Tools of Engagement: Practical Considerations for Utilizing Technology-Based Tools in CBT Practice

Treatment engagement in cognitive behavioral therapy (CBT) is associated with positive outcomes. Technology-based tools present an opportunity to facilitate engagement in CBT. This paper will first review specific CBT engagement-related constructs, modalities/formats for applying technology in treatment delivery, specific engagement features available in CBT-based apps, and the relationship between CBT engagement and outcome. The Fogg Behavior Model may inform a process for enhancing CBT engagement, specifically utilizing technology towards achieving perceived simplicity and activating behaviors. Two vignettes are presented that apply the Fogg Behavior Model (FBM) and Persuasive Design framework to illustrate CBT engagement related constructs and practical considerations in applying technology-based tools to support CBT engagement. The vignettes focus on homework adherence with a thought record as well as activity scheduling. This paper concludes with a brief discussion of clinician engagement with technology applying the FBM, considerations of cultural responsiveness and inclusiveness, and additional implications for future research.