Therapy in Space

You haven’t seen your family for weeks. Your job performance is literally a matter of life and death. You’re cooped up in a small living space with work colleagues, and you can’t even step outside for a quick breath of fresh air. You’re an astronaut in space, and you’re depressed. Who can you turn to? The answer — a new computerised therapy system being developed for NASA — might turn out to be pretty useful right here on Earth, too.

Following successful beta tests using researchers in Antarctica, additional clinical evaluation of a new NASA-sponsored computerised depression treatment system is about to get underway. Developed by the National Space Biomedical Research Institute, the interactive multimedia software system will, according to a recent press release, “assist astronauts in recognizing and effectively managing depression and other psychosocial problems, which can pose a substantial threat to crew safety and mission operations during long-duration spaceflights”.

Project leader Dr James Cartreine, a research psychologist at Harvard Medical School, notes that the depression treatment module, part of a larger project called the Virtual Space Station, offers significant potential as a self-guided treatment resource for many people right here on Earth, not just for astronauts on space missions.

And Cartreine’s co-investigator, former astronaut Dr Jay Buckey, now a professor and physician at Dartmouth Medical School, suggests that the solution-focused approach of the depression module is both novel and based entirely upon proven methods: “These are unique NSBRI products that did not exist before,” he said. “The Virtual Space Station is based on proven treatment programs and is a very helpful way to work on problems in general.”

Of course, self-directed computerised depression treatment has been available for a long time, using a CBT model. Probably best known is Australia National University’s MoodGYM, while in the UK, struggling software company Ultrasis has long championed the use of Beating the Blues, their software system which has been approved by NICE (National Institute for Clinical Excellence) for use in the National Health Service.

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This new contribution to the field from such a deep-pocketed sponsor as NASA promises both a new take on the idea of self-directed computer-mediated depression therapy and the potential for significantly wider — and probably free — access to the latest research-backed methods. (By contrast, even though MoodGYM provides computerised CBT for free, Ultrasis tries to sell individual consumers access to Beating the Blues for a whopping £300.)

As for astronauts in space, you might wonder: why not just rely on live communications with a psychologist or therapist over a radio link? As pointed out in a widely-reprinted Associated Press article this past weekend (here, for example), on a far-away mission to somewhere like Mars, where the distance to Earth could be as much as 250 million miles, it takes over 40 minutes for a radio signal to make the round trip. (22 minutes, 21 seconds each way, to be precise.) That makes the couple of seconds of delay we sometimes experience speaking by phone to people on the other side of the planet seem positively insignificant.

What about asynchronous online therapy via email with a real therapist, as opposed to synchronous therapy with a computer system? The press releases don’t mention the possibility, although my guess is that here, too, time plays an issue: if you’re feeling stressed or depressed right now about your colleague floating right on the other side of the bulkhead, it’s probably best not to have to wait until re-entry time to get that email reply back from your psychologist or therapist!

Editor’s Note: Dr Catreine formerly conducted research under the name James Carter, PhD.

• anxiety and stress
• CBT
• depression
• online mental health
• public health
• technology