Effectively
The DBT App
Designing and prototyping a mobile app for learning and practicing DBT: Dialectical Behaviour Therapy
Effectively
The DBT App
Overview
Case study and product proposal; research, design and prototyping
Duration
Ongoing
Deliverables
- Literature review
- Competitive analysis
- User interviews
- User personas
- Journey mapping
- Feature auditing
- Feature ideation
- User flows
- Wireframing
- Prototyping
- Strategy + foresight documentation
Software
Adobe Creative Suite
Figma + Figjam
Google Gemini Pro
Claude Sonnet Pro
Context
What is DBT?
Dialectical behaviour therapy (DBT) is a practice-based behavioural therapy providing clients with actionable frameworks for managing intense emotions and improving relationships.
Clinician-led programs last six months to one year or more. Participants attend weekly skill seminars and learn from a source text, the DBT Manual of Handouts and Worksheets.
DBT skill modules focused on practicing acceptance
Mindfulness
Practice
Developing awareness of the present moment by consciously engaging the physical senses
Seeking intuitive balance between logical reasoning and emotional responses, referred to as wise mind
Distress
Tolerance
Skills for reducing intensity of emotion during episodes of emotional distress
Skills for minimizing risk of harm to self or relationships during episodes of distress
DBT skill modules focused on changing behaviour
Interpersonal Effectiveness
Skills for effectively pursuing, managing and ending relationships
Processes for fact-based validation of the self and others
Emotion
Regulation
Regulating the nervous system through repetition of structured routines
Increasing emotional self-awareness (ESA) through the practice of naming emotions and pairing coping strategies
Problem
What makes DBT challenging?
Structured DBT demands a substantial commitment of cognitive and emotional resources from clients in order for them to experience the max potential benefits of therapy.
There are a variety of factors that can potentially impact a client’s success in therapy and adoption of the DBT skills:
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Emotional Instability
Mood instability and emotional distress can impact the client’s executive functioning, reducing the likelihood of skill practice and implementation.
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Resources Req'd For Success
Structured DBT requires self-discipline, organizational skills, and practice outside of therapy. Clients are often balancing weekly DBT with work, school, childcare or other important commitments.
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Resistance to Behavioural Change
The cognitive and emotional resources required to interrupt existing coping patterns may initially cause clients to resist or avoid skill practice—especially with complex DBT skills such as Chain Analysis.
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Methods of Documentation
Paper binders are often used to manage the large volume of information. Binders are inconvenient to keep on-hand, restricting how often clients are likely to practice skills.
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Long-Term Skill Recollection
Past clients of DBT displayed a common difficulty recalling skills during user interviews. These clients, who had completed DBT programs between 1-3 years ago, described abandoning skill practice after programs ended.
Solution
How will Effectively meet the needs of users?
Effectively is a mobile-first toolkit empowering users to document the practice of DBT skills.
It better enables on-the-go engagement with the skills, and actively encourages users to develop habit formation—to maximize therapeutic benefit and to increase the likelihood of long-term adoption of the skills.
Effectively: The DBT App — Core Feature Toolkit
Practice Timeline
The Practice Timeline enables users to document DBT skill practice by adding Elements to a series of chronologically placed cards.
Elements include sheets from the manual, user-generated notes, device media and web links (videos, podcasts, articles and other resources).
DBT Manual of Handouts and Worksheets
Effectively provides users with a transcription of the DBT Manual designed for findability.
The manual of interactive sheets is designed for mobile-first documentation.
Skill Discovery
The Skill Discovery feature enables users to triage emotions and behavioural urges in order to determine the best skills to cope with next.
The suggestions are curated based on the user’s self-report.
Reminders + Practice Planning
Reminders in the form of push notifications aim to help users remain accountable and encourage them to build the habit of skill practice over time.
Practice planning allows users to pre-populate the Practice Timeline with tasks and reminders based on their personal needs.
Validating concepts with in-depth research and analysis
Discovery
Literature Review
Making the case for self-directed mobile mental healthcare
Empirical data sourced from academic literature provided dynamic, transferable insight:
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Examined the efficacy of mental healthcare apps based on affective conditions (anxiety, depression, etc.)
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Validated the use of mobile mental healthcare interventions from a cost-analysis perspective
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Provided research-validated heuristics for designing mobile mental healthcare experiences
Discovery
Competitive Analysis
Identifying strengths and opportunities in competitor products
Analysing direct competitors and reviewing publicly-available user feedback (forums, comment sections) allowed me to identify a clear market gap in terms of quality-of-service and affordability of available products.
A podcast featuring two certified DBT practitioners offered qualitative analysis from the clinical perspective.
Discovery
User Research
Conducting user research within an ethics-focused framework
I conducted semi-structured interviews with clients who have completed a DBT program, gathering qualitative data about their experiences before, during and after therapy.
I implemented a framework for conducting ethical research:
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Informed Consent
Consent forms outlining participant right-of-refusal during interviews + right-of-withdrawal in perpetuity after
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Conditions for Participation
A) Current access to MH therapist or counselor
B) Material stability — housing, food, income
C) Not in active crisis potentially requiring professional intervention
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Honorarium
Providing interviewees with cash honorariums to compensate for time and data
Exploring the design of a key feature: Skill Discovery
How might we help users discover relevant skills in the moments when heightened emotion or emotional distress impact executive functioning?
Feature Ideation
Sketching + Evaluation
Conceptualizing and assessing skill discovery strategies
I conducted a solo brainstorm as well as asking interviewees to describe how they might access the source text and go through the skill discovery process in order to manage an emergent emotional crisis or to resolve an interpersonal conflict.
I plotted those combined ideas and processes along an evaluation matrix, considering the effort and time it may take to tackle each approach.
Feature Audit
Heuristic Evaluation
Analysing how a competitor approaches the process of skill discovery
DBT Travel Guide offers a feature for skill discovery based on the user selecting an emotion or behavioural urge from a simplified list.
Heuristic analysis of the tool uncovered opportunities to improve upon the base concept.
Screen flow — DBT Travel Guide’s ‘Crisis‘ tool makes use of a traffic light colour code for users to triage emotional intensity
Documenting the skill modules where skill suggestions originate from for a given emotional state (here, sadness).
Prototyping
User Flows
Purpose-built filtering: cascading suggestions to users based on the method of triage
Both methods under consideration prompt the user to select a root emotion or behavioural urge, similar to the DBT Travel Guide ‘Crisis‘ feature.
The methods diverge at the second step of the triage, generating a possible A/B testing condition to reveal the more effective method.
Method A: Suggestions are provided to the user based on the user’s reported intensity rating of the emotion or behavioural urge
Method B: Suggestions are provided to the user based on the selection of a problem-solving strategy for managing the emotion or behavioural urge
Exploring other components of Effectively's feature toolkit
Providing access to source materials, enabling documentation, and encouraging users to form the habit of consistent practice
Feature Exploration
DBT Manual + Practice Sheets
Mobile-first handouts and worksheets
The DBT Manual is a dense text, featuring over 250 handouts and worksheets.
Transcription of the manual prioritizes a mobile-first design ethos. The table of contents integrates search and filter functionality for improved findability. Interactivity of sheets prioritizes ease-of-use.
Feature Exploration
Practice Timeline
Versatile tooling for documenting skill practice
The Practice Timeline allows users to create a searchable chronology of practice sheets and other forms of documentation using a system of sequenced Cards populated by Elements.
Elements include: assigned sheets, notes, local device media and links to web-based media (articles, videos, podcasts and other web resources).
Feature Exploration
Reminders + Practice Planning
Encouraging users to adopt the habit of consistently practicing skills
Empirical data points to a strong correlation between the frequency of skill use and reduction of symptoms.
Effectively encourages users to set practice reminders and pre-populate the Practice Timeline with sheets in order to increase the likelihood of habit-formation over time.
Strategic messaging and UX writing — taking inspiration from a market leader, Headspace
Headspace Says:
10 Minutes,
3 Times
Per-Week
Headspace’s UXR team was able to quantify a minimum amount of meditation practice required to achieve therapeutic benefit — 10 minutes, 3 times per week.
This quantifiable minimum amount is now a component of the strategic brand messaging for the Headspace app, creating an achievable goal for users.
Effectively Says:
Practice
Makes
Progress
There is currently no quantified minimum amount of DBT required to experience therapeutic benefit, however, data suggests that a higher volume of skill practice is strongly correlated with improved outcomes overall.
Practice Makes Progress; this messaging will be a core part of the brand’s voice.
Preparing for future success with Effectively
User Testing + Dev Hand-Off
How might we design user testing and prepare for dev?
One of the most vital next steps for validating the proposed tooling will be effective user testing.
Continuing the process of building out feature prototypes, we will document error states and edge cases to prepare for future dev handoff, making use of Figma’s Dev Mode to create systematized annotations.
Strategic Partners + KPIs
How might we resource the development of Effectively and measure impact?
Future research and development of Effectively could potentially be supported through public and private funding pathways.
Lastly, we consider future impact metrics to gather once an MLP lands in users’ hands.
