Cognitive-behavioral therapy is the empirically supported treatment of choice for a wide range of mental and behavioral health problems. However, a majority of individuals with mental health disorders do not receive treatment, resulting in a major public health concern. Those who do receive treatment often receive less than adequate care, and due to both individual- and system-level barriers in treatment access, there is typically a long delay between symptom onset and access to care. Patient-level barriers to treatment include logistical barriers (e.g., transportation and/or time needed to attend appointments), high costs of in-person treatment, and stigma associated with seeking in-person mental healthcare. Broader, system-level barriers include the dearth of mental healthcare professionals, particularly those who provide high-quality and/or specialized treatment. Addressing these issues is complex and costly. However, emerging technologies offer exciting, novel solutions to the treatment gap.

Technology-based solutions offer the potential to (1) provide a low-cost, low-stigma, high-caliber, and widely accessible treatment option, (2) facilitate novel, ecologically-valid assessment of symptoms, (3) enhance treatment potency, and (4) significantly enhance the pool of available skilled clinicians. The Massachusetts General Hospital Center for OCD and Related Disorders (CORD) currently has a range of ongoing exciting projects in this space including (but not limited to) research on smartphone- and internet-based cognitive behavioral therapy, virtual reality, digital phenotyping based on smartphone sensors, and internet-based therapist training. We are also using technology (fMRI, eye-tracking software, internet-based neurocognitive assessments) to understand who benefits from our current treatments and why certain people improve when others do not.