Wiring Adolescents With Social Anxiety via Behavioral Interventions (WASABI): a closed-loop mobile intervention to reduce social anxiety and improve social skills - PROJECT SUMMARY
The goal of this project is to further develop (to pivotal trial readiness) and evaluate WASABI (Wiring Adolescents
With Social Anxiety via Behavioral Interventions)–a clinician-assisted, adjunct to treatment, mobile application
designed to augment the efficacy of psychological Evidence Based Treatments through a closed-loop
technology. In this project, we will build upon promising results obtained from two studies in anxiety and
psychosis, leverage pilot data collected in adolescents with Social Anxiety (SA), and test WASABI as an adjunct
to digital Cognitive Behavioral Group Therapy (dCBGT). Via Ecological Momentary Assessments (EMAs)
WASABI will capture data on social anxiety, its underlying cognitive biases, and on social role performance.
These data will populate a predictive machine learning algorithm that will alert the WASABI clinician and end-
user of whenever social anxiety reaches clinical significance. The clinician will use this information to initiate
synchronous or asynchronous Instant Messaging (IM)-based conversations with the goal of supporting,
recommending and reinforcing relevant skills to alleviate the momentary distress, to increase social competence,
and/or to improve contextual social role performance. Similarly, the clinician will leverage WASABI data to
personalize dCBGT content during the weekly group video-calls. This individualized assessment, monitoring,
and treatment approach is posited to induce flexible adaptive long-term learning about social-emotional events,
and support the generalization of trained cognitive skills within the everyday lives of adolescents, thus improving
their clinical and functional status. In Specific Aim 1, we will first involve three adolescents with SA and two
clinicians in three focus groups that will be organized to refine WASABI and qualitatively evaluate its
manageability, clinical usefulness, and acceptability. Once decisions regarding the app and dashboard design
are made, the three adolescents will be involved in a 2-week trial run, during which the predictive ability of the
algorithm will be validated by the WASABI clinician, who will verify via 1:1 remote videocalls the actual presence
of clinically-significant social anxiety whenever she receives an alert. Additionally, the test run will ensure that
WASABI EMA data are timely evaluated by the clinician on the dashboard and meaningfully orient the delivery
of individualized IM and weekly dCBGT content. At the end of this test run, each stakeholder will be asked to
rate enjoyment, ease of use, product quality, and perceived usefulness. Finally, we will submit these data from
the trial run to our consultant to confirm that WASABI is suitable for evaluation in the feasibility trial. In Specific
Aim 2, to evaluate the acceptability and preliminary efficacy of WASABI, we will conduct a pilot augmentation
trial with 32 adolescents with SA who will be randomized to dCBGT+WASABI vs dCBGT only. At the completion
of this project we will have usability data sufficient to support a RCT in Phase II designed to establish medical
claims defining the efficacy of this intervention. At the completion of Phase II, we will be able to complete the
FDA regulatory pathway and have the opportunity to improve the lives of people suffering from this condition.
