies designed to combat SAD, such as light therapy, but the only way to know you need to use a therapy specific to the environment is by properly tracking your mood. With Mood Triggers, your mood, the weather, and many other factors to your mood are kept in one spot, so you don’t have to worry about keeping track of your mood and its influencers; you can just check your phone!

Mood Tracking

The Mood Triggers application prompts you hourly to take a quick survey.  Within this survey, there are many questions that focus on your anxiety, depression, and triggers.  However, the most helpful aspect to this app is that it only asks about the past hour, as you would have taken the survey an hour before.  This makes the app more accurate in figuring out what is truly triggering your negative emotions because it is specific and regular, rather than general and only when you feel anxious or depressed.  Being consistent with the surveys will allow you to have a very accurate reading of when you are feeling anxious or depressed, and why you are feeling that way.  

When reflecting on your past week or two in therapy, it can be very difficult to remember exactly how you were feeling.  If an emotion was prominent you may recall it, but it is much easier to discuss how you feel in the moment than to remember all the emotions you had in the past week.  This is where the Mood Triggers application can come in.  You will remember how you felt every day throughout different times and parts, so if one day or one time period is causing you extreme stress, you will be able to properly identify it and discuss it in therapy to get better.

Different Triggers

Anxiety, depression, and any other mood disorder can be triggered by a plethora of perceptions and outside influences.  There are so many different, small things that can begin a spiral into a bad mood or intense anxiety, and it can sometimes be very difficult to label one specific thing as the reason for your issue.  The Mood Triggers app can do this for you, so you do not have to worry about why you feel the way you do!  There are a multitude of different triggers this app might identify as influencing your mood, such as: helplessness, hopelessness, self reported arousal, fatigue, avoidance, heart rate, and so many more.  Once you are able to identify what triggers your anxiety or depression the most, you will be able to work towards getting better by focusing on the most prominent triggers.  

You will also have something to focus on in therapy, and when your therapist asks how you have been, you will have a much easier time answering.  You will have been tracking your mood very regularly, which will help you to recall almost exactly how you were feeling throughout the week, and better yet, why you were feeling that way.  There are a myriad of possible reasons you are feeling the way you feel, but the Mood Triggers app will help find the most dominant problem that you can work on in therapy and in everyday life.