Integration of cognitive behavioral therapy and mobile health applications among university students with depression: a qualitative study

Abstract

Abstract Background Most applications for depression lack comprehensive theoretical integration and qualitative assessments of university students’ needs remain insufficient. Objective This study aimed to explore the needs and experiences of university students with depressive symptoms and develop a theory-driven app design framework tailored to the target population. Methods A post-positivist qualitative framework was used to recognize the value of subjective experience. Semi-structured interviews were conducted with 32 students with moderate to moderately severe depression. Reflexive thematic analysis was used to identify themes in the data. Results Three themes emerged: app design, help-seeking processes, and core features of cognitive behavioral therapy. Students emphasized the importance of discreet, user-friendly design, such as positive naming, privacy protection, and flexible reminder functions. Although some expressed concerns regarding the empathy and reliability of artificial intelligence, others valued its anonymity and capacity to provide immediate support. Regarding theoretical integration, participants considered monitoring emotions and physical sensations essential but also highlighted the need for diverse and personalized methods. The conceptualization of self-monitoring data was considered useful for facilitating clinical consultations. Conclusion Students considered theory-based health education as effective for improving mental health knowledge and promoting help-seeking awareness. The findings support clinical decision-making in developing more effective digital tools.